Preliminary application of a single-port access technique for laparoscopic ovariohysterectomy in dogs

Laparoscopic ovariohysterectomy for dogs under 5 kg body weight

OBJECTIVE

To describe the surgical method, operative time, safety, and usefulness of 3-port laparoscopic ovariohysterectomy (LOHE) using an ultrasonic coagulation and incision device in dogs <5 kg.

STUDY DESIGN

Retrospective study.

ANIMALS

Female dogs (n = 147).

METHODS

Animals were allocated to one of four groups by bodyweight: <2 kg (n = 18), 2-3 kg (n = 37), 3-4 kg (n = 55), and 4-5 kg (n = 37). All surgical procedures were recorded on video. Mean operative time (i.e., time from first skin incision to last suture), clinical variables, hematologic variables, and blood biochemistry were recorded. Intrasurgical and postsurgical complications were recorded, and wound complications, including signs of inflammation or hernia formation were monitored for 3 months.

RESULTS

The mean operative time for all groups was 18 min, with no significant differences between groups. Eight dogs bled from the mesometrium during surgery. Two dogs had hernia formation at a midline port incision; this complication developed by month 3. No complications such as wound dehiscence or infection of the surgical field were observed at the time of suture removal in any of the dogs.

CONCLUSION

We performed LOHE using an ultrasonic coagulation and incision device in dogs <5 kg, and found it to be a safe procedure with minimal complications.

CLINICAL SIGNIFICANCE

We believe that LOHE, using a 3-port and ultrasonic coagulation and incision device, is a safe, useful, and minimally invasive surgical method for sterilization of dogs <5 kg with minimal complications.

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.

Single-port laparoscopic-assisted ovariohysterectomy with a modified glove-port technique in dogs

Objective

To describe a single‐port laparoscopic‐assisted ovariohysterectomy (LOHE) with a modified glove‐port technique in dogs and compare it with previously published laparoscopic techniques for LOHE in dogs.

Study design

Prospective clinical study and technique description.

Animals

Forty‐two healthy female dogs.

Methods

Laparoscopic‐assisted ovariohysterectomy was performed with a custom‐made single‐port device. The total duration of surgery from first incision to skin closure was compared with previously published durations of LOHE in dogs. Short‐term complications were recorded.

Results

The median total duration of surgery was 24 minutes (range, 17.5–39.5; mean, 25.73; SD, 6.12), which was shorter than that described in most previously reported studies of LOHE in dogs (range, 20.8 ± 4.00–60.0 ± 18.45 minutes; P < .001). Intraoperative complications were minor, but wound complications occurred in 12 of 42 (29%) dogs.

Conclusion

Single‐port LOHE with the glove‐port technique in combination with a wound retractor and nonarticulated instruments was completed in all dogs. This technique was faster than what has been previously reported for other LOHE, but local wound complications were common.

Clinical relevance

The glove‐port technique described here offers a low‐cost alternative to other commercially available single‐port devices.

Vaginoscopy in Ewes Utilizing a Laparoscopic Surgical Port Device

Vaginoscopy allows for diagnostic evaluation and treatment of the vaginal vault. A laparoscopic surgical port device and rigid telescope were utilized for serial vaginoscopy in 8 healthy anesthetized ewes. Vaginoscopy examinations were performed in each ewe at days 1, 14, and 28. This technique was well-tolerated and facilitated carbon dioxide vaginal inflation, complete vaginal examination, identification of the cervix, and targeted biopsy collection. No complications were encountered during or following the vaginoscopy procedures. The laparoscopic port device was well-suited to the ewe vulvar size. This technique could be applied to clinical evaluation in ewes for the purposes of examination, biopsy, culture, foreign body removal, and minor surgical procedures.

Single incision laparoscopic-assisted ovariohysterectomy for an ovarian tumor in a dog

This report describes a single-incision, laparoscopic-assisted ovariohysterectomy in a 6-year-old, intact female Keeshond dog for the staging and treatment of a left-sided ovarian tumor. Abdominal access was obtained using a modified-Hasson technique allowing for placement of a multi-channel, single incision laparoscopic surgery port. Following carbon dioxide insufflation, superficial laparoscopic exploration of the abdominal cavity was performed and then both ovarian pedicles were sealed and divided using a vessel-sealing device. Laparoscopic-assisted ovariohysterectomy was performed with the aid of a wound retractor for exteriorization of the mass. There were no perioperative complications and the patient was discharged 1 day after surgery. Histopathology of the mass revealed an ovarian teratoma. Telephone follow-up 608 days after surgery revealed a good clinical outcome. Single-incision, laparoscopic-assisted ovariohysterectomy is technically feasible for the treatment of selected ovarian tumors in the dog.