Hand-assisted laparoscopic technique for removal of ovarian tumors in standing mares

Department of Large Animal Clinical Sciences, College of Veterinary Medicine, Gainesville, FL 32510-0136, USA.
Journal of the American Veterinary Medical Association (Impact Factor: 1.56). 06/2002; 220(10):1503-7, 1475. DOI: 10.2460/javma.2002.220.1503
Source: PubMed
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    • "If the GCT has large cystic areas on ultrasound, it is possible to use an injection needle along with a suction device to remove cystic fluid thereby reducing the size of the ovary. There have been a number of reports on the use of hand-assisted laparoscopy for ovariectomy [43, 87–89]. While an enlarged incision is necessary for this technique, the eventual size of the incision is not dissimilar to the final incision for ovarian removal. "
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    ABSTRACT: Minimally invasive surgery in the human was first identified in mid 900's. The procedure as is more commonly practiced now was first reported in 1912. There have been many advances and new techniques developed in the past 100 years. Equine laparoscopy, was first reported in the 1970's, and similarly has undergone much transformation in the last 40 years. It is now considered the standard of care in many surgical techniques such as cryptorchidectomy, ovariectomy, nephrosplenic space ablation, standing abdominal exploratory, and many other reproductive surgeries. This manuscript describes the history of minimally invasive surgery, and highlights many of the techniques that are currently performed in equine surgery. Special attention is given to instrumentation, ligating techniques, and the surgical principles of equine minimally invasive surgery.
    10/2012; 2012:492650. DOI:10.5402/2012/492650
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    • "In a recent report on HALS for removal of ovarian tumors in horses , incisional drainage or dehiscence occurred postoperatively in 6 of 10 mares ( Rodgerson et al . 2002 ) . Incisional emphysema and edema is frequently described after standing laparoscopic ovariectomy ; infection or dehiscence are rare occurrences ( Gottschalk and van den Berg 1997 , Bouré et al . 1997 , Hanson and Galuppo 1999 , Rodgerson et al . 2001 ) . Wound healing complication was observed in one of the 5 horses recovered from ane"
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    ABSTRACT: To develop a minimally invasive, hand-assisted laparoscopic ovariohysterectomy (HALS-OHE) technique in the mare and to evaluate safety and any associated complications. Experimental study. Eight, 11-24-year-old mares with anatomically normal urogenital tracts. The surgical technique was developed in 2 non-survival mares and subsequently evaluated in 6 survival procedures. Food was withheld for 48 hours, then mares were anesthetized and positioned in dorsal recumbency for laparoscopic surgery. A hand access device (Omniport) was placed followed by 4 laparoscopic portals. Transection of the ovarian pedicles and broad ligaments was achieved using a combination of a laparoscopic stapling instrument (Endo GIA II), an ultrasonically activated instrument (Harmonic Scalpel), and endoscopic clips (Endo Clip II ML). The genital tract was exteriorized through the laparotomy, and the uterus transected and sutured in a conventional pattern. Horses were evaluated through postoperative day 14 when a necropsy was performed. Four mares recuperated well after surgery, 1 mare was euthanatized because of bilateral femur fracture during anesthetic recovery, and another developed severe pleuropneumonia. At necropsy all but 1 abdominal incision was healing routinely. One mare had abscessed along the celiotomy incision and developed visceral adhesions. Uncomplicated healing of transected mesovarial, mesometrial, and uterine remnants was observed. Ovariohysterectomy in horses can be accomplished using HALS technique. HALS-OHE technique represents a minimally invasive and technically feasible alternative for conventional OHE. Careful patient selection and preparation may reduce the complications observed. The HALS technique may be useful in other laparoscopic surgical procedures.
    Veterinary Surgery 08/2004; 33(5):487-94. DOI:10.1111/j.1532-950x.2004.04063.x · 1.04 Impact Factor
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    ABSTRACT: Diagnostic and surgical laparoscopy has become a routine procedure in human and veterinary medicine and has similar potential uses in zoological medicine. Surgical telescopes and fiberoptic cables allow the veterinarian to look inside body cavities of the patient and specialized instruments provide the ability to perform a wide variety of diagnostic and surgical procedures. Rigid laparoscopy is considered minimally invasive surgery and is associated with a more rapid post-operative recovery rate and an improved prognosis as compared to conventional surgical techniques. 3 Laparoscopic surgery is commonly being utilized in horses and other zoo animals for a variety of abdominal surgical procedures including tubal ligation and ovariectomy. 7,8,12 Recent advances in technology now provide the ability to perform laparoscopy in the largest mammalian species maintained in zoological collections. 11 A variety of disease problems and reproductive disorders have been documented in the rhinoceros and elephant. Due to their size and anatomy, many of the standard diagnostic tests available in human and veterinary medicine are not routine in these animals (radiography, advanced imaging techniques, liver biopsy, abdominal tap, etc.) at this time. Although conventional abdominal surgery has been performed in rhinoceros and elephants 1,5,10 survival rates have been extremely low. Laparoscopy can provide a variety of additional diagnostic options, and may also provide an avenue for performing surgical procedures that would otherwise be impossible in these animals.
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