Jorgensen Laboratories, Inc. Da Toggle Suture

With the cow lying on her back, sterilize the area right of the sternum (when viewed from the front) with the greatest ‘ping.’ Puncture a hole, with the trocar inside the cannula, about 4 to 7 inches behind the breastbone and 2 to 3 inches right of the midline. After removing the trocar, ensure that you have entered the abomasum by smelling for abomasal gases.

Next, insert a toggle attached to a suture through the cannula until reaching the end. Tug slightly on the suture to make sure the toggle is perpendicular. Remove the cannula, drawing the suture up until the toggle is perpendicular to the abdominal wall. Hold in place with a pair of forceps. Repeat the process with the next hole 2 to 3 inches anterior (towards the head) from the first hole.

Before removing cannula, press on abdominal wall to remove as much gas as possible. Tie the two sutures together using multiple square knots with the distance between the knots and abdominal wall being 3 to 4 inches. Tip the cow back on her side by rotating her clockwise (when viewed from the rear) and then onto her sternum.