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Prospective evaluation of access incision position for minimally invasive surgical organ exposure in cats

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  • 1 Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California-Davis, Davis, CA 95616.
  • | 2 Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California-Davis, Davis, CA 95616.
  • | 3 Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California-Davis, Davis, CA 95616.
  • | 4 Department of Population Health and Reproduction, School of Veterinary Medicine, University of California-Davis, Davis, CA 95616.
  • | 5 Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California-Davis, Davis, CA 95616.

Abstract

Objective—To evaluate the exposure obtained for minimally invasive abdominal organ biopsy (MIOB) from 3 access incisions in cats.

Design—Prospective experimental study and clinical case series.

Animals—6 purpose-bred research cats and 6 feline clinical patients with indications for abdominal organ biopsy.

Procedures—Three 3-cm incisions into the peritoneal cavity were created at different locations along the linea alba in research cats in randomized order. A wound retraction device was inserted in each incision. Ability to exteriorize various abdominal organs to the extent required to reasonably perform a surgical biopsy was recorded, and results were compared among incision sites. On the basis of results obtained, the access incision that provided exposure of the most frequently biopsied abdominal organs was used to perform MIOB in 6 feline clinical patients with various underlying pathological conditions.

Results—On the basis of experiments with research cats, a 3-cm access incision centered midway between the caudal margin of the xiphoid cartilage and the umbilicus was found to provide access for MIOB for most organs. In 5 of 6 clinical patients, all of the organs of interest were biopsied successfully via this incision location, although access to all hepatic lobes and all parts of the pancreas was inconsistent. In 1 cat, conversion to an open approach was performed because a palpable mass was detected in the area of the duodenocolic ligament.

Conclusions and Clinical Relevance—Optimization of access incision location for MIOB allowed biopsy specimen collection from organs of interest to be performed in a minimally invasive manner in cats.

Abstract

Objective—To evaluate the exposure obtained for minimally invasive abdominal organ biopsy (MIOB) from 3 access incisions in cats.

Design—Prospective experimental study and clinical case series.

Animals—6 purpose-bred research cats and 6 feline clinical patients with indications for abdominal organ biopsy.

Procedures—Three 3-cm incisions into the peritoneal cavity were created at different locations along the linea alba in research cats in randomized order. A wound retraction device was inserted in each incision. Ability to exteriorize various abdominal organs to the extent required to reasonably perform a surgical biopsy was recorded, and results were compared among incision sites. On the basis of results obtained, the access incision that provided exposure of the most frequently biopsied abdominal organs was used to perform MIOB in 6 feline clinical patients with various underlying pathological conditions.

Results—On the basis of experiments with research cats, a 3-cm access incision centered midway between the caudal margin of the xiphoid cartilage and the umbilicus was found to provide access for MIOB for most organs. In 5 of 6 clinical patients, all of the organs of interest were biopsied successfully via this incision location, although access to all hepatic lobes and all parts of the pancreas was inconsistent. In 1 cat, conversion to an open approach was performed because a palpable mass was detected in the area of the duodenocolic ligament.

Conclusions and Clinical Relevance—Optimization of access incision location for MIOB allowed biopsy specimen collection from organs of interest to be performed in a minimally invasive manner in cats.

Contributor Notes

Dr. Kelli Mayhew's present address is Loomis Basin Veterinary Clinic, 3901 Sierra College Blvd, Loomis, CA 95650.

Dr. Shilo-Benjamini's present address is Veterinary Teaching Hospital, Koret School of Veterinary Medicine, Hebrew University of Jerusalem, Rehovot 76100, Israel.

Address correspondence to Dr. Philipp Mayhew (philmayhew@gmail.com).