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McGaffey MES, Singh A, Buote NJ, Mayhew PD, Rupnik N, Massari F, Case JB, Fransson BA, Oblak ML, Brisson BA, Scott JE, Donovan VA, Appleby R, Monteith G. Complications and outcomes associated with laparoscopic-assisted splenectomy in dogs. J Am Vet Med Assoc 2022; 260:1309-1315. [PMID: 35482563 DOI: 10.2460/javma.21.12.0536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To report the perioperative characteristics and outcomes of dogs undergoing laparoscopic-assisted splenectomy (LAS). ANIMALS 136 client-owned dogs. PROCEDURES Multicentric retrospective study. Medical records of dogs undergoing LAS for treatment of naturally occurring splenic disease from January 1, 2014, to July 31, 2020, were reviewed. History, signalment, physical examination and preoperative diagnostic test results, procedural information, complications, duration of hospitalization, histopathologic diagnosis, and perioperative outcomes were recorded. Perioperative complications were defined using the Veterinary Cooperative Oncology Group - Common Terminology Criteria for Adverse Events (VCOG-CTCAE v2) guidelines. RESULTS LAS was performed for treatment of a splenic mass (124/136 [91%]), immune-mediated disease (7/136 [5%]), splenomegaly (4/136 [3%]), or immune-mediated disease in conjunction with a splenic mass (1/136 [1%]). Median splenic mass size was 1.3 cm3/kg body weight. Conversion to open laparotomy occurred in 5.9% (8/136) of dogs. Complications occurred in 78 dogs, with all being grade 2 or lower. Median surgical time was 47 minutes, and median postoperative hospital stay was 28 hours. All but 1 dog survived to discharge, the exception being postoperative death due to a suspected portal vein thrombus. CLINICAL RELEVANCE In the dogs of this report, LAS was associated with low rates of major complications, morbidity, and mortality when performed for a variety of splenic pathologies. Minimally invasive surgeons can consider the LAS technique to perform total splenectomy in dogs without hemoabdomen and with spleens with modest-sized splenic masses up to 55.2 cm3/kg, with minimal rates of complications, morbidity, and mortality.
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Affiliation(s)
- Marissa E S McGaffey
- 1Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Canada
| | - Ameet Singh
- 1Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Canada
| | - Nicole J Buote
- 2Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY
| | - Philipp D Mayhew
- 3Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California-Davis, Davis, CA
| | - Nicole Rupnik
- 3Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California-Davis, Davis, CA
| | | | - J Brad Case
- 5Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL
| | - Boel A Fransson
- 6Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Washington State University, Pullman, WA
| | - Michelle L Oblak
- 1Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Canada
| | - Brigitte A Brisson
- 1Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Canada
| | - Jacqueline E Scott
- 7Illinois Veterinary Teaching Hospital, College of Veterinary Medicine, University of Illinois, Urbana, IL
| | - Victoria A Donovan
- 1Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Canada
| | - Ryan Appleby
- 1Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Canada
| | - Gabrielle Monteith
- 1Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Canada
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Laparoscopic Castration Using Bipolar Forceps vs. Orchiectomy in Dogs: A Comparison of Two Techniques. Animals (Basel) 2021; 11:ani11113041. [PMID: 34827774 PMCID: PMC8614276 DOI: 10.3390/ani11113041] [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: 09/03/2021] [Revised: 10/05/2021] [Accepted: 10/12/2021] [Indexed: 11/19/2022] Open
Abstract
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.
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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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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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Use of Minimally Invasive Surgery in the Diagnosis and Treatment of Cancer in Dogs and Cats. Vet Sci 2019; 6:vetsci6010033. [PMID: 30897763 PMCID: PMC6466197 DOI: 10.3390/vetsci6010033] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Revised: 03/07/2019] [Accepted: 03/08/2019] [Indexed: 12/31/2022] Open
Abstract
Surgical management of neoplastic disease is common in veterinary medicine. Minimally invasive surgery (MIS) has gained widespread acceptance by veterinary surgeons and is experiencing rapid growth and frequency of use. Many neoplastic diseases in the abdomen and thorax of dogs and cats can be treated as effectively with MIS as with traditional open surgery. Additionally, MIS allows for less invasive options for organ biopsy in cancer patients either for initial diagnosis or for staging to inform prognosis and treatment. Despite the recent increase in MIS, additional research is required to further characterize the benefits to oncology patients and to ensure that surgical oncologic principles and patient outcomes are not compromised by the use of MIS.
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Hughes J, Raszplewicz J. Phenylephrine use for blood sparing during splenectomy in a dog. VETERINARY RECORD CASE REPORTS 2018. [DOI: 10.1136/vetreccr-2018-000640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
A dog with immune-mediated haemolytic anaemia was presented for splenectomy. Phenylephrine administration immediately before the removal of the spleen induced splenic contraction and significantly elevated packed cell volume. This technique conserved red blood cells and may be beneficial in euvolaemic animals to reduce the likelihood of a transfusion being required in the event of surgical haemorrhage.
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Mayhew PD, Sutton JS, Singh A, Runge JJ, Case JB, Griffin MA, Giuffrida MA. Complications and short-term outcomes associated with single-port laparoscopic splenectomy in dogs. Vet Surg 2017; 47:O67-O74. [DOI: 10.1111/vsu.12752] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2016] [Revised: 09/25/2017] [Accepted: 10/03/2017] [Indexed: 02/06/2023]
Affiliation(s)
- Philipp D. Mayhew
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine; University of California-Davis; Davis California
| | - Jessie S. Sutton
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine; University of California-Davis; Davis California
| | - Ameet Singh
- Department of Clinical Studies, Ontario Veterinary College; University of Guelph; Ontario Canada
| | - Jeffrey J. Runge
- Department of Clinical Studies; Matthew J. Ryan Veterinary Hospital at the University of Pennsylvania; Philadelphia Pennsylvania
| | - J. Brad Case
- Department of Small Animal Clinical Sciences; University of Florida; Gainesville Florida
| | - Maureen A. Griffin
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine; University of California-Davis; Davis California
| | - Michelle A. Giuffrida
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine; University of California-Davis; Davis California
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Wright T, Singh A, Mayhew PD, Runge JJ, Brisson BA, Oblak ML, Case JB. Laparoscopic-assisted splenectomy in dogs: 18 cases (2012–2014). J Am Vet Med Assoc 2016; 248:916-22. [DOI: 10.2460/javma.248.8.916] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Oliveira M, França R, Feranti J, Coutinho Júnior A, Soares A, Santos FB, Corrêa L, Hartmann H, Pinto Filho S, Chaves R, Pohl V, Brun M. Meloxicam associado ou não ao tramadol no controle da dor após ovário-histerectomia videoassistida em cadelas. ARQ BRAS MED VET ZOO 2016. [DOI: 10.1590/1678-4162-8299] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
O objetivo deste estudo foi avaliar a eficácia do meloxicam associado ou não ao tramadol, no controle da dor após ovário-histerectomia (OVH) laparoscópica com dois portais. Foram selecionadas 14 cadelas hígidas. Os animais foram separados de forma aleatória, em dois grupos. O grupo M (GM) recebeu meloxicam (0,2mg kg-1, s.i.d.), enquanto os animais do grupo MT (GMT) receberam a associação de meloxicam (0,2mg kg-1, s.i.d.) e tramadol (4mg kg-1, t.i.d.), ambos durante dois dias de pós-operatório. Para avaliação da dor pós-cirúrgica, foram utilizadas as escalas de Melbourne e escala visual analógica (EVA), além de mensurações de glicemia e cortisol sérico. Não houve diferença ao se avaliarem os grupos GM e GMT pela escala de Melbourne nem pela EVA. As mensurações de cortisol não atingiram valores superiores aos de referência para a espécie, enquanto os valores de glicemia não apresentaram variação significativa ao longo do tempo de avaliação nem entre grupos. Com os resultados deste estudo, foi possível concluir que a utilização de meloxicam associado ou não ao tramadol, nas doses e posologias propostas, é eficaz para controlar a dor pós-operatória de cadelas submetidas à OVH laparoscópica com dois portais.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | - M.V. Brun
- Universidade Federal de Santa Maria; CNPq
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Christensen MB, Eriksen T, Kjelgaard-Hansen M. C-reactive protein: quantitative marker of surgical trauma and post-surgical complications in dogs: a systematic review. Acta Vet Scand 2015; 57:71. [PMID: 26483038 PMCID: PMC4615867 DOI: 10.1186/s13028-015-0164-5] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2015] [Accepted: 10/11/2015] [Indexed: 01/04/2023] Open
Abstract
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.
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Abstract
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.
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Affiliation(s)
- Michele A Steffey
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California Davis, 1 Shields Avenue, Davis, CA 95616, USA.
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Shaver SL, Mayhew PD, Steffey MA, Hunt GB, Mayhew KN, Culp WTN. Short-Term Outcome of Multiple Port Laparoscopic Splenectomy in 10 Dogs. Vet Surg 2014; 44 Suppl 1:71-5. [DOI: 10.1111/j.1532-950x.2014.12312.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- Stephanie L. Shaver
- Department of Surgical and Radiological Sciences; School of Veterinary Medicine; University of California-Davis; Davis California
| | - Philipp D. Mayhew
- Department of Surgical and Radiological Sciences; School of Veterinary Medicine; University of California-Davis; Davis California
| | - Michele A. Steffey
- Department of Surgical and Radiological Sciences; School of Veterinary Medicine; University of California-Davis; Davis California
| | - Geraldine B. Hunt
- Department of Surgical and Radiological Sciences; School of Veterinary Medicine; University of California-Davis; Davis California
| | - Kelli N. Mayhew
- Department of Surgical and Radiological Sciences; School of Veterinary Medicine; University of California-Davis; Davis California
| | - William T. N. Culp
- Department of Surgical and Radiological Sciences; School of Veterinary Medicine; University of California-Davis; Davis California
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O'Donnell E, Mayhew P, Culp W, Mayhew K. Laparoscopic splenectomy: operative technique and outcome in three cats. J Feline Med Surg 2013; 15:48-52. [PMID: 23254241 PMCID: PMC10816495 DOI: 10.1177/1098612x12466553] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/10/2024]
Abstract
CLINICAL SUMMARY: The clinical findings, treatment and outcome for three cats that underwent laparoscopic splenectomy using bipolar vessel-sealing devices for resection of diffuse splenic disease are described. In each case, a three-portal laparoscopic technique was used. The spleen was manipulated and its mesentery and associated vessels sequentially cauterized and ligated to enable removal through a portal incision with minimal hemorrhage. Each of the three patients recovered from anesthesia without incident and was able to be discharged to the owner the next day. PRACTICAL SIGNIFICANCE: Laparoscopic splenectomy may be a safe and effective alternative to celiotomy in a select group of cats requiring splenectomy.
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Affiliation(s)
- Erica O'Donnell
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California-Davis, Davis, CA 95616, USA
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Khalaj A, Bakhtiari J, Niasari-Naslaji A. Comparison between single and three portal laparoscopic splenectomy in dogs. BMC Vet Res 2012; 8:161. [PMID: 22963734 PMCID: PMC3585911 DOI: 10.1186/1746-6148-8-161] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2011] [Accepted: 08/27/2012] [Indexed: 01/25/2023] Open
Abstract
Background Single incision laparoscopic surgery (SILS) is a newly growing technique to replace a more invasive conventional multiple portal laparoscopic surgery. The objective of this study was to compare single (SILS) with three portal (Conventional) laparoscopic splenectomy in dogs. Mongrel dogs (n = 18), weighting 15 ± 3 kg, were selected for this study (n = 12 SILS; n = 6 conventional). The area from xiphoid to pubis was prepared under aseptic conditions in dorsal recumbency with the head down and tilted 30 degree in the right lateral position. Pneumoperitoneum was established by CO2 using an automatic high flow pressure until achieving 12 mm Hg. Instrumentation used consisted of curved flexible-tip 5 mm Maryland forceps and ultracision harmonic scalpel for sealing and cutting of the vessels and splenic attachments. Results All dogs recovered uneventfully. The splenectomy procedure using SILS and conventional methods were significantly different in the respective operative time (29.1 ± 1.65 vs. 42.0 + 2.69 min) and the length of the surgical scar (51.6 ± 1.34 mm vs. 72.0 ± 1.63 mm; P < 0.001). There were no post-operative wound complication including inflammation, infection, hernia formation and dehiscence up to one month after surgery. Meanwhile, the conversion to open surgery or application of additional portals was not required in both approaches. Conclusion This study demonstrated that SILS is a safe and feasible operation and could be used as an alternative approach to three portal (Conventional) for splenectomy in dog.
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Affiliation(s)
- Alireza Khalaj
- Minimally Invasive Surgery Research Centre, Rasool Akram Hospital, Tehran University of Medical Sciences, Tehran, Iran
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