A Mechanical Study of Ligature Security of Commercially Available Pre-Tied Ligatures Versus Hand Tied Ligatures for Use in Equine Laparoscopy

Current Use of Equine Laparoscopy in Urogenital Disorders: A Scoping Review of the Literature from 2000 to 2021

(1) Background: Laparoscopic surgery replaced traditional invasive techniques for the treatment of common urogenital disorders in equids. The aim of this review is to evaluate applications and the development of urogenital laparoscopy from 2001 to 2021. (2) Methods: A scoping review of literature was undertaken according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines for scoping reviews on three databases (NCBI-PubMed, Web of Science-Thompson Reuters, and SciVerse Scopus). (3) Results: A total of 452 papers were identified. After duplicate removal and title screening, 181 papers underwent abstract screening. Of these, 160 + 10 papers (cited by others) were assessed for eligibility according to the PICOs. A total of 132 papers were considered eligible. Most of the research was focused on ovaries and testes, followed by urinary bladder and general articles about laparoscopy in horses. We identified 43 original studies (33%, RCT, NoRCT, and experimental trials), 39 case series/retrospective studies (29%), 37 case reports (28%), and 13 reviews (10%, narrative or systematic). (4) Conclusions: Gonadal disorders were the most investigated. Hand-Assisted Laparoscopic Surgery (HALS) and laparoscopic-assisted surgery represent valuable options for more challenging conditions (uterine and urinary bladder disorders).

A Novel Shape-Memory Monofilament Suture for Minimally Invasive Thoracoscopic Cardiac Surgery

OBJECTIVES

Endoscopic knot tying can complicate or prolong minimally invasive surgical procedures. A novel shape-memory monofilament suture with a spiral tail has been developed to speed up suture fixation during minimally invasive cardiac surgery. The purpose of this study was to evaluate its usefulness and safety in minimally invasive cardiac surgery.

METHODS

We installed a needle with a 4-0 monofilament suture, composed of polyvinylidene difluoride and hexafluoropropylene copolymers, in an originally invented jig and heated it in an oven. By only passing through the needle and then into the spiral made at the tail of the suture, a hangman's knot was easily made. For the fundamental experiment, to evaluate the effectiveness of the novel shape-memory monofilament suture, 4 surgeons with varying thoracoscopic experience tied knots within a simulated minimally invasive setting, using both the novel shape-memory and conventional monofilament sutures. The time elapsed for knot tying and tensile strength of each knot was measured.

RESULTS

The mean knot-tying time was significantly shorter with the novel suture than with the conventional suture (108 ± 29 vs. 172 ± 42 seconds, P = 0.01). The ultimate tensile strength of each knot was 17.4 N in the novel suture and 16.5 N in the conventional suture.

CONCLUSIONS

The novel shape-memory monofilament suture has great potential for reducing operative time of minimally invasive thoracoscopic surgery while retaining the strength of the knot.

A review of equine laparoscopy

Minimally invasive surgery in the human was first identified in mid 900's. The procedure as is more commonly practiced now was first reported in 1912. There have been many advances and new techniques developed in the past 100 years. Equine laparoscopy, was first reported in the 1970's, and similarly has undergone much transformation in the last 40 years. It is now considered the standard of care in many surgical techniques such as cryptorchidectomy, ovariectomy, nephrosplenic space ablation, standing abdominal exploratory, and many other reproductive surgeries. This manuscript describes the history of minimally invasive surgery, and highlights many of the techniques that are currently performed in equine surgery. Special attention is given to instrumentation, ligating techniques, and the surgical principles of equine minimally invasive surgery.

Comparison of selective uterine artery double ligation at the isthmic level of uterus and bipolar uterine artery coagulation in total laparoscopic hysterectomy

In this article, we would like to compare the clinical characteristics and effectiveness of selective uterine artery double ligation and bipolar uterine artery coagulation in total laparoscopic hysterectomy (TLH) retrospectively. TLH was performed on 72 patients with selective uterine artery double ligation and on 312 patients with uterine artery bipolar coagulation in tertiary university hospital from January 2004 through January 2006. Both groups were similar with respect to age, body mass index, parities, rate of menopause and uterine weight. The mean transfusion, postoperative hospital stay and drain insertion in the selective uterine artery double ligation group were significantly lower than those in the bipolar uterine artery coagulation group in TLH, respectively (p < .05). There were no differences in the hemoglobin, hematocrite change, additional operations, operation time, rate of complication between the two kinds of operation (p > .05). In conclusion, selective uterine artery double ligation in TLH showed lower transfusion rate, less hospitalization and less discomfort due to drain than bipolar uterine artery coagulation. Also, it did not take a longer time for operation and thus provides a feasible and secure method to manage uterine vessels at the level of uterine isthmus inside of the broad ligament.

On the origin and evolution of the Roeder knot and loop--a geometrical review

The first laparoscopic sliding knot to be described was the Roeder knot; it has been used for a variety of procedures in all surgical disciplines. It was surmised that the introduction of new modifications in the geometry of the knot paralleled the introduction of its new indications, and that not all modifications improved its security. Therefore, a geometrical review was made of all modifications and all data on knot security and loop security of the knot were analyzed. The introduction of the original knot and its 14 applicable modifications paralleled the increase in minimally invasive techniques and the spread of these techniques in all the medical specialties. Roeder loop security depends predominantly on the number of initial turns around the standing part. Its knot security depends on the additional half hitches used to backup the knot after it has been tightened. Only a few of the modifications improved the security of the knot or its previous modifications.

Laparoscopic cryptorchidectomy and ovariectomy in horses

Laparoscopic surgery has become commonplace in the field of equine urogenital surgery. As with most surgical procedures, the limiting factors in developing new surgical techniques are limited to the patient size and demeanor, the skills of the surgeon, and the available equipment. Some of the greatest benefits of laparoscopic surgery in the horse include better visualization of the important structures; tension-free amputation of the testes or ovaries,which generally leads to less postoperative pain; and the ability to evaluate the transected stump carefully to make sure there is no hemorrhage. This article is limited to the use of laparoscopy for cryptorchidectomy and ovariectomy.