Bladder Stone Removal in Sidley, the Sulcata Tortoise

Sidley the sulcata presented to the clinic showing signs of discomfort - a radiograph revealed the formation of a large bladder stone.  Bladder stones are surprisingly common in tortoises, and can be fatal if left untreated.  Sidley's stone was so large that it requires removal through a window created in her shell, called a plastronotomy. 
Tortoises commonly hold their breath under sedation, so manual ventilation is critical under anesthesia.  The endotracheal tube is stabilized with a tongue depressor and covered with a plastic casing to protect it from Sidley's strong jaws. A doppler flow monitor and three-lead electrocardiogram are used to monitor her cardiac rate and rhythm.
The sterile vinyl drape is applied to minimize infection, and works in conjunction with warming devices to preserve body heat.  A reciprocating surgical saw is used to create a hinge in the plastron - the bottom portion of a tortoise's shell.  This plastronal flap is carefully lifted to expose the abdominal membrane, allowing access to her ceolomic cavity.
At just 0.5 pounds, Sidley's size meant that the window in her shell is less than 1/2 the size of a business card.  An incision is made in her bladder through this tiny opening. The stone is removed whole, and the bladder sutured closed and checked for leaks.
With her bladder stone removed, Sidley's abdomen is closed and plastronal flap replaced.  Her surgery site is coated with a mixture of epoxy and fiberglass to protect the incision site during the healing process.
She recovered from anesthesia uneventfully while resting on a warm bag of saline to help regulate her body temperature.  Thanks to her mom's dedicated care, she was bright, alert, and eating shortly after surgery.
A few weeks later, Sidley's plastron is healing well.  The fiberglass will continue to protect her incision for a number of months, but will be checked periodically to ensure it does not impede any growth plates as she rapidly matures.
A recheck radiograph shows no evidence of new stone formation.  Her shell density has improved after adjustments and careful management of her diet and lighting schedule, which should continue to prevent future problems.
Now two months post-operation, Sidley is feeling great!  She is a model patient, and one lucky tortoise to have an owner who is so dedicated to her health and care.