Page 67 - WSAVA2017
P. 67

• Mini-invasive assisted procedure
o Laparoscopic-assisted gastropexy
Laparoscopic-assisted gastropexy represents a fast
and very convenient method used in the prophylaxis
of gastric dilatation volvulus. It could be done as a standalone procedure or concomitantly with others (e.g. laparoscopic gonadectomy). One can choose between single-incision-multiple-port, single-incision-single-port or multiple-incisions-multiple port variation of laparoscopic- assisted techniques. No matter which technique is used they all have in common that the gastric wall is grasped in the area of pyloric antrum by a laparoscopic grasper and brought to the right abdominal wall just caudal to
the last rib while the abdomen is being deflated. The original incision of the abdominal wall is usually extended, the serosa and the muscular layer of the stomach are also incised and the muscular layers are appositionally sutured to each other from outside of the abdominal wall.
o Laparoscopic-assisted cystotomy
This technique is usually used for uroliths removal and biopsy of the urinary bladder as well as removal of intraluminal masses. Urinary bladder is brought to the abdominal wall by means of laparoscopy. An incision
is created directly over the bladder and the bladder is temporarily sutured there. A trocar could be placed into the bladder and it will be explored and treated endoscopically.
o Laparoscopic-assisted entero-/enterectomy and/or intestinal anastomosis
After proper laparoscopic examination of the abdominal cavity the affected intestinal loop is grasped and brought outside of the abdominal cavity where the contaminated part of the procedure is performed and the intestinal segment is cleaned, flushed and returned into the abdomen.
o Other laparoscopic and video-assisted procedures
Many other video-assisted procedures have been published in the veterinary literature:
Laparoscopic-assisted placement of gastrointestinal feeding tube, Laparoscopic-assisted placement of peritoneal dialysis catheter and cholecystostomy tube, Laparoscopic-assisted placement of gastrointestinal feeding tube, Laparoscopic-assisted splenectomy, Laparoscopic-assisted treatment of pyometras. In the chest, partial or total lung lobectomies, PDA closure, Ligamentum arteriosum removal, Thymomas removal have been performed.
Finally, these questions are to be answered in order to understand why and how one shall start
• Does mini-invasive surgery present any advantage to the patient?
On many elective surgeries (ovariectomy, ovario- hysterectomy, cryptorchiectomy) as well as on some
An Urban Experience
specific procedures (pericardiectomy, adrenalectomy) pain scores and behavior scores have been shown to be in favor of mini-invasive approach.
• What are the advantages for the owners?
The idea of mini-invasive surgery as well as the idea of offering the « state of the art technology » pushes the owners to ask for mini-invasive surgeries. They easily compare human surgery with veterinary surgery and expect for their pet what they want for themselves.
• Can the practitioner benefit from it?
Placing a scope into a cavity has brought over the years a tremendous amount of information. The practitioner willing to start with mini-invasive surgery should start
with rigid endoscopic examination: Urethro-cystoscopy, Otoscopy, Rhinoscopy, Laryngo-pharyngoscopy, Bronchoscopy. Then, further progresses can be achieved by performing intra-abdominal biopsies: Liver, Lymph node, Pancreas...Once this has been done, elective surgeries can be offered: Ovariectomy, Cryptorchiectomy.
Over the past twenty years mini-invasive surgery has
represented a major progress in diagnosis and treatment
of surgical diseases. In small animal surgery, practitioners
shall benefit of it and shall offer it to their clients. Going
step by step, getting trained in training centers, not
being too ambitious when getting started are the keys for
efficient progresses and successes.
Monnet E, Twedt DC: Laparoscopy. Vet Clin North Am Small Anim Pract. 2003 Sep;33(5):1147-1163.
Barnes RF, Greenfield CL, Schaeffer DJ, Landolfi J, Andrews J: Comparison of biopsy samples obtained using standard endoscopic instruments and the harmonic scalpel during laparoscopic and laparoscopic-assisted surgery in normal dogs. Vet Surg. 2006 Apr;35(3):243-251.
G. Dupre, V. Fiorbianco,, M. Skalicky,n. N gultike, S. Serhat ay, and M. Findik,
Laparoscopic ovariectomy in dogs: comparison between single portal and two- portal access. Veterinary surgery 38:818–824, 2009
Fiorbianco, V; Skalicky, M; Doerner, J; Findik, M; Dupre, G (2012): Right Intercostal Insertion of a Veress Needle for Laparoscopy in Dogs. Vet Surg (41), 3 367-373.
G.Dupre and V.Fiorbianco in D.Griffon and A. Hamaide (Editors) Complications in Small Animal Surgery, ISBN: 978-0-470-95962-6, 2016
MJ Pelaez, BM. Bouvy, G. Dupre, Laparoscopic Adrenalectomy for Treatment of Unilateral Adrenocortical Carcinomas: Technique, Complications, and Results in Seven Dogs
Veterinary Surgery, 37:444–453, 2008
Buote NJ, Kovak-McClaran JR, Schold JD: Conversion from diagnostic laparoscopy to laparotomy: risk factors and occurrence. Vet Surg. 2011 Jan;40(1):106-114.
G. Dupre, K.Coudek: Laparoscopic-Assisted Placement of a Peritoneal Dialysis Catheter with Partial Omentectomy and Omentopexy in Dogs: An Experimental Study. Vet Surg. 2013
Petre SL, McClaran JK, Bergman PJ, Monette S: Safety and efficacy of laparoscopic hepatic biopsy in dogs: 80 cases (2004-2009). J Am Vet Med Assoc. 2012 Jan 15;240(2):181-185.
McDevitt HL, Mayhew PD, Giuffrida MA, Brown DC, Culp WT, Runge JJ: Short- term clinical outcome of laparoscopic liver biopsy in dogs: 106 cases (2003- 2013). J Am Vet Med Assoc. 2016 Jan 1;248(1):83-90.
Becher-Deichsel A1, Aurich JE2, Schrammel N3, Dupré G4. A surgical glove port technique for laparoscopic-assisted ovariohysterectomy for pyometra in the bitch. Theriogenology. 2016 Jul 15;86(2):619-25. doi: 10.1016/j.theriogenology 2016
N Katic, G Dupré Advances in endoscopic surgery for small animal reproduction Reprod Dom Anim 2016; 51 (Suppl. 1): 25–30

   65   66   67   68   69