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Costa GL, Leonardi F, Licata P, Tabbì M, Iannelli N, Iannelli D, Macrì D, Bruno F, Ferrantelli V, Nava V, Interlandi C, Bruschetta G. Effect of surgery on oxidative stress and endogenous tocopherol concentrations in juvenile female dogs. Acta Vet Scand 2024; 66:30. [PMID: 38992641 PMCID: PMC11241787 DOI: 10.1186/s13028-024-00753-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Accepted: 07/02/2024] [Indexed: 07/13/2024] Open
Abstract
BACKGROUND Surgery such as ovariectomy causes an inflammatory and oxidative stress. This study was designed to evaluate endogenous tocopherol levels in response to surgical oxidative stress induced by abdominal surgery (ovariectomy) in thirty-two juvenile female dogs. The dogs received meloxicam before surgery (0.2 mg/kg SC) and after surgery (0.1 mg/kg OS every 24 h), 0.03 mg/kg of atropine sulfate (IM), and propofol 4 mg/kg intravenously (IV). General anesthesia was maintained with sevoflurane. Physiological, hematological and biochemical parameters, malondialdehyde (MDA) and α-, δ-, γ-tocopherols were evaluated at baseline, 36 and 48 h after surgery. RESULTS The physiological parameters remained within normal ranges. Blood glucose concentration increased, while the albumin levels decreased after surgery. Rescue analgesia was not required. MDA levels increased above the baseline at 36 and 48 h after surgery (P < 0.001). The α-, δ-, and γ-tocopherol concentrations decreased from baseline at 36 and 48 h after surgery (P < 0.001). CONCLUSIONS Surgery in juvenile female dogs revealed oxidative, increased MDA concentrations, reduced tocopherol levels, and had a clinically insignificant influence on homeostasis.
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Affiliation(s)
- Giovanna Lucrezia Costa
- Department of Veterinary Sciences, University of Messina, Via Palatucci Annunziata, 98168, Messina, Italy
| | - Fabio Leonardi
- Department of Veterinary Science, University of Parma, Via del Taglio 10, 43126, Parma, Italy
| | - Patrizia Licata
- Department of Veterinary Sciences, University of Messina, Via Palatucci Annunziata, 98168, Messina, Italy
| | - Marco Tabbì
- Department of Veterinary Sciences, University of Messina, Via Palatucci Annunziata, 98168, Messina, Italy
| | - Nicola Iannelli
- Department of Veterinary Sciences, University of Messina, Via Palatucci Annunziata, 98168, Messina, Italy
- Clinica Veterinaria Camagna, Via Fortunato Licandro 13, 84124, VetpartnersReggio Calabria, Italy
| | - Diego Iannelli
- Clinica Veterinaria Camagna, Via Fortunato Licandro 13, 84124, VetpartnersReggio Calabria, Italy
| | - Daniele Macrì
- Zooprophylactic Institute, Via Gino Marinuzzi 4, 90100, Palermo, Italy
| | - Fabio Bruno
- Department of Veterinary Sciences, University of Messina, Via Palatucci Annunziata, 98168, Messina, Italy.
| | | | - Vincenzo Nava
- Department of Veterinary Sciences, University of Messina, Via Palatucci Annunziata, 98168, Messina, Italy
| | - Claudia Interlandi
- Department of Veterinary Sciences, University of Messina, Via Palatucci Annunziata, 98168, Messina, Italy.
| | - Giuseppe Bruschetta
- Department of Veterinary Sciences, University of Messina, Via Palatucci Annunziata, 98168, Messina, Italy
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Williams EA, Monnet E. Clinical outcomes of the use of unidirectional barbed sutures in gastrointestinal surgery for dogs and cats: A retrospective study. Vet Surg 2023; 52:1009-1014. [PMID: 37332126 DOI: 10.1111/vsu.13978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 04/26/2023] [Accepted: 05/29/2023] [Indexed: 06/20/2023]
Abstract
OBJECTIVE To report the clinical outcomes of gastrointestinal surgery using unidirectional barbed sutures in single-layer appositional closure in dogs and cats. STUDY DESIGN Retrospective and descriptive study. SAMPLE POPULATION Twenty-six client-owned dogs; three client-owned cats. METHODS Medical records of dogs and cats that received gastrointestinal surgery closed with unidirectional barbed sutures were reviewed to collect information on signalment, physical examinations, diagnostics, surgical procedures, and complications. Short- and long-term follow-up information was collected from the medical records, the owners, or the referring veterinarians. RESULTS Six gastrotomies, 21 enterotomies, and nine enterectomies were closed with a simple continuous pattern with unidirectional barbed glycomer 631 sutures. Nine dogs had multiple surgical sites closed with unidirectional barbed sutures. None of the cases in the study developed leakage, dehiscence, or septic peritonitis during the 14-day short-term follow up. Long-term follow up information was collected for 19 patients. The median long-term follow-up time was 1076 days (range: 20-2179 days). Two dogs had intestinal obstruction due to strictures at the surgical site 20 and 27 days after surgery. Both were resolved with an enterectomy of the original surgical site. CONCLUSION Unidirectional barbed suture was not associated with a risk of leakage or dehiscence after gastrointestinal surgery in dogs and cats. However, strictures may develop in the long term. CLINICAL SIGNIFICANCE Unidirectional barbed sutures can be used during gastrointestinal surgery in client-owned dogs and cats. Further investigation of the role of unidirectional barbed sutures leading to abscess, fibrosis, or stricture is necessary.
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Affiliation(s)
- Evan A Williams
- Department of Clinical Sciences, Colorado State University, Fort Collins, Colorado, USA
| | - Eric Monnet
- Department of Clinical Sciences, Colorado State University, Fort Collins, Colorado, USA
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Fransson BA, Ragle CA, Mickas MM, Martin KW, Karn KNL. Ability to Perform Laparoscopic Intra- and Extracorporeal Suture Ligations in a Live Canine Ovariectomy Model after Simulation Training. JOURNAL OF VETERINARY MEDICAL EDUCATION 2022; 50:e20210143. [PMID: 35613302 DOI: 10.3138/jvme-2021-0143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Veterinary resident training in minimally invasive surgery is currently inconsistent and depends on innate psychomotor skills. Simulation training has been shown to effectively increase basic skills, but demonstration of simulation training effects on advanced skills in the operating room is sparse. We aimed to determine if simulation-trained novice surgeons were able to perform laparoscopic suture ligation in live dogs. Three novice laparoscopic surgeons underwent a 12-session simulation training program with subsequent laparoscopic skills testing to demonstrate competency. The median skills scores of trainees and of one experienced surgeon were 417 and 472, respectively. Eighteen healthy client-owned (shelter) dogs were operated on by four surgeons: one experienced American College of Veterinary Surgeons (ACVS) diplomate, two novice ACVS residents, and one novice ACVS diplomate. Laparoscopic ovariectomy was performed with suture ligation of the ovarian pedicles. Successful surgery was defined as no evidence of ovarian vessel bleeding after transection of the pedicles. Simulation-trained novices performed successful suture-ligated ovariectomies in 11/13 dogs (85%), and the experienced surgeon in 5/5 (100%) dogs. Median total ligation time was 30 minutes (range: 17-57), which was not different among surgeons (p = .118). Median total surgery time was 105 minutes (range: 69-156) for novices and 89 minutes (range: 65-99) for the experienced surgeon (p = .038). Extensive simulation training including suturing may contribute toward surgery residents being able to perform complex laparoscopic procedures. These results need to be confirmed in larger numbers of trainees.
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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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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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8
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Fracassi L, Crovace AM, Staffieri F, Lacitignola L. Biomechanical evaluation of an absorbable fixation strap for use in total laparoscopic gastropexy in dogs. Am J Vet Res 2020; 81:594-599. [PMID: 32584176 DOI: 10.2460/ajvr.81.7.594] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To compare load-to-failure results for laparoscopic absorbable fixation straps (AFSs) deployed at various angles and for AFSs versus absorbable knotless (barbed) suture when used in simulated total laparoscopic gastropexy (TLG) in specimens from cadaveric dogs. SAMPLE 30 stomach and abdominal body wall specimens. PROCEDURES Specimens were assigned to 1 of 3 groups for use in simulated TLG constructs for comparisons of load-to-failure results for single AFSs deployed at 30°, 60°, or 90° (AFS-angle group; n = 10) or for a gastropexy span of 4 to 5 cm achieved with 3-0 absorbable knotless (barbed) monofilament suture applied in a simple continuous pattern (TLG-1; 10) versus 8 AFSs applied with a deployment angle > 30° (TLG-2; 10). A 1-way ANOVA was used to compare results among AFS deployment angles (30°, 60°, or 90°) and between TLG-1 and TLG-2. RESULTS Mean ± SD load to failure for the AFS-angle group was significantly higher for the AFS deployment angles of 60° (8.00 ± 3.90 N) and 90° (12.71 ± 8.00 N), compared with 30° (5.17 ± 1.90 N). However, no substantial difference was detected in the mean ± SD load to failure for TLG-1 (39.18 ± 7.1 N) versus TLG-2 (31.43 ± 10.86 N). CONCLUSIONS AND CLINICAL RELEVANCE Results of the present study supported the potential use of AFSs in gastropexy in dogs; however, prospective clinical research with adequate long-term follow-up is warranted before recommendations can be made.
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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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Perivoliotis K, Sarakatsianou C, Tepetes K, Baloyiannis I. Single incision laparoscopic fundoplication: A systematic review of the literature. World J Gastrointest Surg 2019; 11:179-190. [PMID: 31057702 PMCID: PMC6478600 DOI: 10.4240/wjgs.v11.i3.179] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2019] [Revised: 03/12/2019] [Accepted: 03/16/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Fundoplication, was first introduced as a surgical treatment method of gastroesophageal reflux disease. Consequently, several modifications of this method have been described, whereas laparoscopic fundoplication was recently introduced. Although single incision (SI) fundoplication was considered as an alternative to the conventional laparoscopic approach, several studies reported an increased operation duration, and high rates of multiport conversion and incisional hernia.
AIM To provide a current overview of the technical variations and the postoperative outcomes of patients submitted to SI fundoplication.
METHODS The present systematic review of the literature was designed and conducted on the basis of the PRISMA guidelines. A systematic screening of the electronic scholar databases (Medline, Scopus and Web of Science) was performed.
RESULTS Literature search resulted in the identification of 19 studies. Overall, 266, 137 and 110 SI Nissen, Dor and Toupet fundoplications were reported, respectively. In the majority of the trials, standard laparoscopic instruments were used. The left liver lobe was displayed through the use of forceps, graspers, retractors, drains or even glue. Both intra-corporeal and extracorporeal suturing was described. Mean operative time was 136.3 min. Overall complication rate was 5.2% and the rate of incisional hernia was 0.9%. No mortality was reported.
CONCLUSION Due to the methodological heterogeneity and the lack of high quality studies comparing multi to single access techniques and the several variations, we conclude that further well designed studies are necessary, in order to evaluate the role of SI fundoplication.
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Affiliation(s)
| | | | | | - Ioannis Baloyiannis
- Department of Surgery, University Hospital of Larissa, Larissa 41110, Greece
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Deroy C, Hahn H, Bismuth C, Ragetly G, Gomes E, Poncet C. Simplified Minimally Invasive Surgical Approach for Prophylactic Laparoscopic Gastropexy in 21 Cases. J Am Anim Hosp Assoc 2019; 55:152-159. [PMID: 30870607 DOI: 10.5326/jaaha-ms-6879] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The objective of this study was to describe the operative technique and outcome of a simplified laparoscopic gastropexy approach in dogs. Twenty-one dogs undergoing prophylactic laparoscopic gastropexy with a simple continuous barbed suture without incising the seromuscular layer of the stomach and transversus abdominis muscle were reviewed. In 20 cases, additional procedures were performed (18 ovariectomies and 2 prescrotal castrations); 1 dog had two prior episodes of gastric dilation without volvulus and underwent gastropexy with a prophylactic intent. The gastropexy procedure had a median duration of 33 min (range 19-43 min). V-Loc 180 absorbable and the V-Loc PBT nonabsorbable suturing devices were used in 8 and 13 dogs, respectively. Minor intraoperative complications occurred in four cases: broken suture (1), needle dislodgement (2), and folded needle (1). Minor complications included self-limiting wound complications (3), abdominal discomfort (2), vomiting (1), and inappetence (2). Postoperative abdominal ultrasound performed after a median of 8 mo (6-36 mo) confirmed permanent adhesion at the gastropexy site in all dogs. One dog developed a fistula (1 yr postoperatively) and another a granuloma (3 mo postoperatively), both at the gastropexy site. Prophylactic laparoscopic gastropexy may be performed with knotless unidirectional barbed suture without creating an incision on the abdominal wall and stomach.
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Affiliation(s)
- Claire Deroy
- From Clinique Veterinaire Alliance, Bordeaux, France (C.D.); and Center Hospitalier Vétérinaire Fregis, Acrueil, France (H.H., C.B., G.R., E.G., C.P.)
| | - Harriet Hahn
- From Clinique Veterinaire Alliance, Bordeaux, France (C.D.); and Center Hospitalier Vétérinaire Fregis, Acrueil, France (H.H., C.B., G.R., E.G., C.P.)
| | - Camille Bismuth
- From Clinique Veterinaire Alliance, Bordeaux, France (C.D.); and Center Hospitalier Vétérinaire Fregis, Acrueil, France (H.H., C.B., G.R., E.G., C.P.)
| | - Guillaume Ragetly
- From Clinique Veterinaire Alliance, Bordeaux, France (C.D.); and Center Hospitalier Vétérinaire Fregis, Acrueil, France (H.H., C.B., G.R., E.G., C.P.)
| | - Eymeric Gomes
- From Clinique Veterinaire Alliance, Bordeaux, France (C.D.); and Center Hospitalier Vétérinaire Fregis, Acrueil, France (H.H., C.B., G.R., E.G., C.P.)
| | - Cyrill Poncet
- From Clinique Veterinaire Alliance, Bordeaux, France (C.D.); and Center Hospitalier Vétérinaire Fregis, Acrueil, France (H.H., C.B., G.R., E.G., C.P.)
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