Laparoscopic-Assisted Colopexy and Sterilization in Male Dogs: Short-Term Results and Physiologic Consequences

Laparoscopic Castration Using Bipolar Forceps vs. Orchiectomy in Dogs: A Comparison of Two Techniques

Simple Summary

Castration of dogs is one of the most often performed surgeries in veterinary medicine. Minimally invasive techniques used in human medicine are now being used in animals. We compared the feasibility and effects on pain and inflammation of a new laparoscopic technique with the classical castration technique. The animals in which the new technique was applied showed less pain and inflammation then the other group. Our results suggest that this is a feasible alternative to classical castration.

Abstract

This paper aimed to study the feasibility of a new laparoscopic castration technique in male dogs, evaluate the pain associated with it, and compare it with the classical orchiectomy. Surgical times, pain scores, blood and salivary cortisol, and CRP were recorded and compared between the two groups. The use of high-frequency bipolar forceps allowed quick and uneventful laparoscopic procedures. The laparoscopic group had significantly lower pain scores, cortisol, and PCR values than the orchiectomy group. No complications were seen in any group. Our results suggest that this laparoscopic castration is a safe and beneficial surgical alternative to traditional orchiectomy in dogs.

A systematic review of complications related to laparoscopic and laparoscopic-assisted procedures in dogs

OBJECTIVE

To evaluate and report the quality of the scientific literature reporting complications associated with laparoscopic and laparoscopic-assisted procedures in client-owned or healthy research dogs and to report and illustrate laparoscopic complications related to individual organ systems.

STUDY DESIGN

Systematic review.

ANIMALS

Client-owned or healthy research dogs.

METHODS

A literature review was performed by using PubMed and CAB abstracts for English-language studies providing descriptions of complications related to laparoscopic and laparoscopic-assisted procedures in dogs. Study selection used PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) guidelines. Quality assessment was performed by using a MINORS (Methodological Items for Non-Randomized Studies) scoring system and a grading scale of level of evidence. Descriptive statistics were used.

RESULTS

In total, 741 manuscripts were identified, with 64 manuscripts eligible for data extraction and quality assessment. The most represented organ system was the female genital tract, represented by 22 (34.4%) studies. The most commonly reported intraoperative and postoperative complications were related to abdominal entry and portal incisions, respectively. In 53 of 54 non-randomized studies, high risk of bias was found. Forty-eight (75%) studies provided level III or IV evidence.

CONCLUSION

This report provides an updated review of complications related to laparoscopic and laparoscopic-assisted procedures in dogs, classified by organ system. The overall quality of evidence was low, limiting direct comparison of complication rates between studies.

CLINICAL SIGNIFICANCE

There is a need for implementation of standardized criteria for defining complications, study time frames and greater numbers of high quality prospective randomized trials in veterinary laparoscopy to permit comparison of complication and conversion rates between published studies and across organ systems.

Laparoscopic repositioning of an obstructed ventriculoperitoneal shunt catheter with laparoscopy-assisted partial omentectomy and omentopexy

OBJECTIVE

To describe the use of laparoscopy for repositioning of a ventriculoperitoneal shunt (VPS) catheter.

STUDY DESIGN

Case report.

ANIMAL

One 11-month-old male cairn terrier weighing 5.5 kg.

METHODS

The dog had placement of a VPS system for primary hydrocephalus at 4 months of age. Poor functioning of the shunt system was suspected because of deteriorating neurological signs. A contrast study of the VPS system provided evidence of a distal shunt obstruction, and repeated brain computed tomography (CT) was consistent with persistent hydrocephalus.

RESULTS

Laparoscopy was used to free the abdominal catheter of the shunt system and perform a partial omentectomy and omentopexy of the remaining omentum. Concurrently, the dog was sterilized. Recovery was routine, and follow-up CT 1 year after repositioning revealed that the hydrocephalus had substantially improved. Results of a contrast study of the VPS system also provided evidence that it was functional.

CONCLUSION

Ventriculoperitoneal shunt systems are placed in dogs with primary and secondary hydrocephalus, and complications are quite common, including obstruction, bleeding, infection, and overshunting or undershunting. This is the first published clinical case report in which the repositioning of a VPS catheter with partial omentectomy and omentopexy in a dog are described.

CLINICAL SIGNIFICANCE

Future studies may be performed to determine whether laparoscopy can be considered as a treatment to assist with safe placement of VPS systems, avoiding misplacement of the shunt system and iatrogenic damage to the viscera and vessels.

Biomechanical analysis of unidirectional knotless suture loop weld integrity after passage through a cadaveric body wall

OBJECTIVE

To evaluate the integrity of the welded end loop on unidirectional knotless suture after transabdominal passage in a canine cadaver.

STUDY DESIGN

Ex vivo biomechanical study.

STUDY POPULATION

Four variations of unidirectional knotless suture and 1 canine cadaver.

METHODS

Welded end loop on strands consisted of 0 Quill polydioxanone (QP; n = 22), 0 Quill monoderm (QM; n = 23), 2-0 V-Loc 90 (V9; n = 12), and 2-0 V-Loc 180 (V18; n = 12). Half of the suture strands in each group were passed percutaneously through an insufflated cadaveric body wall, and the remaining half served as intact controls. A linear testing machine was used to load the sutures to failure. Modes of and loads to failure were compared within and between suture types.

RESULTS

Loads to failure did not differ between sutures passed through the body wall and their controls when the loop remained intact. Sutures V9, V18, and QM sustained higher loads to failure compared with QP. All Quill suture lines failed at the weld during testing. Thirty-three percent of QP sutures failed at the weld during initial passage through the body wall. V-Loc sutures failed at the suture-apparatus interface, within the welded loop, or a combination.

CONCLUSION

Passing suture through a cadaveric body wall did not affect the integrity of the welded end loop of any of the unidirectional knotless sutures tested here when the loop remained intact.

CLINICAL SIGNIFICANCE

Unidirectional knotless suture (V9, V18 and QM) can be safely passed through a canine body wall for use in laparoscopic procedures. The use of QP in this manner cannot be recommended.

Plasma-Mediated Bipolar Radiofrequency Ablation of Overlong Soft Palate in the Dog: A Pilot Study

The objective of this study was to compare the clinical, biological, macroscopic, and histologic outcomes after resection of the soft palate by plasma-mediated bipolar radiofrequency ablation (PBRA) or traditional incisional techniques (incisional soft palate resection [INC]) in dogs. Ten dogs were divided in two groups. In the INC group, the soft palate was incised with scissors and the wound was sutured in a continuous pattern. In the PBRA group, a wand was used to ablate the desired portion of the soft palate, without suture. Clinical, biological, macroscopic, and histologic assessments were scheduled over 14 days. The duration of surgery was significantly shorter for the PBRA group. The C-reactive protein concentrations were significantly higher in the PBRA group at 6 hr and on day 3 (P < .05) but with values very close to the baseline. C-reactive protein concentrations were maximal, but with low values (<25 mg/L), at day 1 for both techniques. The irregularity scores for the soft palate caudal border on days 1, 3, and 14 were significantly higher in the INC group than in the PBRA group (P < .05). The main histopathologic changes were the presence of superficial granulomas and a significantly greater depth of tissue damage in the INC group (2.5 ± 0.3 mm) compared with the PBRA group (1.5 ± 0.1 mm; P < .05). PBRA compared favorably with the traditional technique in terms of ease, duration of surgery, and depth of tissue damage. Future studies are warranted to validate its effectiveness for treating brachycephalic airway obstruction syndrome in dogs.

Efficacy of vaporized hydrogen peroxide for repeated sterilization of a single-use single-incision laparoscopic surgery port

OBJECTIVE

To determine the ability of vaporized hydrogen peroxide (VHP) to sterilize a single-use single-incision laparoscopic surgery port and its associated components after repeated simulated uses.

STUDY DESIGN

Prospective in vitro experimental study.

SAMPLE POPULATION

Six single-use single-incision laparoscopic surgery ports with associated cannulas and insufflation tubing.

METHODS

Ports, cannulas, and tubing were subjected to 10 cycles of simulated use, bacterial inoculation with Staphylococcus pseudintermedius and Escherichia coli, decontamination and sterilization, and testing via culture based on their treatment group designation. Bacteriological scores were compared among the negative control, positive control, and 4 treated ports and components.

RESULTS

There was no difference in bacteriological scores between treated ports, cannulas, and insufflation tubing and the negative control port and components. Bacteriological scores of ports and components undergoing 6-10 cycles were not significantly different from scores of ports and components undergoing 5 or fewer sterilization cycles. No difference was found in detection of bacteria from treated ports by biopsy of the foam versus sampling via wash.

CONCLUSION

This study suggests that a single-use single-incision laparoscopic port and its associated components can be effectively sterilized after multiple simulated uses by using VHP.

CLINICAL SIGNIFICANCE

Reuse of a single-use single-incision laparoscopic port is a safe and effective method of cost reduction in veterinary patients.

C-reactive protein: quantitative marker of surgical trauma and post-surgical complications in dogs: a systematic review

C-reactive protein (CRP) is a major acute phase protein showing increasing serum concentrations in dogs with systemic inflammation following e.g., surgery, trauma, infections, or neoplasia. CRP is a useful diagnostic marker of systemic inflammation in dogs and automated assays have been validated for reliable measurements for routine diagnostic purposes. In the present study available evidence for the use of CRP as a marker of surgery related systemic inflammation in dogs was reviewed and assessed. Two main themes were in focus: (1) canine CRP as a potential marker of postsurgical infectious complications and (2) canine CRP as a marker of the degree of surgical trauma. As outlined in the review several studies suggest that CRP is a useful marker for both purposes. However, the evidence level is limited and studies in the field are all affected by considerable risks of bias. Thus, further studies are needed in order to confirm the assumptions from previous studies and increase the level of evidence for CRP as a useful marker for detecting inflammation after surgery in dogs.

Laparoscopic-Assisted Surgical Procedures

Laparoscopic-assisted procedures allow a balance between the improved patient recoveries often associated with smaller incisions and the need for appropriate visualization of visceral organs/identification of lesions. The organ systems of small animal veterinary patients that are highly amenable to laparoscopic-assisted procedures include the urinary bladder, the gastrointestinal tract, and the reproductive tracts. Laparoscopic-assisted procedures are especially beneficial in the approach to luminal organs, allowing the organ incision to be exteriorized through the body wall, protecting the peritoneal cavity from contamination from luminal contents. Procedure-specific morbidities and patient selection should be considered when choosing between assisted laparoscopic and open approaches.

Laparoscopic-assisted cryptorchidectomy in a cat

A 21-month-old male castrated domestic short hair cat was presented due to suspected unilateral abdominal cryptorchidism. Unilateral abdominal cryptorchidism was confirmed with ultrasonography and laparoscopic-assisted cryptorchidectomy was performed. Laparoscopic-assisted cryptorchidectomy is a simple, fast and safe method for the treatment of abdominal cryptorchidism in dogs and cats, offering the benefits of minimal invasive surgery, which is still underreported in the veterinary literature.

Laparoscopic colopexy in dogs

Colopexy was accomplished in eight healthy mixed-breed dogs by use of a 3-portal laparoscopic technique without major intraoperative and postoperative complications. A permanent adhesion between the colon and the abdominal wall was observed. Concentrations of acute-phase C-reactive protein (CRP) were measured in serum as a marker of systemic inflammation postoperatively, and no relevant increase in CRP concentrations was found.