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  • Author or Editor: Claude A. Ragle x
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Abstract

Objective—To describe clinical and physiologic changes during lift laparoscopy in dogs and cats and determine immediate surgical outcome.

Design—Retrospective case series.

Animals—Client-owned dogs (n = 7) and cats (5).

Procedures—A custom-made lift device was used to retract the abdominal wall for laparoscopic instrumentation. The lift device was used first in 3 dog cadavers to assess the risk of complications. Thereafter, the device was used for routine laparoscopic procedures in client-owned animals. Data collected from medical records included signalment, body weight, clinical signs, diagnosis, surgery type and duration, conversion from laparoscopic to open surgery, preoperative American Society of Anesthesiologists score, mean intraoperative respiratory rate, mean and peak end-tidal partial pressure of CO2 during the laparoscopic surgery, ventilation method, mean saturation of hemoglobin with O2, mean and systolic arterial pressures during the laparoscopic surgery, total anesthesia time, signs of pain immediately after recovery, duration of hospitalization, and postoperative complications.

Results—Lift laparoscopy was successfully performed in 10 of the 12 patients. No adverse effects were noted with the use of this technique. However, in 1 dog and 1 cat, conversion to laparotomy was necessary because of poor visualization.

Conclusions and Clinical Relevance—Results suggested that lift laparoscopy is feasible in dogs and cats and is an option that can be used in clinical practice, especially if creation of positive-pressure pneumoperitoneum is not desirable.

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in Journal of the American Veterinary Medical Association

Abstract

Objective—To determine whether scores for basic laparoscopic skills were significantly associated with extent of laparoscopic experience and compare basic laparoscopic skill scores obtained before and after 2 laparoscopic training sessions incorporating a canine abdominal model.

Design—Evaluation study.

Sample Population—8 experienced and 25 novice individuals.

Procedures—Novice participants were randomly assigned to control (n = 10) and training (15) groups. Individuals in the experienced and novice training groups were required to undergo 2 training sessions with a canine abdominal model. Basic laparoscopic skills were assessed twice on the basis of 3 tasks included in the McGill Inanimate Simulator for Training and Evaluation of Laparoscopic Skills (MISTELS).

Results—For the novice training group, laparoscopic skills scores were significantly higher after training than before, but for individuals in the novice control group, scores did not differ significantly between the first and second assessments. The increase in score for the novice training group was significantly higher than increases for the experienced group and for the novice control group, but the increase in score for the experienced group was not significantly different from the increase in score for the novice control group.

Conclusions and Clinical Relevance—Results suggested that basic laparoscopic skills scores obtained with the MISTELS were associated with extent of laparoscopic experience and that training with a canine abdominal model could increase skills scores for individuals without previous laparoscopic experience.

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in Journal of the American Veterinary Medical Association
in Journal of the American Veterinary Medical Association

Abstract

CASE DESCRIPTION 2 fillies, aged 3 months and 1 month, were examined because of urinary incontinence and urine scalding.

CLINICAL FINDINGS In horse 1, ultrasonography did not reveal any structural abnormalities of the kidneys; however, unilateral ureteral ectopia was diagnosed cystoscopically. In horse 2, CT revealed bilateral nephropathy, bilateral distended ureters (up to 3.6 cm in diameter), and bilateral ureteral ectopia. Cystoscopy revealed intramural ureteral ectopia with abnormally caudally positioned ureteral ostia in both horses.

TREATMENT AND OUTCOME Ureteral ostioplasty was performed under cystoscopic guidance. Laparoscopic scissors (horse 1) or a vessel-sealing device (horse 2) was introduced, and the tissue separating the intramural portion of the ureter from the urethra and bladder was cut longitudinally in a cranial direction toward the trigone. After surgery, both horses were continent and voided normal streams of urine for the duration of the follow-up periods of 20 and 9 months for horse 1 and horse 2, respectively.

CLINICAL RELEVANCE Cystoscopically guided ureteral ostioplasty provided an effective and minimally invasive surgical treatment option for correction of ureteral ectopia in 2 fillies.

Full access
in Journal of the American Veterinary Medical Association
in Journal of the American Veterinary Medical Association
in Journal of the American Veterinary Medical Association
in Journal of the American Veterinary Medical Association

Abstract

Case Description—A 4-year-old castrated Arabian horse was evaluated for a history of a right-sided nonstrangulating inguinal hernia that was manually reducable.

Clinical Findings—Physical examination revealed a right-sided hydrocele and bilateral enlargement of the inguinal rings detectable by both external digital and rectal palpation.

Treatment and Outcome—Biportal laparoscopic internal inguinal ring closure was performed with a continuous suture line of unidirectional barbed suture applied with a mechanical suturing instrument. The barbed suture contributed to a secure closure with the added benefit of not requiring knots to be tied at either the beginning or end of the suture line. Follow-up physical examination and laparoscopy confirmed healing of the surgical sites and a reduction in size of the inguinal rings. The horse exercised for 20 months following surgery without recurrence of the inguinal hernia.

Clinical Relevance—In horses, laparoscopic application of unidirectional barbed sutures should be considered among the treatment options for recurrent inguinal herniation. This technique was accomplished with only 2 portals/side, in contrast to the additional 3 to 4 portals that are most commonly required. The use of a barbed suture with a mechanical suturing instrument offered added security to the closure. The difficulties of dual instrument suturing and intracorporeal knot tying were eliminated, dramatically reducing the challenges of performing suture reduction of the internal inguinal ring.

Full access
in Journal of the American Veterinary Medical Association
in Journal of the American Veterinary Medical Association