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Comparison of Conventional and Laparoscopic Abdominal Cryptorchidectomy in Dogs (2008-2017)

  • Veterinary Specialty Hospital - North County


Compare short term outcomes in dogs undergoing laparoscopic and conventional abdominal cryptorchidectomy. Retrospective study. Client‐owned dogs. An electronic medical records search was performed. Inclusion criteria included dogs undergoing laparoscopic or conventional abdominal cryptorchidectomy between 2008‐2017. Twenty‐eight abdominal cryptorchidectomies were assessed; 15 were performed via laparoscopy, 13 via laparotomy. Of the 28 dogs, 7 had left sided cryptorchid testicles, 12 had right sided, and 9 bilateral. Surgical time ranged from 30 to 95 minutes (mean 53.3) for laparoscopy and 45 to 105 minutes (mean 63.5) for laparotomy. Laparotomy was associated with a higher incidence of intraoperative hypotension and hypothermia, compared to the laparoscopic group. In the laparoscopic group, 93% were discharged the day of surgery, versus 46% of those in the laparotomy group. One minor complication was observed; a seroma, in the laparoscopic group, which resolved with conservative management. Cost of surgery averaged $1045.91 and 823.92, with total bill averaging $1538.54 and 1314.23 for laparoscopic and conventional surgery, respectively. Intraoperative anesthetic complications were lower in the laparoscopic group, with equivalent surgical times and client costs between groups, which may be an important consideration in small, young dogs. Laparoscopic approach to cryptorchid testicle retrieval should be considered a safe, viable procedure with comparably excellent outcomes to open laparotomy.
Proceedings of the Veterinary Endoscopy Society
Annual Meeting, Lisbon, Portugal
May 21-23, 2018
Endoscopic Guided Use of Ultrasonic Aspirator
Technique (Sonopet
) in the Upper Airways
Preliminary Experiences
Oechtering GU, Hoehns K, Roesch S
College of Veterinary Medicine, University of Leipzig, Germany
To describe and evaluate endoscopic intervention using ultra-
sonic aspirator (UA) technique in patients with obstructive dis-
eases of the upper airways. Prospective pilot study. Client-
owned dogs and cats with upper airway obstructions. Airway
obstructions were confirmed by means of computed tomogra-
phy and/or rigid endoscopy (Hopkins-Optic, Storz). After bio-
pting, the obstructive tissue was removed with UA (Sonopet,
Strycker). We used an angled 25 kHz handpiece, in most cases
an extra-long (200 mm) tip, outer diameter 1.9 mm. All proce-
dures were performed under endoscopic guidance, the tip of
the UA introduced alongside the endoscope either trans-
nasally or trans-orally. Between June 2017 and January 2018
23 dogs and 2 cats were included. Obstruction sites were the
nasal entrance, nasal cavity, nasal exit, frontal sinus, nasophar-
ynx, larynx and trachea. The lesions involved chronic inflam-
matory tissue, tumors, scar tissue, adhesions and granulomas.
Surgery was successfully completed in all patients. The very
slim and long design of the UA is advantageous for small
entries and deeper anatomic regions. The use of angled rigid
endoscopes allowed easier handling especially during a bilat-
eral nasal approach. We regarded the broad multi-functionality
as the outstanding advantage of the Sonopet UA, providing
three key features simultaneously: flushing, suction and tissue
ablation, each separately adjustable. This made the easy
removal of both, soft and bony tissue possible.
Efficacy of Laparoscopic Assessment of the Canine
Liver and Clinical Feasibility of Hepatic
Laparoscopic Microwave Ablation in Dogs
Oramas A
, Case JB
, Toskich BB
, Zendejas I
, Alvarez WA
Giglio R
, Dark M
Department of Small Animal Clinical Sciences, University of Florida,
Veterinary Medical Center, Gainesville, Florida;
Department of
Interventional Radiology, Mayo Clinic, Jacksonville, Florida;
Intermountain Healthcare, Salt Lake City, Utah
To determine laparoscopic accessibility of individual canine
liver lobes, with emphasis on access to the hilus. To determine
the clinical feasibility of laparoscopic microwave ablation
(LMWA) in dogs. Cadaveric and clinical study. 6 cadavers and
3 canine patients. Cadavers were placed in dorsal recumbency
for laparoscopic assessment. Once the hilus of each liver lobe
was identified, a 17-guage microwave ablation probe was
inserted to create an ablation zone at the proximal aspect of the
hilus. Following assessment and ablation of each hepatic lobe,
the abdomen was opened and measurements from the center of
each ablation zone to the most proximal aspect of the corre-
sponding hilus were determined. Three dogs with clinical
hepatic disease underwent LMWA of their lesions. All lobes of
the canine liver were accessible via laparoscopy. The median
(IQR) distances from the ablation zones to the hilus for the cau-
date process, left lateral, left middle, quadrate lobe, right lateral
and right middle were as follows 2.2 (1.2-2.6), 2.1 (1-4.4), 1.5
(1.4-3.7), 2 (1-3), 1 (1-3), 2.5 (1-4.1) cm, respectively. Histopa-
thologic diagnoses treated by LMWA included metastatic
hemangiosarcoma, primary hepatocellular carcinoma and nodu-
lar hyperplasia. LMWA was applied safely to each dog and no
complications from the procedure resulted. Complete laparo-
scopic assessment of the canine liver is possible and LMWA is
clinically applicable in some dogs with hepatic neoplasia.
Single Port Laparoscopic Treatment of Ovarian
Remnant Syndrome in 10 Dogs
Singh A
, Percival A
, Gartley C
, Gatineau M
, Oblak M
, Balsa
, Case JB
, Runge JJ
, Valverde A
University of Guelph, Guelph, ON, Canada;
Centre DMV, Montreal,
QC, Canada;
University of California-Davis, Davis, CA;
University of
Florida, Gainesville, FL;
University of Pennsylvania, Philadelphia, PA
To describe the operative technique and report outcome follow-
ing single-port (SP) laparoscopic treatment of ovarian remnant
Veterinary Surgery. 2018;47:O107O118. V
C2018 The American College of Veterinary Surgeons
DOI: 10.1111/vsu.12909
syndrome (ORS) in dogs. Case series. Ten, client-owned, female
dogs. Medical records of dogs that underwent SP laparoscopic
treatment of ORS were retrospectively reviewed. Inclusion crite-
ria included dogs that had undergone a previous attempt at surgi-
cal sterilization. In all cases a commercially available, multi-
channeled, SP device was inserted in a subumbilical location.
Dogs were rotated 458into lateral recumbency to allow for
exploration of each ovarian pedicle region. Suspected ovarian
remnant tissue was resected using a vessel sealing device and
withdrawn from the SP incision. Histopathological evaluation of
resected tissue was performed. Ten dogs were included. Seven
dogs had ovarian remnants located on the right side, one dog
had left sided ovarian remnant and two dogs had bilaterally
located ovarian remnant tissue. In one dog, an additional 6mm
portal was established cranial to the SP to aid in dissection of a
massively distended uterine horn associated with the ovarian
remnant. Intraoperative complications did not occur and conver-
sion was not required in any dog. Median surgical time was 55
min (range 30-90). Histopathological evaluation revealed ovar-
ian tissue in eight dogs. In two dogs, a sex cord stromal tumor
was found. Follow-up revealed that signs related to estrus had
ceased in all dogs. SP laparoscopic treatment for ORS was feasi-
ble and successful in this cohort of dogs.
Effect of Intra-abdominal Pressue on Working
Space and Cardiorespiratory Parameters in the
Domestic Rabbit (Oryctolagus Cuniculus)
Kabakchiev C, Beaufrere H, zur Linden A, Valverde A, Singh A
Department of Clinical Studies, Ontario Veterinary College, University of
Guelph, Guelph, Ontario, Canada
To assess the effect of varying intra-abdominal pressures (IAP)
on working space and cardiorespiratory parameters in domestic
rabbits. Balanced cross-over design. 6 female New Zealand
White rabbits. Repeated latin-square designs were used to ran-
domize the sequence of IAP in anesthetized rabbits. To exam-
ine working space, a baseline (0 mm Hg) computed
tomography (CT) scan was followed by CO
insufflation at 4,
8, or 12 mm Hg, with a wash-out period between IAPs. Pneu-
moperitoneal volumes were measured from CT scans. One
week later, the following parameters were measured under
general anesthesia at IAPs of 0, 4, and 8 mmHg: mean arterial
pressure (MAP), cardiac output (CO), cardiac and stroke vol-
ume indices (CI, SVI), heart rate, end-tidal CO
), par-
tial arterial pressures of CO
and oxygen (PaCO
), and
arterial oxygen saturation (SO
). Mixed linear regression mod-
els were used to assess the effects of IAP and sequence on
working space and cardiorespiratory parameters. Based upon
evaluation CT data, there was a significant increase in working
space when IAP of 4 and 8 mm Hg were compared
(P<0.001), but not between 8 and 12 mm Hg. MAP was sig-
nificantly increased at 4 and 8 mm Hg (P50.022 and 0.016,
respectively); whereas CO, CI, and SVI were decreased at 4
and 8 mm Hg, as compared to baseline (P0.022). ETCO
was greater at each subsequent pressure (P0.003). PaCO
was increased only at 8 mmHg (P<0.01). IAP of 8 mm Hg
provides adequate working space and minimal cardiorespira-
tory alterations for laparoscopic surgery in rabbits.
Natural Orifice Transluminal Endoscopic Surgery
(NOTES) Transrectal in A Porcine Model with
Mesenchymal Stem Cell Therapy
Trindade-Gerardi AB
, Beck CAC
, Guerra PR
, Duda NC
Oliveira FS
, Gerardi DG
, Garcez TN
, Gonçalves MC
Cirne-Lima EO
, Contesini EA
Department of Animal Medicine, Universidade Federal do Rio Grande
do Sul (UFRGS), Porto Alegre, RS, Brazil;
Laboratory of Embryology
and Cell Differentiation, CPE, Hospital de Clínicas de Porto Alegre,
UFRGS, Porto Alegre, RS, Brazil
To describe and evaluate the inflammatory effects and rectal cica-
trization of transrectal NOTES access and association with mes-
enchymal stem cells in a porcine model. Experimental study. 10
swine. Pigs were randomly assigned to one of two groups:
NOTES or NOTES1MSC. The only difference between the
treatments was the use of adjuvant local stem cell therapy in the
NOTES1MSC group. Blood samples and peritoneal lavage fluid
were collected for inflammatory biomarkers analyses and micro-
biological culture, respectively. Serum concentrations of
interleukin-6 (IL-6) were determined by enzymelinked immuno-
sorbent assay (ELISA), while serum levels of C-reactive protein
(CRP) were measured by immunoturbidimetry. Albumin was
quantified in the serum and peritoneal fluid by biochemical
assays. Histopathological evaluation of the rectum was performed
by hemotoxilin-eosin (HE) and Massons trichrome stains and
not detected in any of the groups. A significant increase in the
serum albumin level (p50,03) was observed in the
NOTES1MSC group after 24h of the surgical procedure. CRP
concentrations and microbiological growth did not differ between
groups. A statistically lesser amount of inflammatory cells
(p<0,05) was noticed in the rectum muscular layer of the
NOTES1MSC group by the HE staining. Cytokine activity after
NOTES with and without local stem cells therapy is similar; how-
ever, local inflammatory cellular response is diminished in the
muscular layer of rectum with the use of mesenchymal stem cells.
Use of Laparoscopy in the Management of Intra-
abdominal Foreign Bodies in 5 Dogs
Gibson EA, Culp WTN, Mayhew PD, Balsa IM, Kim SY,
Epstein SE, Duval J.
Department of Surgical & Radiological Sciences, University of
California-Davis, Davis CA
To describe the use of laparoscopy in the management of
intra-abdominal foreign bodies and report complications and
outcomes. Retrospective case series. 5 client-owned dogs. The
medical records database was searched to identify dogs under-
going laparoscopy as part of the management of intra-
abdominal foreign bodies. Dogs undergoing laparoscopic or
laparoscopic-assisted retrieval of intra-abdominal foreign
bodies between 2011-2017 were included. Clinical data,
including complications and outcomes were recorded. Five
dogs (4 female, 1 male) met the inclusion criteria. Ages and
weights ranged from 10-120 months and 6-33 kg, respectively.
Two dogs were asymptomatic for their intra-abdominal for-
eign bodies, and three dogs demonstrated gastrointestinal-
related clinical signs. Foreign bodies were identified radio-
graphically in all dogs. Two dogs had laparoscopic removal of
intra-abdominal foreign bodies (intravenous catheter, metallic
bristle) and three dogs had laparoscopic-assisted retrieval of
gastric foreign bodies (trichobezoar, gravel, ball). The laparo-
scopic approach was performed in dorsal recumbency in all
cases, and either a 2- or 3-port technique was utilized. Surgical
time ranged from 16 to 105 minutes (median 62 minutes). All
dogs had resolution of clinical signs immediately following
surgery and were discharged the following day. No complica-
tions were reported. Laparoscopic or laparoscopic-assisted
retrieval of intra-abdominal or gastric foreign bodies was suc-
cessfully performed in this cohort of dogs. No major compli-
cations were identified and short-term outcome was excellent
in this group. A minimally invasive approach should be con-
sidered in appropriate cases diagnosed with intra-abdominal
foreign bodies.
Simplified Minimally Invasive Surgical Approach
for Prophylactic Laparoscopic Gastropexy in 21
Deroy C
, Ragetly G
, Gomes E
, Poncet C
Department of Small Animal Surgery, Centre Hospitalier Veterinaire
egis, Arcueil, France;
Department of Small Animal Diagnostic
imaging, Centre Hospitalier Veterinaire Fregis, Arcueil, France
To describe the operative technique and outcome of a simpli-
fied laparoscopic gastropexy approach in dogs. Retrospective
study. Twenty-one client-owned dogs. Dogs undergoing pro-
phylactic laparoscopic gastropexy with a simple continuous
barbed suture without incising the seromuscular layer of the
stomach and transversus abdominis muscle were reviewed.
Signalment, surgical information, length of hospitalization,
short- and long-term (minimum of 6 months) complications,
and long-term postoperative ultrasound studies were ana-
lyzed. Twenty-one cases met the inclusion criteria. In 20
cases, additional procedures were performed. One dog had
prior episode of gastric dilation without volvulus and under-
went gastropexy. The gastropexy procedure had a median
duration of 33 minutes [range 19-43 minutes]. The median
number of suture bites was 7 [6-9 bites]. V-Loc
absorbable and the V-Loc
PBT non-absorbable suturing
devices were used in 8 and 13 dogs, respectively. Minor
intraoperative complications occurred in 4 cases: broken
suture (1), needle dislodgement (2), folded needle (1). Minor
complications included self-limiting wound complications
(3), abdominal discomfort (2), vomiting (1). Postoperative
abdominal ultrasound performed after a median of 7 months
[3-36 months] confirmed permanent adhesion at the gastro-
pexy site in all dogs. One dog developed a fistula (1 year
postoperatively) and another a granuloma (3 months postop-
eratively), both at the gastropexy site. Prophylactic laparo-
scopic gastropexy can be performed with knotless
unidirectional barbed suture without creating an incision on
the abdominal wall and stomach. This method creates a last-
ing adhesion, is less challenging, and significantly reduces
the gastropexy time compared to previously reported
Comparison of Conventional and Laparoscopic
Abdominal Cryptorchidectomy in Dogs (2008-2017)
Thomson CB, Kiefer K, LaFond E
Department of Veterinary Clinical Sciences, University of Minnesota,
Saint Paul, MN
Compare short term outcomes in dogs undergoing laparo-
scopic and conventional abdominal cryptorchidectomy. Ret-
rospective study. Client-owned dogs. An electronic medical
records search was performed. Inclusion criteria included
dogs undergoing laparoscopic or conventional abdominal
cryptorchidectomy between 2008-2017. Twenty-eight
abdominal cryptorchidectomies were assessed; 15 were per-
formed via laparoscopy, 13 via laparotomy. Of the 28 dogs,
7 had left sided cryptorchid testicles, 12 had right sided, and
9 bilateral. Surgical time ranged from 30 to 95 minutes
(mean 53.3) for laparoscopy and 45 to 105 minutes (mean
63.5) for laparotomy. Laparotomy was associated with a
higher incidence of intraoperative hypotension and hypother-
mia, compared to the laparoscopic group. In the laparoscopic
group, 93% were discharged the day of surgery, versus 46%
of those in the laparotomy group. One minor complication
was observed; a seroma, in the laparoscopic group, which
resolved with conservative management. Cost of surgery
averaged $1045.91 and 823.92, with total bill averaging
$1538.54 and 1314.23 for laparoscopic and conventional
surgery, respectively. Intraoperative anesthetic complications
were lower in the laparoscopic group, with equivalent surgi-
cal times and client costs between groups, which may be an
important consideration in small, young dogs. Laparoscopic
approach to cryptorchid testicle retrieval should be
considered a safe, viable procedure with comparably excel-
lent outcomes to open laparotomy.
Using Vaginal Cannula in Natural Orifice
Transluminal Endoscopic Surgery (NOTES) and
Using Transvaginal Access for Ovary Extraction
(NOSE) in Healthy Mares Subjected to
Laparoscopic Ovariectomy
Beck, CAC
, Merini, LP
, Gerardi, ABT
, Brun, MV
Faculdade de Veterin
aria da Universidade Federal do Rio Grande do
Sul, Porto Alegre, Rio Grande do Sul, Brasil
To check the practicality of the vaginal cannula in performing
transvaginal access to the abdominal cavity through the NOTES
technique in standing healthy mares and assess the vaginal
access as an canal extraction of specimens (NOSE) in mares
subjected to laparoscopic ovariectomy. A pilot study. Six
healthy mares. The mares were sedated with detomidine hydro-
chloride and to perform the low epidural, lidocaine hydrochlor-
ide was used. The vaginal incision was performed dorsally to
the cervix at 12 oclock position. Using a round-tipped vaginal
cannula, an indirect visualization of the pelvic and abdominal
cavity was performed through a flexible endoscope inserted
into the cannula. The ovaries were removed through the vagina
in five of the six mares used in the experiment (NOSE). In one
of the animals, the ovary had to be sectioned and removed
through the flank incision, increasing the incision of the laparo-
scopic work channel performed during the ovariectomy proce-
dure. The NOTES vaginal procedure using a 50 cm rigid
cannula to access the abdominal cavity, with posterior ovarian
extraction (NOSE) after laparoscopic ovariectomy in healthy
mares, proved to be viable and safe without post-surgical com-
plications in the six animals of the study.
Transvaginal Laparoscopic Ovariectomy in Dogs:
30 cases (2016-2017)
Arntz GJ
Veterinary Clinic Beneden Leeuwen, the Netherlands
To describe the surgical technique and outcomes of a relatively
new surgical approach (Natural Orifice Transluminal Endoscopic
Surgery) for ovariectomy in dogs using minimally invasive sur-
gery. Retrospective study. 30 female dogs with a body weight of
10-33 kg in good physical condition and at least 6 months old.
The dogs were anesthetized and placed in dorsal recumbency.
The abdomen was accessed using an endovideo-assisted cannula
inserted through the cranial vaginal wall. The ovarian pedicles
were dissected using a rigid surgical endoscope with a working
channel and an ultrasonic dissecting shears. The ovarian pedicles
were removed through the cannula. All dogs were released from
the hospital two hours after the procedure. Mean surgery time
was 35 610 minutes. Anesthesia and surgery were without com-
plications in all animals. No postoperative complications were
noted in any dog. Aftercare consisted of oral carpofen 2 mg/kg
q12each for three days. Initial findings suggest that transvaginal
laparoscopic ovariectomy may reduce the risk of complications
during and after surgery as compared to conventional ovariec-
tomy and transabdominal laparoscopic ovariectomy and may
reduce post-operative care and shorten recovery time.
Evaluation of the Role of Bronchoscopy in the
Surgical Management of Confirmed Intrathoracic
Plant Awn Migration
Gibson EA
, Giuffrida M
Johnson LR
William R. Pritchard Veterinary Medical Teaching Hospital;
of Surgical and Radiological Sciences; University of California, Davis;
Department of Medicine and Epidemiology; University of California,
To report outcomes and describe the use of bronchoscopy,
computed tomography (CT), and surgical exploration in the
management of dogs diagnosed with intrathoracic disease sec-
ondary to migrating plant awns. Retrospective case series. 26
client-owned dogs. Medical records from 2008-2017 were
reviewed and data recorded. Dogs were included if thoracic
CT scan, bronchoscopy and thoracotomy were performed in
the clinical management of intrathoracic disease secondary to
confirmed migrating plant awn. Twenty-six dogs met the
inclusion criteria and included 10 males and 16 females. Mean
age was 45 626 months and median weight was 29 kilograms
(range 7 to 43 kg). Plant awns were identified bronchoscopi-
cally in 10 of 26 (38%) dogs and a total of 35 plant awns were
removed. Plant awns were retrieved bronchoscopically from
the right middle and accessory lobe combined (21), left lobe
(10) and right caudal lobe (4). Mean duration of bronchoscopy
was 40 615 minutes and no complications were reported. Sur-
gical approach included sternotomy, lateral thoracotomy, or
thoracoscopy. Additional plant awns were identified surgically
(18 of 26 dogs) and/or histopathologically (9 of 26 dogs).
Twenty-four dogs survived to discharge. Of the 2 non-
survivors, one dog suffered cardiopulmonary arrest secondary
to septic shock and one dog was euthanized due to persistent
post-operative pneumothorax. Bronchoscopy was a useful
adjunctive diagnostic and therapeutic modality for dogs in
which migrating plant awn was suspected. This procedure was
well tolerated and short-term outcomes were excellent.
Effect of Hypotension on Tissue Perfusion During
Laparoscopy in Dogs
Monnet E
and Hazenfield K
Colorado State University, Fort Collins, CO;
Kansas City, KS
Evaluate the effect of hypotension on organ perfusion during
laparoscopy in dogs. 14 purpose bred dogs. Dogs were ran-
domly assigned to either a laparoscopy (LAP) group or a no-
laparoscopy (NLAP) group. In each group, blood flow of
abdominal organs and myocardium was measured at baseline
and after induction of hypotension. Colored microspheres
were used to measured blood flow. Arterial blood pressure
and heart rate were recorded. Hypotension was induced with
intravenous administration of acepromazine. The dosage was
adjusted until the mean arterial pressure was below 60 mm
Hg. Intra-abdominal pressure was set at 13 mm Hg for the
laparoscopy group. Mean arterial pressure was significantly
decreased from 77.6 1/210.4 mmHg to 43.7 1/24.2
mmHg (p50.0402) in the NLAP group and from 68.7
1/28.2 mmHg to 46.3 1/28.5mmHg(p50.0012) in the
LAP group. Blood flow was not significantly reduced by
hypotension in any abdominal organ in the NLAP group.
Blood flow was significantly reduced in the jejunum
(p50.046), pancreas (p50.0195), spleen (p50.039), and liver
(p50.0156) in the LAP group after induction of hypotension.
Median myocardial blood flow was 2.1 ml/mg/min (range:
1.50-3.80 ml/gm/min) at baseline and 0.65 ml/mg/min (range:
0.10-1.50 ml/gm/min) after induction of hypotension in the
LAP group (p50.0313). Hypotension induced a significant
reduction of blood flow in jejunum, pancreas, spleen and liver
during laparoscopy. Myocardial blood flow is also affected
when hypotension is induced during laparoscopy.
Determination of the Location of the Disk
Material that Could be Retrieved with a
Hemilaminectomy Performed with an Integrated
Endoscopic System in Dogs
Drury AG, Monnet E, Packer RA, Marolf, AJ
Colorado State University, Fort Collins, Co.
To define the location of the herniated disk that can be suc-
cessfully accessed with an integrated endoscopic system
based on presurgical CT scan Experimental, controlled,
randomized cadaveric study. Six medium sized dog cadavers
that had been euthanized for reasons other than this study.
Hemilaminectomy was performed with an integrated endo-
scopic system at T11-12, T12-13, L1-2, and L2-3 on the left
and right side on each dog. Hemilaminectomies were ran-
domly performed with a 19 or a 23 mm cannula. The entire
procedure, including soft tissue dissection, hemilaminectomy
and spinal cord manipulation, was performed through the
cannula. Afterward, the spines were imaged by CT scans to
measure the cranial and caudal extents of the hemilaminec-
tomy from the center of the disk space. The cranial extent of
the hemilaminectomy was 4.5 1/21.4 mm for the 19 mm
cannula and 5.6 1/21.4 mm for the 23 mm cannulas
(p50.0757). The caudal extent of the hemilaminectomy was
9.5 1/22.2 mm for the 19 mm cannula and 10.3 1/2
1.6 mm for the 23 mm cannula (p50.206). The mean length
of the hemilaminectomy was 13.0 1/21.5 mm for the
19 mm cannula and 15.0 1/22.1 mm for the 23 mm can-
nula (p50.022). Integrated endoscopic system can be used to
perform an hemilaminectomy in dogs to retrieve herniated
disc materials if they are in an appropriate location. CT scan
will be required to determine which disc can be reached with
a minimally invasive approach.
Prevalence of Subclinical Gastroenteropathy in
Adult Canine Patients With Foreign Body
Martínez-Gomariz F
, Casas DL
anchez C
erez Duarte FJ
Gutierrez J
, Batalla M
C.V. Bonafe-CMEV-Murcia;
CVMIC-Las Palmas;
Endoscopia Veterinaria Movil-Barcelona. Espa~
To describe the existence of a possible relationship between
the aberrant ingestion of foreign bodies in animals with no
previous gastric symptoms and the subclinical presence of
any gastric or intestinal disorder. Retrospective study: Remit-
ted cases with previous radiologic and or ultrasound evi-
dence of foreign body presence. 25 dogs of different breeds
and sizes, all of them more than 5 years old. The symptoms
were changes in their eating habits and sporadic vomits with
progressive evolution. The foreign bodies removal was per-
formed by videoendoscopy. After the procedure the gastric
and intestinal mucosa were assessed and biopsies were taken
from the descendent duodenum, antrum and body of the
stomach. The samples were sent to our reference laboratory
for their anatomopathological study. The biopsies revealed a
subclinical mild to moderate lymphoplasmocitic gastroenter-
opathy in 13 (52%) of the 25 patients evaluated, accompa-
nied by a mild to moderate lymphoplasmocitic duodenitis in
7 of them. In 1 of the patients the diagnosis was acute gastri-
tis due to Helicobacter pylori. There is a high prevalence of
subclinical lymphoplasmocitic gastroenteropathy in patients
older than 5 years treated for foreign body ingestion. In these
cases biopsies should be taken.
Single-port Laparoscopic-assisted
Ovariohysterectomy in the Bitch Using A Modified
Glove-Port Technique
Bydzovsky N, Bockstahler B, Dupré G
Clinic for small animal surgery, Department for small animals and
horses, University of veterinary medicine, Vienna
To evaluate the feasibility, the complicationsand conver-
sions rate of a laparoscopic-assisted ovariohysterectomy
(LOHE) in dogs using a modified glove-port technique and
to compare it with previously published laparoscopic techni-
ques. Prospective clinical trial and meta-analysis. 42 healthy
female dogs. In a homemade single-port made of a 6,5 sterile
surgical glove, two 5 mm and one 10 mm cannulas were
placed. The glove was secured to an Alexis wound retractor
placed through a 2,5-3 cm incision managed in the caudal
third of the abdomen. A 5 mm 308scope, a 5 mm grasping
forceps and a 10mm Ligasure device were introduced and
LOHE was performed. After exteriorization of the uterus, the
cervix was sealed and the abdominal wound was closed rou-
tinely. Conversion and complicationsrate and total opera-
tion time were compared to those of previously published
studies. No conversion and no major complications occurred.
Sword fighting and operators interference were reported.
Minor wound complications happened in 12/42 cases. The
median total operation time was 24 minutes (range from 17.5
to 39.5 minutes, mean 25.73 min, SD 6.12) and was less
than in any other previously reported study for LOHE in
dogs. LOHE in dogs can be performed safely and fast using
the modified glove-port technique.
Feasibility of the Single-Incision Subxiphoid
Approach for Video-assisted Thoracoscopic
Surgery in 3 Dogs
Brissot H, Gordo I, Hubers M, Bird F
From Pride Veterinary Centre. Derby. United Kingdom
To evaluate and describe early results of an alternative tech-
nique for video-assisted thoracoscopic surgery (VATS) in
dogs using a single-incision subxiphoid approach.
Prospective case-series with three different clinical sce-
narios. An 11yo Standard Poodle with spontaneous pneumo-
thorax due to diffuse bullae underwent mechanical
pleurodesis. A 10yo Labrador Retriever with recurrent idio-
pathic pericardial effusion was submitted to pericardectomy.
A 12yo Labrador with a retained swab after thoracotomy.
Approach in dorsal recumbency based on reported techni-
ques in canine models using a 3 to 4-cm incision over the
xiphoid process, which was then excised. A tunnel was cre-
ated toward the pleura, and the access was maintained with
an AlexisTM wound retractor. Thoracic exploration was per-
formed with a 10mm 308or 5mm 08laparoscope. One-lung
ventilation with a bronchial blocker was used in 2 cases.
Mechanical abrasion pleurodesis of the costal pleura was per-
formed with a rough pad. Subtotal pericardectomy and swab
retrieval were facilitated by dissection using a vessel sealing
device. The approach was closed routinely after placement
of a thoracostomy tube. The planed surgery was successfully
completed within 65 minutes (55-65 minutes). No complica-
tions were encountered. It allowed easy and adequate
visualization of the intra-thoracic structures. Post-operative
pain scores were 1-4/24 (Short Form of The Glasgow Com-
posite Pain Scale) in the first 24 hours. Single-incision subxi-
phoid approach can be performed successfully and in an
efficient manner in dogs. Additional studies are required to
further characterize its advantages and different applications
compared to the conventional techniques.
Determination of Optimal Location for
Thoracoscopic-Assisted Pulmonary Surgery for
Lung Lobectomy in Dogs
Scott J
, Singh A
, Case JB
, Mayhew PD
, Runge JJ
Ontario Veterinary College, University of Guelph, Guelph, Canada;
College of Veterinary Medicine, University of Florida, Gainesville, FL;
School of Veterinary Medicine, University of California-Davis;
of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA
To determine optimal intercostal space (ICS) to perform
thoracoscopic-assisted pulmonary surgery (TAPS) lung
lobectomy. Six, mature, canine cadavers. The cadavers were
placed in right or left lateral recumbency. A 15 mm thoraco-
scopic cannula was inserted in the middle third of the 9 or
intercostal space (ICS). Wound retraction devices
(WRD) were placed into 7 cm mini-thoracotomy incisions
created in the middle third of the following ICSs: 4-7 on left
side and 4-8
on the right side. The pulmonary ligament was
sectioned using a combined intra- and extra-corporeal tech-
nique. Each lung lobe was sequentially withdrawn from the
WRD at the respective ICS and side. A 30 mm thoracoabdo-
minal (TA) stapler was positioned to simulate lung lobec-
tomy and the distance from the stapler anvil to the hilus was
measured (cm). Median weight of dogs was 25.0 kg (IQR,
23.5, 32). Simulated TAPS lobectomy performed at left or
right ICS 4 and 5 compared to other intercostal spaces
resulted in a significantly shorter median distance from the
stapler anvil to the hilus of the left cranial, caudal and right
cranial and middle lung lobes, respectively (all P<0.05).
Lobectomy at right ICS 5 or 6 resulted in a significantly
shorter median distance from the stapler anvil to the hilus of
the right caudal and accessory lung lobes, respectively (both
P<0.05). These data may inform mini-thoracotomy position-
ing to optimize tumor margin excision during TAPS lung
lobectomy for treatment of lung cancer in dogs.
The Short-Term Outcome of Laparoscopic
Cholecystectomy in 76 Dogs
Kanai H
, Hagiwara K
, Nukaya A
, Kondo M
, Aso T
Kanai veterinary surgery;
Department of Digestive Surgery, Nihon
University School of Medicine;
Aya Animal Hospital;
Apple tree animal
Animal Medical Center ALOHA;
Study group of Small Animal
Minimal Invasive Treatment (SAMIT)
To describe laparoscopic cholecystectomy in 76 dogs who
underwent laparoscopic cholecystectomy (LC) for gall bladder
diseases; mucocele, cholecystitis and cholelithiasis from 2008 to
2016. Cases with jaundice, gall bladder rupture and ascites were
not excluded from indication of LC in this study. Since 2012,
our procedure has been evolving step by step. We started the
anterograde LC prior to transection of cystic duct. In the case of
high probability of common bile duct (CBD) injury or bleeding
from the liver as a result of dissecting cystic duct, we dissected
the gall bladder firstly without attempting to secure cystic duct
by force. In addition, we routinely performed a dissection fol-
lowing the subserous layer of gall bladder wall. These procedure
contributed to prevent injury to cystic duct and CBD, and bleed-
ing from hepatic fossa during dissection. A Cholangiography
was performed laparoscopically to confirm the status of CBD as
a matter of routine. LC was successfully completed in 71 dogs
(93%). The median age was 11 years old and the median body
weight was 5.3 kg. 50% of case had no symptom. The median
operative time was 124 minutes. Cholangiography was per-
formed in 57 cases (75%). There are 3 cases (4.1%) that were
converted to open cholecystectomy. There were intraoperative
death in 2 cases (2.6%) and death within one week after opera-
tion in 2 cases (2.6%). Two cases required re-operation. Laparo-
scopic cholecystectomy may be safe and feasible considering
operative indication and as an appropriate procedure.
Comparison Between Open and Endoscopic
Procedures for Treatment of Idiopathic
Chylothorax in Dogs
Ishigaki K
, Sakurai N
, Horikirizono H
Asano K
Department of Veterinary Medicine, College of Bioresource Sciences,
Nihon University, Fujisawa, Kanagawa, Japan
To compare the outcomes between endoscopic (thoracoscopic
thoracic duct clipping and pericardectomy, and laparoscopic
cisterna chyli ablation) and open procedures (open thoracic duct
ligation, pericardectomy, and cisterna chyli ablation) for the
treatment of idiopathic chylothorax in dogs. A retrospective
study. Nineteen client-owned dogs. Medical records of dogs
with idiopathic chylothorax that underwent open or endoscopic
procedures were reviewed. In the open procedures, thoracic
duct ligation was performed via caudal intercostal thoracotomy,
followed by pericardectomy via the same approach or cranial
intercostal thoracotomy in left lateral recumbency; subse-
quently, cisterna chyli ablation was performed via midline celi-
otomy in dorsal recumbency. In the endoscopic procedures,
thoracoscopic duct clipping was performed via 3 portals each in
the right and left caudal hemithorax, followed by laparoscopic
cisterna chyli ablation via 2 3 portals in the left flank in ventral
recumbency; subsequently, thoracoscopic pericardectomy was
performed via 3 portals in dorsal recumbency. Eleven and 8
patients underwent open and endoscopic procedures with a
median operation time of 184.0 and 240.0 min, respectively.
The operation time had no significant difference between open
and endoscopic procedures. Major intraoperative complications
were not observed in both procedures. After the open proce-
dures, 9 patients had no pleural effusion, 1 had modified transu-
date effusion, and 1 showed no improvement in chyle
accumulation; whereas, after the endoscopic procedures, pleural
effusion disappeared in all patients. Endoscopic procedures are
potentially more effective than open procedures for the treat-
ment of idiopathic chylothorax in dogs.
Endoscopic Laser Surgery as Adjuvant Therapy
for Residual Nasal Neoplasia Following Curative-
Intent External Beam Megavoltage Radiation
Therapy in Dogs
Van Stee LL, Zandvliet MMJM, van Nimwegen SA
Department of Clinical Sciences of Companion Animals, Faculty of
Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
To prospectively evaluate feasibility, effectiveness, complica-
tions, and long-term follow-up of minimally invasive rhinoscopic
laser ablation of residual intranasal neoplasia after previous cura-
tive intent external beam megavoltage radiation therapy in dogs.
Prospective feasibility study in dogs with residual intranasal neo-
plasia after curative intent radiation therapy. 13 client-owned
dogs. Dogs with residual/recurrent intranasal tumor on follow-up
CT evaluation 3 months after radiation therapy were offered sur-
gical reduction/removal of the mass by laser ablation (1064 nm
Nd:YAG or 1470 nm diode) through a normograde or retrograde
rhinoscopy approach. Additional follow up diagnostic imaging
and/or rhinoscopy, and repeated laser surgery if indicated, were
performed at the courtesy of the owner. Thirteen dogs were
accrued between 2013-2017. Male:female ratio 1.2:1, median
age 9 years (range 6-14). A median of 3 laser surgery sessions
were performed (range 1-6). Median survival time was 481 days
(range 174-1250), with 4 dogs currently alive. Clinical signs post
laser ablation were considered mild and included mucoid dis-
charge (n511), mild epistaxis (n510) and sneezing (n58).
Repeated treatment sessions did not increase the risk for side
effects. Rhinoscopic laser ablation of residual intranasal neoplasia
following radiation therapy is a feasible and repeatable adjunctive
therapy providing mass reduction and improved quality of life.
Ovariectomy in Dogs by Hybrid and Total
Transvaginal Notes: A Cardiorespiratory,
Hemogasometrics and Cortisol Levels Evaluation
Linhares MT
, Martins LR
, Martins AR
Machado-Silva MA
, Teixeira LG
, Libardoni, R
,Brun MV
Researcher of CNPq-Brazil (308019/2015-
To compare cardiopulmonary parameters, hemogasometry and
cortisol in ovariectomy by hybrid (HNG) and total (TNG)
transvaginal NOTES. Prospective randomized clinical trial
(Research Ethics Committee- CEUA/UFSM- 120/2011). 16
female dogs. Animals were assigned to the TNG (n58) and
HNG (n58). A transvaginal 10-mm operative laparoscope
was used in TNG. A 6-mm abdominal port and a vaginal 11-
mm trocar were used in HNG. Heart rate (HR), respiratory rate
(f), rectal temperature, systolic, mean and diastolic arterial pres-
sures (SAP, MAP, DAP) were assessed before administering
preanesthetic medication (PM), 15 minutes after anesthetic
induction and at every 10 min. throughout the surgery, imme-
diately after extubation (AE) and, then, at 2, 4, 6, 12, 24 and
72 hours. Blood gas analysis and serum cortisol were meas-
ured before PM, and at AE, 6, 12, 24 and 72 hours. HR, fand
rectal temperature were similar between groups as was blood
arterial pressure, except for MAP 2h after surgery
(TNG5111 618/HGN595 610; p50.045). After extubation,
mild respiratory acidosis was observed in both groups (pH:
TNG57.32 60.03/HGN57.3 60.05; PCO
:TNG543.79 6
5.77/HGN543.05 68.27), without statistical significance.
Cortisol values were not different in the different time points
of evaluation. Both techniques presented similar global results
in these analyses. They provide minimal impact on cardiores-
piratory, serum cortisol and blood gas parameters.
Canine Ovariectomy by Hybrid or Total
Transvaginal NOTES: Technical Feasibility Study
and Pain Assessment
Linhares MT
, Feranti JPS
, Coradini GP
, Martins LR
, Martins
, Sarturi VZ
, Gavioli FB
, Machado Silva MA
, Ataíde
, Teixeira, LG
, Brun MV
Researcher of CNPq- Brazil (308019/2015-6, 200346/2017-2)
To compare technical feasibility, surgical time, complications
and postoperative pain in ovariectomy by hybrid (HNG) and
total (TNG) transvaginal NOTES. Prospective randomized
clinical trial. 16 bitches. Patients were assigned to the HNG
(n58) and TNG (n58). A 5-mm abdominal port and a vaginal
10-mm trocar were used in HNG. A transvaginal 10-mm oper-
ative laparoscope was used in TNG. Pain was assessed before
surgery and at 2, 4, 6, 12, 24, and 72h after extubation, using
the visual analogue (VAS) and Melbourne pain scales. Surgical
time did not differ between the groups (HNG546.25 618.46
min.; TNG554.625 631.07 min.; p50.5229). Retrieval of the
ovaries through the vaginal wound was the most challenging
step. One splenic puncture and a case of subcutaneous were
reported on HNG. Complications on TNG included mild vul-
var edema (all patients) and mild vaginal bleeding (two dogs,
for 12 and 72 hours) and dysuria (one patient, for 48 hours).
No dogs required rescue analgesia at any time point. Groups
did not differ regarding post-op pain, except for VAS at 72h
(HNG51.11 60.29 and TNG50.68 60.37; p50.0221). Both
NOTES approaches were feasible for canine ovariectomy and
required no additional analgesia.
Thoracoscopic Extirpation of Sternal Lymph
Nodes in Dogs
Oblak ML
, Mayhew PD
, Case JB
, Singh A
, Brisson BA
University of Guelph, Guelph, ON, Canada,
University of California-
Davis, Davis, CA,
University of Florida, Gainesville, FL
To describe the use of thoracoscopy for extirpation of
enlarged sternal lymph nodes (LN) in dogs. Multi-
institutional, case series. Nine, client owned dogs. Medical
records were retrospectively evaluated for dogs that had
undergone thoracoscopic sternal lymphadenectomy and data
collected included primary diagnosis, imaging performed,
LN size, surgical approach, extraction method, complica-
tions, if conversion to open thoracotomy (OT) was required
and LN histopathology. Nine dogs were included. Primary
diagnoses included neoplasia (anal sac (2), thoracic body
wall, pleura, abdomen, lymphoma or unknown), chylothorax
or pyothorax. Preoperative CT was performed in all cases
and LN ranged in size from 8-40mm. Dogs were placed in
dorsal recumbency with a transdiaphragmatic 5mm camera
port (8) or lateral recumbency (1). Two (67%) to three (33%)
instrument ports were used with ports both ipsilateral and
contralateral to the LN being removed. One lung ventilation
was used in two cases. Lymphadenectomy was performed
with a combination of blunt dissection, 5mm vessel sealing
device and endo-peanuts. Retrieval was through an existing
port or with a specimen retrieval bag and port enlargement
as necessary to facilitate removal. Surgery times ranged from
45 to 250 minutes with concurrent procedures including peri-
cardectomy, thoracic duct ligation, exploratory laparotomy
with mass excision, abdominal lymphadenectomy and anal
sac excision. No complications were reported and conversion
to OT was not required in any case. Histopathology revealed
metastatic neoplasia (7) and reactive lymphadenitis (2).
Thoracoscopic extirpation of enlarged sternal lymph nodes
in dogs can be performed with minimal complications.
Comparison of LESS Approach Using A New
Handmade Multiport and Open Ovariectomy in
Machado-Silva MA
, Pedrotti LF
, Pardilha AS
, Schimdt JT
Bordin TG
, Costa D
, Libardoni RN
, Ataíde MW
, Brun MV
Teixeira PPM
UFG-Brazil, PPGMV/UFSM, Researcher of CNPq-Brazil (460892/2014-
To assess pain, serum cortisol and surgical aspects of LESS
approach using a low-cost handmade multiport device and
conventional technique for ovariectomy (OVE) in bitches. A
prospective double-blinded study. 20 healthy bitches. Hand-
made LESS access device was assembled by covering an eth-
ylene polytereftalate cone and a ring made of no.8 urinary
catheter with a latex balloon. Two 5-mm trocar sleeves were
attached to the device for scope and instrument use. The LESS
access (n510) was established at the pre-pubic area through a
1.5-cm celiotomy. LESS-OVE was performed using tacking
suture and bipolar electrocoagulation and transection tech-
nique. Open-OVE (n510) was carried out using standard tech-
nique. Pain was scored by two-blinded observers, using visual
analog (DIVAS) and Glasgow (SF-GCPS) scales. Pain scores
and serum cortisol were compared between baseline and post-
op moments (1, 2, 4, 8, 16 and 24 hours). Surgical time and
complications were compared between groups. There was no
significant difference (p50,3719) regarding surgical time
between LESS-OVE (23,4 66,4 min) and open-OVE (21.5 6
1.5 min). No complications occurred in both groups. LESS-
OVE had no significant increase in post-op serum cortisol
(p50,7745). Open-OVE presented raised cortisol at 1, 2 and 4
hours post-op (p<0.0001). DIVAS and SF-GCPS post-op
scores were higher than baseline values at 1, 2 and 4 hours in
LESS-OVE (p<0.05) and in all time points in open-OVE
(p<0.0001). LESS ovariectomy using a low-cost handmade
multiport device is as safe and time-consuming as conventional
technique, while triggering less postoperative pain and stress in
Comparative Study Between Laparoscopic
Assisted and Conventional Cystotomy in Dogs
Nadkarni NN, Pawar AA, Varun V and Manjure NC
Happy Tails Healthcare Services, Neelkanth Gardens, Govandi (East),
Mumbai, Maharashtra 400088, India
Clinical study. Two groups with 6 animals in each group.
Laparoscopic Assisted cystotomy (Group I), the camera port
was established at the umbilicus through which the bladder
was visualized using a laparoscope. A second working trocar
was then inserted anterior to the penis to exteriorize the blad-
der using laparoscopic Babcock forceps. After performing a
360 degree cystopexy, an incision was made on it and the
same laparoscope along with a suction/irrigation probe was
used to visualize and remove the calculi within the bladder.
Cystotomy by conventional method (Group II), the incision
was made either parapreputial or ventral midline depending
on the sex of the animal, the bladder was exteriorized and
calculi removed with a gloved finger after incising the blad-
der. Surgical time was 106.33 63.07 minutes in Group I and
82.66 66.18 in Group II. Significantly more time was
required in the laparoscopic assisted method. Postoperative
pain scores were 0.45 60.07 and 1.70 60.17 in Group I and
II respectively, showing significant difference. Incision
lengths in Group I and Group II were 1.9 60.28 cm and
6.13 60.47 cm respectively. More intra and postoperative
complications were observed in Group II. Laparoscopic
assisted cystotomy was more time consuming. However it
provided lesser intra and postoperative complications, lesser
pain, smaller incisions. Thus, laparoscopic assisted cystot-
omy can be used as an alternative to routine cystotomy as it
also provides better visualization and is more aesthetic.
Prophylactic Laparoscopic Gastropexy by Total
Intracorporeal Suturing: Our Experience
Properzi R, Boschi P
Studio Medico Veterinario Properzi, Rapallo (GE) Italy
Describing the technique of laparoscopic gastropexy
obtained by unidirectional self-locking barbed suture with
needle holder. Retrospective. 70 dogs from breeds predis-
posed to GDV. Anesthetized patients are placed in reverse
Trendelenburg. Three ports are identified. T1, in right para-
median position 2-3 cm caudally from the sternal xiphoid
apophysis, is used to create the pneumoperitoneum and insert
the optics. T2, 2-3 cm caudally from the navel on the alba
line. T3 on the alba line between the first two. The self-
locking barbed suture is inserted in the abdomen with a lapa-
roscopic needle holder through T2. A second needle holder
is inserted in the abdomen through T3. Suture is started 5 cm
cranially from the pyloric antrum, between the big and the
small stomach curves. The stomach is anchored at TVA
level, in right paracostal position. The first two suture cycles
ensure adherence of the gastric to the abdominal wall. The
peritoneum is cut with a monopolar electrical hook. After
each cycle the thread is tensioned so that the gastric wall
adheres to the abdominal wall. The suture is reinforced with
a clamp also acting as landmark in the follow-up echogra-
phy. Surgery duration was approximately 20 minutes. No
long-term or intrasurgical complications occurred. Minor
complications in 6 dogs consisted of seroma formation.
Out of 45 dogs submitted to follow-up echography, 43
showed pexys formation. This technique boasts short times,
total intracorporeal suturing and minor complications.
Long-Term Follow-Up After Laparoscopic
Castration, A Prospective Study
Libermann SV
, DVM, Diplomate DESV, Bonneau LH
, DVM,
Audrey Gautherot
, DVM, Etienne-Raffestin CL
AP, Diplomate ECVP, Coste M
, DVM, Etchepareborde S
DVM, PhD, Diplomate ECVS
CHV Cordeliers, Meaux, France;
Laboratoire Idexx, Maisons Alfort,
To report short-term and long-term outcomes and complica-
tions associated with laparoscopic castration in a cohort of
owned dogs; and to validate long-term suppression of testos-
terone. Prospective non-randomized study. Intact male dogs
(n524). Dogs were divided into two groups: Laparoscopic
castration (LC) and Conventional castration (CC). Laparo-
scopic castration was achieved using a two port approach
and a vessel sealing device to transect testicular blood supply
and ductus deferens. For each group, postoperative pain was
evaluated after 1, 7, 48 hours and 5 days. Serum testosterone
concentration was measured preoperatively, 6 months and 1
year postoperatively. Testicular volume was assessed preop-
eratively, 5 days and 6 months postoperatively. LC surgical
time ranged between 12 and 45 minutes (median: 15 min).
One minor and one major intraoperative complication
occurred. Postoperative testosterone concentration was sig-
nificantly decreased in all dogs; values of LC 1 year postop-
eratively were not significantly different from CC (<1ng/
mL). Testicular volume evolution was first marked by a sig-
nificant enlargement 5 days postoperatively in 75% of dogs,
followed by a significant reduction at 6 months postopera-
tively. Overall, there was no significant difference in pain
scores between CC and LC. LC is a reliable technique to
achieve testosterone suppression and neutering and deserves
further studies including larger cohort and longer follow-up.
Two-Stage, Endoscope-Guided Translaryngeal
Approach to the Spenopalatine Sinus in Horses
McCarrel TM, Freeman DE, Gordon-Porter E, Moore N
College of Veterinary Medicine, University of Florida, Gainesville, FL
To assess safety and feasibility of a two-stage approach to
the sphenopalatine sinus (SPS). In vivo terminal study. 6
horses were sedated and the dorsal pharyngeal mucosa on
the left side from the dorsal pharyngeal recess to the ventral
aspect of the ethmoturbinates was ablated using a transendo-
scopic diode laser to cause mucosal sloughing on the floor of
the SPS. Three days later, horses were anesthetized, posi-
tioned in right lateral recumbency, and intubated through a
tracheotomy. A laryngotomy was performed to allow intro-
duction of a custom long shank carbide burr under transnasal
endoscopic guidance. The burr was used to remove denuded
bone on the floor of the sphenopalatine sinus and the sinus
cavity explored endoscopically. Horses were euthanized and
CT and gross post mortem of the head performed to assess
injury to critical structures. All horse had complete ablation
of pharyngeal mucosa and exposure of bone on the floor of
the SPS. Access to the SPS was successful in all cases and
there was no inadvertent trauma to critical structures. The
transnasal endoscopic approach permitted access to the sphe-
noidal portion of the sinus, while the translaryngeal endo-
scopic approach permitted access to the maxillary sinus
through the palatinomaxillary aperture. Two horse experi-
enced significant hemorrhage due to inadvertent contact of
the burr with remote pharyngeal mucosa. The approach
described provides safe access to the SPS in the horse. Clini-
cal cases with SPS disease previously considered inaccessi-
ble may benefit from this approach.
Evaluation of Andiroba Oil (Carapa guianensis) as
an Anti Adhesion Substance in Laparoscopic
Procedures in the Genitourinary Tract of Sheep
Barbosa, AEC
, Santos, GMA
, Borges, LPB
, Guilherme, BC
Morais, HLM
, Siqueira, LS
, Bezerra, DKO
, Oliveira RA
Rossy, KC
, Frachi, CJ
, Albuquerque, RS
, Silva, MAM
Teixeira, PPM
Veterinary Institute, Veterinary Medicine College, Para Federal Universit
(UFPA), Campus II, Castanhal, Par
a, Brazil
Evaluate through laparoscopy the effect of andiroba oil (Car-
apa guianensis) applied in the uterine horn and ovary of
sheep to avoid genitourinary adhesions. Experimental study.
8 ewes. Animals were divided into two groups: control group
(GC, n54), with no anti adhesion treatment; and treatment
group (GA, n54), which animals were treated with the appli-
cation of andiroba oil. Through laparotomy, adhesions were
induced by bipolar diathermy method, which three cauteriza-
tion points were performed in the right uterine horn and one
in the right ovary. In the treatment group, andiroba oil was
placed in the cauterization points. After fifteen days, all ani-
mals underwent exploratory laparoscopy, with the realization
of 3 portals to introduce the endoscope and atraumatic for-
ceps. Manipulating the uterus and ovary with the forceps,
adhesiolysis were performed and adhesion degree were clas-
sified. Both groups presented adhesions, however with lower
quantity in GA (p>0,05). Adhesiolysis was easier to perform
in GA than in GC, showing that the andiroba oil had a posi-
tive effect. Andiroba oil did not prevent adhesions but
formed a barrier that could decrease the adhesion strength
when compared to GC (p <0.05) and the adhesion was less
traumatic. Adhesiolysis through laparoscopy showed to be a
helpful method to disrupt the affection.
Efficacy of Vaproized Hydrogen Peroxide for
Repeated Sterilization of A Single-Use Single-
Incision Laparoscopic Surgery Port
Scharf VF
, Dent B
, Jacob ME
, Moore B
College of Veterinary Medicine, North Carolina State University,
Raleigh, NC
To determine the ability of vaporized hydrogen peroxide
(VHP) to sterilize a single-use single-incision laparoscopic
surgery port and its associated components following
repeated simulated uses. Prospective in vitro experimental
study. 6 single-use, single-incision laparoscopic surgery ports
with associated cannulas and insufflation tubing. Ports, can-
nulas, and tubing were subjected to 10 cycles of simulated
use, bacterial inoculation with Staphylococcus pseudinterme-
dius and Escherichia coli, decontamination and sterilization,
and culture. Bacteriological scores were compared among
the negative control, positive control, and four treated ports
and components. There was no difference between bacterio-
logical scores of treated ports, cannulas, and insufflation tub-
ing and the negative control port and components
(P50.500-1.000). Bacteriological scores of ports and com-
ponents undergoing 6 to 10 cycles were not significantly dif-
ferent from scores of ports and components undergoing 5 or
fewer sterilization cycles (P50.500-1.000). No difference in
bacterial detection was found when comparing foam biopsy
to sampling via wash (P51.000). These findings suggest
that a single-use single-incision laparoscopic port and its
associated components can be effectively sterilized with
VHP following multiple simulated uses. Reuse of a single-
use single-incision laparoscopic port may provide a clinically
feasible method for reducing costs associated with minimally
invasive surgery in veterinary patients.
Maneuverability of Scopes and Instruments
Within 3 Different Single Incision Laparoscopic
Ports: An Experimental Study
Haider G
, Schulz U
, Katic N
, Dupre G
Vetmeduni Vienna, Small Animal Clinics, Vienna, Austria;
Vienna, Large Animal Clinics, Vienna, Austria;
Vet Chirurgie, Vienna,
Single port access systems (SPAS) are currently being used
for many surgical procedures in human and veterinary medi-
cine. However, they pose technical challenges as instrument
crowding, intra-and extracorporeal instrument collision and
reduced manoeuvrability. Studies comparing the manoeu-
vrability of scopes and instruments are missing in the litera-
ture. The aim of the study was to compare these value in 3
different currently used SPAS: Covidien SILS-Port, Storz
Endocone and Glove port. Experimental study. An acrylic
glass box with an artificial skin placed at the bottom, was
used to mimic the abdominal wall. SPAS were placed and a
10mm endoscope and one 5mm instrument were alternately
introduced. A Motion analysis system, consisting of 20 cam-
eras, was used to track the maximal possible movements of
either endoscope alone or endoscope and instrument. For our
study, the area of the conic section described by the endo-
scope was defined as area of maneuverability (AoM). Using
a mathematical software, the resulting data were converted in
areas and statistically compared using Mann-Whitney-U-
Test. AoM with endoscope alone was significant higher with
glove-port (1.546 cm
) than those with SILS-Port
(1.010 cm
) or Endocone (201 cm
). When inserting an addi-
tional instrument, AoM significantly decreases in SILS and
Endocone, but not in Glove-port. Therefore, Glove-port still
provides the highest AoM (2.161 cm
) when compared to
SILS-Port (867 cm
) or Endocone (87 cm
). Glove-port
showed the highest AoM using either an endoscope alone or
a fixed endoscope and an instrument.
Endoscopy in Sharks and Rays
Villalobos J,
no J
Hospital Veterinario Del Valle, Mexico City;
Xcaret Park, Riviera
Maya, Mexico
To evaluate the health of captive sharks and rays in an
aquatic park by testing the effectiveness of preventive medi-
cine protocols described in the fish literature using flexible
endoscopy in respiratory and digestive organs, recognizing
the endoscopic anatomy and damages on tissues. Retrospec-
tive and descriptive study. 10 Caribbean rays (Styracura
schmardae) and 10 Nurse sharks (Ginglymostoma cirratum),
total of animals 20. The organisms are subjected to two anes-
thetic protocols individually in containers with a quantity of
salt water under a system that guarantee the availability of
oxygen dissolved necessary to cover the respiratory expense
of each animal. The two anesthetic protocols used are: Tri-
caine metasulfonate and Eugenol directly added in the water
in controlled concentrations to achieve the desired anesthetic
depth by direct incorporation of the anesthetic by the respira-
tory route. The anesthetized organism is managed in sternal
and dorsal recumbency to obtain access to the entrance
routes of the respiratory and digestive system using a Silver-
scope of 7.9 mm in diameter and a Telepack (Karl Storz
GmbH & Co. KG, Tuttlingen, Germany). By the incorpora-
tion of the diagnostic endoscopy in those sharks and rays
specimens, punctual evaluations and descriptions of the topo-
graphic anatomy of the evaluated organisms have been car-
ried out, as well as the evidence of diseases such as the
presence of internal and external parasites as leeches, nemat-
odes and platyhelminthes in the respiratory and digestive
tract, endoscopy also allow the observation of secondary
injuries as erythema, ulcers and granulomas in the organs
and tissues evaluated. Endoscopy was performed just on 19
of 20 individuals, 10 rays and 9 sharks, the first shark
attempted to do endoscopy was not in a good anesthetic
plane and bit the endoscope causing severe damage on it, the
procedure was suspended in this individual. Average time of
endoscopy navigation on each organism was 20 minutes
1/25 minutes for respiratory and digestive tract. Endos-
copy as a minimally invasive diagnostic technique incorpo-
rated into the management of elasmobranches (sharks and
rays) in captivity showed to be the tool that offers the possi-
bility of managing evidence-based medicine as part of the
health plan established for these populations of aquatic ani-
mals. Special care must be taken when evaluating the anes-
thetic depth of each individual to avoid damage to the
endoscopy equipment and damage to the patients tissues.
Use of the VITOM II ICG for Fluorescence-
Guided Sentinel Lymph Node Mapping in Dogs
Oblak M
University of Guelph, Guelph, ON, Canada
This short case presentation is intended to describe and show
video footage of preliminary experiences using the Storz
SPIES video telescopic operating microscope (VITOM) II
system for evaluation of sentinel lymph nodes (SLN) in dogs
using indocyanine green (ICG) near infrared fluorescence
imaging technology. Peritumoral 4 quadrant injection of ICG
was performed intraoperatively in dogs with malignant
tumours. Methylene blue was injected concurrently in some
cases. The VITOM II was attached with a sterile articulating
holder and connected to the Storz SPIES Full HD D-Light P
ICG technology tower (Karl Storz, Mittelstrasse, Tuttlingen,
Germany) with a portable flat screen monitor. Room lights
were switch off following injection and the local injection
site and resultant lymphatic tracts and SLN evaluated. Dis-
section of the lymph node (s) was performed with fluores-
cence guidance and removal was performed in a routine
manner. Lymph nodes were examined in situ and ex vivo
under white light and fluorescence. In all cases, with the aid
of the VITOM fluorescence, ICG allowed some percutane-
ous visualization of sentinel lymph nodes and provided mag-
nified visualization for dissection and removal of the node.
Based on this preliminary work, the VITOM II ICG is useful
for open SLN procedures allowing for percutaneous visual-
ization in specific cases. ICG concentration and room dark-
ness are important for successful fluorescence visualization.
FIGURE 1 Percutaneous appearance of lymphatic tracts following peritumoral injection and ex vivo lymph node fluorescence
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