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de la Vega M, Ralphs SC. Outcomes and complications of prophylactic incisional gastropexy in 766 dogs (2009-2019). BMC Res Notes 2023; 16:300. [PMID: 37908004 PMCID: PMC10619303 DOI: 10.1186/s13104-023-06595-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 10/24/2023] [Indexed: 11/02/2023] Open
Abstract
OBJECTIVE To report the outcomes and complications associated with prophylactic incisional gastropexy performed in dog breeds at risk for GDV. RESULTS Seven hundred and sixty-six dogs underwent prophylactic incisional gastropexy of which 61 were electively performed at the time of castration or spay and 705 were adjunctively performed at the time of emergency abdominal surgery. All dogs had short-term follow-up, and 446 dogs (58.2%) had additional follow-up with a median long-term follow-up time of 876 days (range 58-4450). Only 3 dogs (0.4%) had a direct complication associated with the gastropexy site including hemorrhage causing hemoabdomen (2) and infection with partial dehiscence (1). No dogs with long-term follow-up experienced gastric dilatation (GD), gastric dilatation volvulus (GDV), or persistent GI signs following gastropexy. Results of this study found that complications directly associated with prophylactic gastropexy were rare and limited to hemorrhage causing hemoabdomen and infection with partial dehiscence. Transient postoperative GI signs may occur. Gastropexy malpositioning and bowel entrapment were not encountered. There was no occurrence of GD or GDV.
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Oviedo-Peñata CA, Giraldo Mejía GE, Riaño-Benavides CH, Maldonado-Estrada JG, Lemos Duque JD. Development and validation of a composed canine simulator for advanced veterinary laparoscopic training. Front Vet Sci 2022; 9:936144. [PMID: 36325095 PMCID: PMC9621388 DOI: 10.3389/fvets.2022.936144] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 09/05/2022] [Indexed: 11/04/2022] Open
Abstract
The development of innovative simulation models for veterinary laparoscopic surgery training is a priority today. This study aimed to describe a didactic simulation tool for the training of total laparoscopic gastropexy (TLG) with intracorporeal sutures in dogs. CALMA Veterinary Lap-trainer composite simulator (CLVTS) was developed from a plaster cast of 2 Great Dane canines mimicking the space and the correct position to carry out a TLG. After video instruction, 16 veterinarians with different degrees of experience in minimally invasive surgery (Experts, n = 6 and intermediates, n = 10) evaluated four sequential simulating TLG with intracorporeal suturing in the CLVTS. Subsequently, they completed an anonymous questionnaire analyzing the realism, usefulness, and educational quality of the simulator. The CLVTS showed a good preliminary acceptance (4.7/5) in terms of the usefulness and adequacy of the exercises that, in the participants' opinion, are appropriate and are related to the difficulty of the TLG. In addition, both experienced and intermediate surgeons gave high marks (4.5/5) to the feeling of realism, design, and practicality. There were no significant differences between the responses of the two groups. The results suggest that the CVLTS has both face and content validity. Where it can be practiced in a structured environment for the development of a total laparoscopic gastropexy with intracorporeal suture and without compromising patient safety, but still has some limitations of the scope of the study. Further studies are needed to establish the ability to assess or measure technical skills, including the degree of transferability to the actual surgical environment.
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Affiliation(s)
- Carlos A. Oviedo-Peñata
- Tropical Animal Production Research Group, Faculty of Veterinary Medicine and Zootechny, University of Cordoba, Monteria, Colombia,OHVRI-Research Group, Faculty of Agrarian Sciences, College of Veterinary Medicine, University of Antioquia, Medellín, Colombia,*Correspondence: Carlos A. Oviedo-Peñata
| | - Gloria E. Giraldo Mejía
- OHVRI-Research Group, Faculty of Agrarian Sciences, College of Veterinary Medicine, University of Antioquia, Medellín, Colombia
| | - Carlos Humberto Riaño-Benavides
- OHVRI-Research Group, Faculty of Agrarian Sciences, College of Veterinary Medicine, University of Antioquia, Medellín, Colombia
| | - Juan G. Maldonado-Estrada
- OHVRI-Research Group, Faculty of Agrarian Sciences, College of Veterinary Medicine, University of Antioquia, Medellín, Colombia
| | - Juan D. Lemos Duque
- Bioinstrumentation and Clinical Engineering Research Group-GIBIC, Department of Bioengineering, Faculty of Engineering, Universidad de Antioquia, Medellín, Colombia
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Updated Information on Gastric Dilatation and Volvulus and Gastropexy in Dogs. Vet Clin North Am Small Anim Pract 2022; 52:317-337. [DOI: 10.1016/j.cvsm.2021.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Bianchi A, Collivignarelli F, Vignoli M, Scaletta L, Cuomo A, Falerno I, Paolini A, Tamburro R. A Comparison of Times Taken for the Placement of the First Portal and Complication Rates between the Veress Needle Technique and the Modified Hasson Technique in Canine Ovariectomy Laparoscopic Surgery. Animals (Basel) 2021; 11:2936. [PMID: 34679957 PMCID: PMC8532732 DOI: 10.3390/ani11102936] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 09/22/2021] [Accepted: 10/06/2021] [Indexed: 11/26/2022] Open
Abstract
Minimally invasive surgery is increasingly being used in veterinary medicine. Laparoscopic procedures have several advantages compared with open surgery. These include the magnification of the field of surgery, reduced post-surgical pain and associated stress, reduced post-operative infection rates, and decreased hospitalization time. The establishment of a pneumoperitoneum is a critical step; however, this procedure can prolong the operation time, and most of the complications associated with laparoscopic surgery have been attributed to the insertion of devices into the abdominal cavity. Two main techniques have been employed to create pneumoperitoneum: the closed-entry method using the Veress needle and the open Hasson technique. The first portal is necessary to start insufflation and, subsequently, to realize the operative channel to insert the laparoscopic instruments into the abdomen. Many authors have compared the time necessary to create the first portal using different techniques in human medicine, but studies on this topic in veterinary medicine are lacking. In the veterinary medicine literature, complications associated with the creation of a pneumoperitoneum and the placement of ports include spleen, bowel, or bladder injuries; pneumothorax; and subcutaneous emphysema. The aim of the present study was to compare the times required for the placement of the first portal and the creation of pneumoperitoneum, and the rates of intraoperative complications using the Veress needle technique (VNT) and the open modified Hasson technique (MHT). The sample population comprised 30 female dogs who underwent laparoscopic ovariectomies. The dogs were randomly organized into two groups and two different entry techniques were used: Veress needle (VNT = group A) and the modified Hasson technique (MHT = group B). Complications related to abdominal entry were classified as major, in cases of organ perforation, and minor, in cases of subcutaneous emphysema and gas leakage. The VNT and MHT required 374.0 s and 242.9 s, respectively, for the placement of the first portal and for establishing pneumoperitoneum (p < 0.05). Their major complications rates were 20% and 0%, respectively (p < 0.05). Their minor complications rates were 20% and 35%, respectively (p < 0.05). No surgical procedures required laparotomy. The MHT was associated with a lower major complication rate and required less time to create the first portal, compared with the Veress needle technique.
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Affiliation(s)
- Amanda Bianchi
- Faculty of Veterinary Medicine, University of Teramo, 64100 Teramo, Italy; (F.C.); (A.C.); (I.F.); (A.P.); (R.T.)
| | - Francesco Collivignarelli
- Faculty of Veterinary Medicine, University of Teramo, 64100 Teramo, Italy; (F.C.); (A.C.); (I.F.); (A.P.); (R.T.)
| | - Massimo Vignoli
- Faculty of Veterinary Medicine, University of Teramo, 64100 Teramo, Italy; (F.C.); (A.C.); (I.F.); (A.P.); (R.T.)
| | - Lorenzo Scaletta
- Veterinaria Enterprise Stp S.R.L., Via Galvani 33d, 00153 Rome, Italy;
| | - Amedeo Cuomo
- Faculty of Veterinary Medicine, University of Teramo, 64100 Teramo, Italy; (F.C.); (A.C.); (I.F.); (A.P.); (R.T.)
| | - Ilaria Falerno
- Faculty of Veterinary Medicine, University of Teramo, 64100 Teramo, Italy; (F.C.); (A.C.); (I.F.); (A.P.); (R.T.)
| | - Andrea Paolini
- Faculty of Veterinary Medicine, University of Teramo, 64100 Teramo, Italy; (F.C.); (A.C.); (I.F.); (A.P.); (R.T.)
| | - Roberto Tamburro
- Faculty of Veterinary Medicine, University of Teramo, 64100 Teramo, Italy; (F.C.); (A.C.); (I.F.); (A.P.); (R.T.)
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Abstract
The goal of preventive care is to maintain and optimize health by averting preventable problems. Effective preventive care programs for working dogs must incorporate standard procedures applicable to dogs in general with additional elements pertinent to the more specific characteristics of breed, geographic location, living and working conditions, and physical and mental tasks required of the working dog. This article covers the basic essential preventive health guidelines for all working dogs as well as the specific breed, occupational, and regional considerations to be taken into account.
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Affiliation(s)
- Marcella Ridgway
- College of Veterinary Medicine, University of Illinois, Urbana, IL 61802, USA.
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Kabakchiev C, Singh A, Dobson S, Beaufrère H. Comparison of intra- and postoperative variables between laparoscopic and open ovariectomy in rabbits ( Oryctolagus cuniculus). Am J Vet Res 2021; 82:237-248. [PMID: 33629896 DOI: 10.2460/ajvr.82.3.237] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To compare intraoperative and short-term postoperative variables pertaining to laparoscopic ovariectomy (LapOVE) and open ovariectomy (OVE) in rabbits (Oryctolagus cuniculus). ANIMALS Twelve 4- to 5-month-old female New Zealand White rabbits. PROCEDURES Rabbits were randomly assigned to undergo LapOVE (n = 6) or OVE (6), with a vessel-sealing device used to seal and transect the ovarian pedicles. Laparoscopic ovariectomy was performed with a 3-port approach. Variables were measured during surgery (surgery and anesthesia times and incision lengths) and for up to 7 days after surgery (food consumption, feces production, body weight, vital parameters, blood glucose and cortisol concentrations, abdominal palpation findings, facial grimace scale scores, and ethograms). RESULTS Mean surgery (43.2 vs 21.7 minutes) and anesthesia (76.2 vs 48.8 minutes) times were longer and mean incision length was shorter (24.0 vs 41.5 mm) for LapOVE versus OVE. No significant differences in postoperative variables were identified between groups. During LapOVE, small intestinal perforation occurred in 1 rabbit, which was then euthanized. Postoperative complications for the remaining rabbits included superficial incisional dehiscence (LapOVE, 1/5; OVE, 2/6), subcutaneous emphysema (LapOVE, 1/5; OVE, 0/6), and seroma formation (LapOVE, 1/5; OVE, 0/6). CONCLUSIONS AND CLINICAL RELEVANCE Surgery time for LapOVE was twice that of OVE, and LapOVE resulted in unique complications in rabbits. No evidence of a reduction in pain or faster return to baseline physiologic status was found for LapOVE. Further evaluation of LapOVE in rabbits is warranted, with modification to techniques used in this study or a larger sample size.
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Lacitignola L, Crovace AM, Fracassi L, Di Bella C, Madaro L, Staffieri F. Comparison of total laparoscopic gastropexy with the Ethicon Securestrap fixation device versus knotless barbed suture in dogs. Vet Rec 2021; 188:e113. [PMID: 33835588 DOI: 10.1002/vetr.113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Revised: 12/14/2020] [Accepted: 10/01/2021] [Indexed: 11/09/2022]
Abstract
BACKGROUND This study evaluated the feasibility and efficacy of a laparoscopic absorbable fixation device (Securestrap) in total laparoscopic gastropexy in dogs susceptible to gastric dilatation-volvulus (GDV) compared to laparoscopic gastropexy performed with a barbed suture. We hypothesised that both techniques provide suitable gastropexy. METHODS The gastropexy was performed by straps (TLG-SS group, n = 6) or with a barbed suture (TLG-Vloc group, n = 6). The total surgery time, gastropexy time, the number of straps used and suture bites were recorded. Clinical and ultrasound investigations were performed during follow-up. RESULTS The total surgery time was 30 minutes in the TLG-SS, while it was 46.66 minutes in the TLG-Vloc. In the TLG-SS group, gastropexy time was 13 minutes, while 36.3 minutes in the TLG-Vloc. The number of straps employed in TLG-SS was 9, while seven bites were employed in TLG-Vloc. Linear regression analysis of gastropexy time versus the number of procedures was highly correlated (r2 = 0.84) in the TLG-SS. Complications, clinical and ultrasound findings did not differ between the two techniques at 90 days post-surgery. CONCLUSION TLG-SS laparoscopic technique can be employed safely and effectively in less time and is associated with a relatively short learning curve, which could encourage the widespread use of prophylactic laparoscopic gastropexy.
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Affiliation(s)
- Luca Lacitignola
- Dipartimento Dell'Emergenze e trapianti di Organo, sez. Cliniche Veterinarie e P.a., Università degli Studi di Bari "Aldo Moro", Bari, Italy
| | - Alberto Maria Crovace
- Scienze mediche di base, neuroscienze e organi di senso, Università degli Studi di Bari "Aldo Moro", Apulia, Italy
| | - Laura Fracassi
- Dottorato di Ricerca in "Trapianti di Tessuti ed Organi e Terapie Cellulari", Bari, Italy
| | - Caterina Di Bella
- Dottorato di Ricerca in "Trapianti di Tessuti ed Organi e Terapie Cellulari", Bari, Italy
| | - Letizia Madaro
- Dipartimento Dell'Emergenze e trapianti di Organo, sez. Cliniche Veterinarie e P.a., Università degli Studi di Bari "Aldo Moro", Bari, Italy
| | - Francesco Staffieri
- Dipartimento Dell'Emergenze e trapianti di Organo, sez. Cliniche Veterinarie e P.a., Università degli Studi di Bari "Aldo Moro", Bari, Italy
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Outcomes and Complications in a Case Series of 39 Total Laparoscopic Prophylactic Gastropexies Using a Modified Technique. Animals (Basel) 2021; 11:ani11020255. [PMID: 33498478 PMCID: PMC7909519 DOI: 10.3390/ani11020255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 01/04/2021] [Accepted: 01/16/2021] [Indexed: 11/20/2022] Open
Abstract
Simple Summary Gastric dilatation and volvulus is a very severe condition that is most commonly seen in large and giant deep-chested dogs, although any dog may be affected. Recently, an increasing number of breeders and owners have become aware of the benefits of prophylactic gastropexy. Many techniques have been developed to perform gastropexy, but laparoscopic surgery, having very low levels of morbidity and invasiveness, fits well with the concept of prevention. The aim of this study is to validate a rapid, modified total laparoscopic prophylactic gastropexy technique with a low rate of complications. The results show that this procedure is safe and effective. Using this technique, it is possible to respect animal welfare and prevent the development of a life-threatening syndrome. Abstract Laparoscopic-assisted, laparoscopic, and endoscopic gastropexy techniques have been proven successful in recent years. Thanks to minimal invasiveness, low morbidity, and fast recovery, total laparoscopic gastropexy techniques have been gaining popularity. The objective of this study was to describe the use of a modified minimally invasive technique to perform prophylactic gastropexy in dogs. A case series study of 39 client-owned dogs was undertaken from June 2019 to August 2020. Each dog underwent total laparoscopic prophylactic gastropexy using a simple continuous barbed suture line and two laparoscopic needle holders without incising the seromuscular layer of the stomach and the abdominal wall. Surgical time, the number of stitches, and the length of suture were recorded. Telephone checks, owner questionnaires, and ultrasonographic exams were used to evaluate the effectiveness of the procedure after surgery. The median gastropexy surgical time was 12 min (range 4–30 min), and the median length of the suture line was 3 cm (range 2–4 cm). The last follow-up check was carried out 9 months (mean, range 3–14 months) after surgery, and all ultrasonographic exams (n = 29) showed an intact gastropexy. Intraoperative and postoperative complications were noted. This total laparoscopic gastropexy technique was found to be safe, fast, simple, and with a low morbidity rate. It appears to be a new alternative to other methods of prophylactic gastropexy; however, further research in this area is warranted.
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Lacitignola L, Fracassi L, Di Bella C, Zizzo N, Passantino G, Tinelli A, Crovace AM, Staffieri F. Absorbable fixation straps for laparoscopic gastropexy in dogs. Vet Surg 2020; 50 Suppl 1:O78-O88. [PMID: 33175434 DOI: 10.1111/vsu.13543] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 10/06/2020] [Accepted: 10/17/2020] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To evaluate the feasibility and efficacy of laparoscopic absorbable fixation straps (AFS) for laparoscopic gastropexy in dogs. STUDY DESIGN Cadaveric and prospective clinical study. ANIMALS Five dog cadavers for the cadaveric study; 12 dogs for the clinical study. METHODS The pyloric antrum was affixed to the abdominal wall laparoscopically by applying a series of straps. The cadaveric study assessed potential challenges during the procedure and stomach mucosal penetration. For the clinical study, the total duration of surgery, time to complete the gastropexy, and the number of straps used were recorded. Ultrasound evidence of adhesion, complications, and weight were monitored at 7, 30, and 90 days after surgery. Owner satisfaction was evaluated at the 6-month follow-up. RESULTS The total duration of surgery was 25.8 minutes (range, 19-39; SD, 6.7), and the time to complete the gastropexy was 10.1 minutes (range, 7-19; SD, 3.9). The linear regression analysis revealed an inverse correlation between the time to complete the gastropexy and the order of the surgeries (r2 = 0.75, P < .05). No complications were recorded. Ultrasound examination was used to confirm gastropexy at all follow-ups. CONCLUSION Laparoscopic gastropexy with AFS was performed in both cadavers and clinical animals with minimal complications. Persistent adhesion was demonstrated during ultrasound evaluations and in one postmortem evaluation. CLINICAL SIGNIFICANCE This novel laparoscopic technique can be employed safely, effectively, and reasonably quickly, and the learning curve is expected to be relatively short.
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Affiliation(s)
- Luca Lacitignola
- Dipartimento Dell'Emergenze e trapianti di Organo, sez Cliniche Veterinarie e PA, Università degli studi di Bari, Valenzano, Bari, Italy
| | - Laura Fracassi
- Dipartimento Dell'Emergenze e trapianti di Organo, sez Cliniche Veterinarie e PA, Università degli studi di Bari, Valenzano, Bari, Italy
| | - Caterina Di Bella
- Scuola di Bioscienze e Medicina Veterinaria, Università degli Studi di Camerino, Camerino, Italy
| | - Nicola Zizzo
- Dipartimento di Medicina Veterinaria, sez Anatomia Patologica, Università degli studi di Bari, Valenzano, Bari, Italy
| | - Giuseppe Passantino
- Dipartimento di Medicina Veterinaria, sez Anatomia Patologica, Università degli studi di Bari, Valenzano, Bari, Italy
| | - Antonella Tinelli
- Dipartimento di Medicina Veterinaria, sez Anatomia Patologica, Università degli studi di Bari, Valenzano, Bari, Italy
| | - Alberto Maria Crovace
- Scuola di Bioscienze e Medicina Veterinaria, Università degli Studi di Camerino, Camerino, Italy
| | - Francesco Staffieri
- Dipartimento Dell'Emergenze e trapianti di Organo, sez Cliniche Veterinarie e PA, Università degli studi di Bari, Valenzano, Bari, Italy
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Maurin MP, Mullins RA, Singh A, Mayhew PD. A systematic review of complications related to laparoscopic and laparoscopic-assisted procedures in dogs. Vet Surg 2020; 49 Suppl 1:O5-O14. [PMID: 32333685 DOI: 10.1111/vsu.13419] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Revised: 01/14/2020] [Accepted: 02/20/2020] [Indexed: 12/14/2022]
Abstract
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.
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Affiliation(s)
| | - Ronan A Mullins
- School of Veterinary Medicine, University College Dublin, Dublin, Ireland
| | - Ameet Singh
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada
| | - Philipp D Mayhew
- Department of Surgical and Radiological Sciences, University of California-Davis, Davis, California, USA
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Leonardi F, Properzi R, Rosa J, Boschi P, Paviolo S, Costa GL, Bendinelli C. Combined laparoscopic ovariectomy and laparoscopic-assisted gastropexy versus combined laparoscopic ovariectomy and total laparoscopic gastropexy: A comparison of surgical time, complications and postoperative pain in dogs. Vet Med Sci 2020; 6:321-329. [PMID: 32017474 PMCID: PMC7397895 DOI: 10.1002/vms3.249] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
The trend in laparoscopy is to develop easy and rapid techniques associated with reduced intraoperative complications and decreased postoperative pain. The aim of this study was to compare combined laparoscopic ovariectomy (OIE) and laparoscopic‐assisted incisional gastropexy (LAG) with combined laparoscopic OIE and total laparoscopic gastropexy (TLG) for surgical time, incidence of complications and postoperative pain. Twenty‐eight female dogs were randomly assigned to the LAG group (n = 14) or the TLG group (n = 14). All laparoscopic procedures were performed using a three‐port technique. The gastropexy was located 3 cm caudal to the 13th rib and 4 cm lateral to the rectus abdominis muscle. Surgical time (minutes [min]), intraoperative complications and postoperative complications were recorded. The Glasgow pain score (GPS) (short form) was calculated before surgery and at 1, 6, 12, 18 and 24 hr after extubation. Surgical time was significantly longer in the TLG group (48 ± 2 min) compared with the LAG group (39 ± 2 min). Minor postoperative complications occurred in both groups and included swelling (n = 2) and subcutaneous emphysema (n = 1). No significant differences regarding the GPS were recorded between groups. The GPS was significantly higher in both groups at 1 hr and 6 hr than before surgery. Two dogs in each group required rescue analgesia. Combined laparoscopic OIE and TLG require more time to perform than combined laparoscopic OIE and LAG. Neither procedure results in significant surgical complications. Postoperative pain for 24 hr was mild and comparable in both groups.
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Affiliation(s)
- Fabio Leonardi
- Department of Veterinary Science, University of Parma, Parma, Italy
| | | | - Jessica Rosa
- Department of Veterinary Science, University of Parma, Parma, Italy
| | | | - Silvia Paviolo
- Department of Veterinary Science, University of Parma, Parma, Italy
| | - Giovanna L Costa
- Department of Veterinary Science, University of Messina, Polo Universitario dell'Annunziata, Messina, Italy
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Baron JK, Casale SA, Monnet E, Mayhew PD, Runge JJ, Follette CM, Phipps K, Powell ME, Reczynska AI, Squire NT, Barton BA, Berg J. Paramedian incisional complications after prophylactic laparoscopy-assisted gastropexy in 411 dogs. Vet Surg 2019; 49 Suppl 1:O148-O155. [PMID: 31814138 DOI: 10.1111/vsu.13348] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Revised: 09/16/2019] [Accepted: 09/21/2019] [Indexed: 12/17/2022]
Abstract
OBJECTIVE To determine the frequency and types of paramedian incisional complications after prophylactic laparoscopy-assisted gastropexy (LAG) in dogs and to evaluate potential risk factors for complications. STUDY DESIGN Multi-institutional retrospective study. ANIMALS Client-owned dogs (N = 411). METHODS Records for dogs that underwent single-incision-port laparoscopy-assisted gastropexy (SIPLAG) or multiple-port laparoscopy-assisted gastropexy (MPLAG) at five veterinary referral hospitals were reviewed. Information regarding signalment, surgical procedures, perioperative care, and incisional complications was collected. Follow-up information was obtained by review of medical records and/or communication with owners. Potential risk factors for complications were examined statistically. RESULTS Paramedian incisional complications were observed in 78 of 411 (19%) dogs. The most common complication was seroma formation, which occurred in 51 (12.4%) dogs. Surgical site infections were observed in 16 (3.9%) dogs, and dehiscence or development of excessive scar tissue at the incision site were each observed in nine (2.2%) dogs. Complications resolved with conservative treatment in 75 of 78 (96.2%) dogs and with surgical treatment in three of 78 (3.8%) dogs. The odds of complications were approximately twice as high in dogs undergoing SIPLAG than in dogs undergoing MPLAG (odds ratio, 2.03; P = .006). CONCLUSION Minor paramedian incisional complications, particularly seroma formation, were frequently observed after LAG. Most complications were successfully managed conservatively. Single-incision-port laparoscopy-assisted gastropexy was associated with a higher complication rate compared with MPLAG. CLINICAL SIGNIFICANCE Owners should be informed that there is a relatively high rate of minor paramedian incisional complications after LAG. The risk of complications appears to be higher for SIPLAG than for MPLAG.
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Affiliation(s)
- Jessica K Baron
- Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, Massachusetts
| | - Sue A Casale
- Angell Animal Medical Center, Boston, Massachusetts
| | - Eric Monnet
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado
| | - Philipp D Mayhew
- Department of Surgical and Radiological Sciences, University of California-Davis, Davis, California
| | - Jeffrey J Runge
- Department of Surgery, Guardian Veterinary Specialists, Brewster, New York
| | - Christelle M Follette
- Department of Surgical and Radiological Sciences, University of California-Davis, Davis, California
| | - Kevin Phipps
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado
| | - Margaret E Powell
- Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, Massachusetts
| | - Alicja I Reczynska
- Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, Massachusetts
| | - Nathan T Squire
- Veterinary Orthopedic Sports Medicine Group, Annapolis Junction, Maryland
| | - Bruce A Barton
- Division of Biostatistics, Department of Quantitative Health Science, University of Massachusetts Medical School, Worcester, Massachusetts
| | - John Berg
- Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, Massachusetts
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Bendinelli C, Properzi R, Boschi P, Bresciani C, Rocca E, Sabbioni A, Leonardi F. Meloxicam vs robenacoxib for postoperative pain management in dogs undergoing combined laparoscopic ovariectomy and laparoscopic-assisted gastropexy. Vet Surg 2019; 48:578-583. [PMID: 30637777 DOI: 10.1111/vsu.13156] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Revised: 04/13/2018] [Accepted: 05/08/2018] [Indexed: 12/01/2022]
Abstract
OBJECTIVE To compare meloxicam and robenacoxib for short-term postoperative pain management after combined laparoscopic ovariectomy and laparoscopic-assisted gastropexy. STUDY DESIGN Double-blind, prospective, randomised clinical trial. ANIMALS Twenty-six client-owned female dogs. METHODS Dogs undergoing combined laparoscopic ovariectomy and laparoscopic-assisted gastropexy were randomly divided into 2 groups. Before induction of anesthesia, 13 dogs received meloxicam (0.2 mg/kg subcutaneously), and 13 dogs received robenacoxib (2 mg/kg subcutaneously). Pain was scored with the Glasgow Composite Pain Scale (short form) before surgery and at 1, 6, 12, 18, and 24 hours after extubation. Rescue analgesia (tramadol, 3 mg/kg) was provided to dogs with a Glasgow pain score (GPS) ≥5. Glasgow pain scores were analyzed by ANOVA with treatment, age, and surgical time as fixed factors. RESULTS Glasgow pain scores were higher at 24 hours postsurgery in dogs treated with robenacoxib (2.18 ± 0.29) compared with those treated with meloxicam (0.68 ± 0.41, P = .04). Two dogs treated with meloxicam and 7 dogs treated with robenacoxib required rescue analgesia. Regardless of the treatment, the overall GPS was lower at 18 and 24 hours postsurgery when the surgical time was >40 minutes compared with surgical times ≤40 minutes, but surgical site inflammation was likely a confounding factor in this finding. Glasgow pain score was not affected by patient age. CONCLUSION Meloxicam was more effective than robenacoxib at controlling pain in the population of dogs reported here. CLINICAL SIGNIFICANCE Preoperative administration of meloxicam effectively controls pain for 24 hours after combined laparoscopic ovariectomy and laparoscopic-assisted gastropexy, but rescue analgesia may be required.
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Affiliation(s)
| | | | | | - Carla Bresciani
- Department of Veterinary Science, University of Parma, Parma, Italy
| | | | - Alberto Sabbioni
- Department of Veterinary Science, University of Parma, Parma, Italy
| | - Fabio Leonardi
- Department of Veterinary Science, University of Parma, Parma, Italy
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Van Heerden FG, Hartman MJ, McClure V, Kirberger RM. Laparoscopic repositioning of chronic gastric volvulus in a dog. J S Afr Vet Assoc 2018; 89:e1-e5. [PMID: 30456979 PMCID: PMC6244192 DOI: 10.4102/jsava.v89i0.1713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Revised: 09/06/2018] [Accepted: 09/28/2018] [Indexed: 11/03/2022] Open
Abstract
A 12-year-old spayed Newfoundland bitch was presented with chronic non-productive vomiting, regurgitation and coughing of six weeks' duration. On clinical examination, the dog was depressed with no other significant findings. Haematology and biochemistry investigations detected no abnormalities. Thoracic and abdominal radiographs revealed a megaoesophagus and an abnormally positioned pylorus. A thoracic and abdominal computed tomography scan confirmed the abnormal position of the stomach, together with moderate aspiration pneumonia. Laparoscopic examination of the peritoneal cavity revealed the greater omentum wrapped over the stomach, with a fold visualised between the abnormally positioned pyloric antrum and the gastric corpus. A 180-degree clockwise gastric rotation was laparoscopically diagnosed and corrected. The normal position of the stomach was confirmed before a laparoscopic-assisted incisional gastropexy was performed. Post-operatively the vomiting and regurgitation resolved and the patient was discharged. Twenty-four hours after discharge, the dog was presented with deteriorating clinical signs of aspiration pneumonia. The owner declined treatment, additional diagnostics as well as a necropsy and requested euthanasia. Chronic gastric volvulus should be considered as a rare differential diagnosis in dogs with non-specific, chronic gastrointestinal signs. Radiography, computed tomography and laparoscopy are valuable diagnostic aids in making this diagnosis. Chronic gastric volvulus can be successfully reduced laparoscopically as reported here for the first time.
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Cray MT, Selmic LE, Lai GP, Tulipan RJ. Surgical errors of incisional gastropexy in two dogs. VETERINARY RECORD CASE REPORTS 2018. [DOI: 10.1136/vetreccr-2017-000559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
| | | | - Grace Pei‐Chun Lai
- Small Animal Clinical ScienceMichigan State UniversityEast LansingMichiganUSA
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Gomes C, Doran I, Friend E, Tivers M, Chanoit G. Long-Term Outcome of Female Dogs Treated with Static Hydraulic Urethral Sphincter for Urethral Sphincter Mechanism Incompetence. J Am Anim Hosp Assoc 2018; 54:276-284. [DOI: 10.5326/jaaha-ms-6709] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
ABSTRACT
The purpose of the study was to report the postoperative outcome, complications, and long-term follow-up of the use of a static hydraulic urethral sphincter for the management of urethral sphincter mechanism incompetence in female dogs. Medical records were reviewed to extract information on long-term (>365 days) outcome data. Telephone owner questionnaire was performed to assess postoperative urinary continence scores (scale 1–10, where 10 is complete continence) and the presence and frequency of complications. Twenty female dogs were included. Mean (±standard deviation) time to follow-up was 1,205.1 (±627.4) days. Median continence score/10 (range) was 3.5 (2–6) preoperatively, and 9.0 (7–10) at the last follow-up. Median continence score was significantly higher at all time points postoperatively compared with before surgery (P < .001). Complete continence was achieved in 90% of bitches. Minor complications occurred in 13 bitches and included dysuria (8), bacterial cystitis (8), longer urination time (10), incisional seroma (5), urinary retention (3), hematuria (2), and pain when urinating (2). Major complications occurred in one dog (static hydraulic urethral sphincter removed 28 mo after placement). Continence scores were sustainably improved in the long-term. Complications were mostly minor. Urinary tract infections were the most common but resolved with conventional antibiotic treatment.
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Affiliation(s)
- Cesar Gomes
- From the School of Veterinary Sciences, University of Bristol, Langford, Bristol, United Kingdom
| | - Ivan Doran
- From the School of Veterinary Sciences, University of Bristol, Langford, Bristol, United Kingdom
| | - Edward Friend
- From the School of Veterinary Sciences, University of Bristol, Langford, Bristol, United Kingdom
| | - Mickey Tivers
- From the School of Veterinary Sciences, University of Bristol, Langford, Bristol, United Kingdom
| | - Guillaume Chanoit
- From the School of Veterinary Sciences, University of Bristol, Langford, Bristol, United Kingdom
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