Complications associated with cannula insertion techniques used for laparoscopy in standing horses (original) (raw)
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Diagnostic and therapeutic laparoscopy in the horse: experiences in 236 cases
Pferdeheilkunde Equine Medicine, 2002
In the past decades the use of minimally invasive surgical techniques has increased dramatically in equine surgery. This report presents 236 cases in which the laparoscopic technique has been used for a variety of indications, both diagnostic and therapeutic. Diagnostic laparoscopy was performed in 26 cases. Indications were: recurrent colic (13), acute colic (1), suspected presence of an intra-abdominal tumour (3), suspected presence of adhesions (3), chronic weight loss (2), suspected presence of intra-abdominal abscesses (2) and to answer the question if an abdominal testicle was present or not (related to an insurance problem). Therapeutic laparoscopy in standing position was performed for the following indications: castration of horses with normally descended testicles (66), abdominal cryptorchidism (68), inguinal cryptorchidism (52), ovary tumours (14), ovariectomy for other reasons (behavioural problems (6) and three to become a teasing mare). Under general anaesthesia dissection of adhesions discovered during diagnostic laparoscopy was performed in 5 horses, dissection of an ovary tumour tightly attached to the bladder in one horse and a traumatic ventral hernia was repaired in a foal with the implantation of a mesh. In the experience of the author, the development of technical skills, the so-called learning curve for a specific laparoscopic intervention comprises about 30 patients. It can be concluded that laparoscopy is a viable and very useful technique for both diagnostic and therapeutic procedures in the equine abdomen.
Advances in Equine Laparoscopy
Wiley eBooks, 2012
For those organizations that have been granted a photocopy license by CCC, a separate system of payments has been arranged. The fee codes for users of the Transactional Reporting Service are ISBN-13: 978-0-4709-5877-3/2012. Designations used by companies to distinguish their products are often claimed as trademarks. All brand names and product names used in this book are trade names, service marks, trademarks or registered trademarks of their respective owners. The publisher is not associated with any product or vendor mentioned in this book. This publication is designed to provide accurate and authoritative information in regard to the subject matter covered. It is sold on the understanding that the publisher is not engaged in rendering professional services. If professional advice or other expert assistance is required, the services of a competent professional should be sought. Dedication This book is dedicated to my colleagues in laparoscopy who shared so generously to enrich our knowledge to care for the horse.
Right Intercostal Insertion of a Veress Needle for Laparoscopy in Dogs
Veterinary Surgery, 2012
Objective: To evaluate right intercostal Veress needle (VN) insertion for laparoscopy in dogs. Study Design: Longitudinal cohort study. Animals: Female dogs (n = 56). Methods: The VN was inserted in the last palpable right intercostal space, either 1/3 (Group T; 28 dogs) or mid distance (Group H; 28 dogs) from the xiphoid cartilage to the most caudal extent of the costal arch. Problems encountered during VN insertion and injuries were recorded, graded, and compared between groups, and also between the first and last 20 insertions. Results: Pneumoperitoneum was successfully achieved by VN insertion in 49 (88%) dogs after a single (45 dogs) or 2nd attempt (4 dogs). Frequency of complications was as follows: 20 grade 1 (subcutaneous emphysema, omentum, or falciform injuries); 6 grade 2 (liver or spleen injury), and 1 grade 3 complication (pneumothorax occurred). No significant difference was found between the 2 groups or between the first and last 20 dogs. Conclusions: Right intercostal VN insertion facilitates pneumoperitoneum in dogs with few consequential complications. No significant difference was found between entry sites; however, the mid distance insertion site in the last palpable intercostal space with dog positioned in dorsal recumbency is likely to result in less complications. Laparoscopic surgery is typically facilitated by creating pneumoperitoneum with CO 2 insufflation, using open or closed methods, to improve observation of viscera and to safely insert instruments. 1, 2 The open method, Hasson's technique and its variants, involves insertion of the 1st trocar after minilaparotomy, 1, 3-18 whereas the closed method is performed by blind insertion of a Veress needle (VN) into the abdomen, usually near or caudolateral to the umbilicus to avoid the falciform ligament; 1, 2, 5, 18-25 although other sites are reported. 26-29 Alternative entry techniques (direct trocar insertion, 30, 31 with or without using an optical trocar 32) have been reported. Pneumoperitoneum created using VN or trocar is not risk free, and reported entry and insufflation-related injuries 33 include trauma to abdominal and abdominal wall vessels, penetration of solid organs or a hollow viscus, subcutaneous emphysema, peritoneal tenting, gas embolism,
Effects of abdominocentesis technique on peritoneal fluid and clinical variables in horses
Equine Veterinary Education, 2014
healthy horses underwent 5 repeated abdominocenteses, with either a sharp-tipped spinal needle or a blunt-tipped teat cannula to investigate possible differences in success rate, sample volume, depth at which a sample was obtained, length of procedure, complications and cytological variables. Variables were analysed with a repeated-measures ANOVA or Fisher's exact test (α = 0.05). Success rate, sample volume, length of procedure, occurrence of haemorrhage during the procedure and incidence of grossly visible blood contamination were not different between techniques or over time. Depth at which samples were obtained was greater using a cannula than a needle (P<0.02), and samples were obtained with either technique at a greater depth than abdominal wall thickness assessed via ultrasound (P<0.014). Peritoneal fluid total and differential nucleated cell counts, and total protein concentration did not differ between techniques or over time. Red blood cell count in the least blood contaminated fraction of each sample was not affected by time, but it was lower after needle abdominocentesis than after cannula abdominocentesis (P = 0.04). Swelling of abdominocentesis sites increased with both techniques over time (P<0.05) and was more severe in horses undergoing cannula abdominocentesis (P<0.05). Enterocentesis occurred with a spinal needle in one horse, but no subsequent complications were noted. Both techniques appear to be safe and reliable for abdominocentesis in healthy horses. Using a blunt-tipped cannula, as opposed to a needle, is likely to result in greater subcutaneous swelling. Both the cannula and needle must be long enough to penetrate well beyond the thickness of the abdominal wall to achieve successful peritoneal fluid collection. bs_bs_banner 262 EQUINE VETERINARY EDUCATION Equine vet.
Journal of Equine Veterinary Science, 2017
The laparotomy surgical procedure allows for the identification and correction of intestinal lesions associated with acute abdomen in horses. The clinician relies on various laparotomy techniques to diagnose and treat this syndrome, and to date, the postsurgical effects of these techniques have not been clarified. The aim of this study was to evaluate the effects of jejunal manipulation during three laparotomy techniques through physical and clinical parameters and echography. Fifteen healthy horses were randomly assigned to three groups: animals in G 1 (n ¼ 5) were subjected to an exploratory laparotomy, animals in G 2 (n ¼ 5) to a laparotomy with an enterotomy, and animals in G 3 (n ¼ 5) to a laparotomy with an enterectomy. Degree of pain, jejunal wall thickness, and clinical parameters were evaluated before and after surgery. Horses in G 3 had higher heart rates, respiratory frequency, degree of pain, and jejunal wall thickness compared with G 1. Clinical variables during the postsurgical period were compared among the laparotomy techniques, and higher values of erythrocytes, leucocytes, neutrophils, and proteins were found in horses belonging to G 3 compared to those in G 1. Intestinal manipulation during the surgical procedure altered the physical and clinical parameters, as well as the results of the echography evaluation, with more significant effects from laparotomy with enterectomy. In the postsurgical period, the heart rate of horses in G 3 was higher (P ¼ .02) than the values obtained in G 1 and G 2. Upon the evaluation of degree of pain, statistically significant differences (P ¼.04) were identified between horses in G 1 versus G 3. G 3 animals presented a higher degree of pain. Regarding the erythrocytes (L/L), higher values were measured in G 3 (P ¼ .001) in comparison with G 1 and G 2. These results suggest that meticulous tissue handling is essential to minimize intestinal trauma and inflammation.
Development of a laparoscopic technique for inguinal hernioplasty in standing horses
Veterinary Record, 2023
Background: Most previously described techniques for laparoscopic inguinal hernioplasty (IH) in horses require advanced laparoscopic skills. Our objective was to describe a new laparoscopic IH technique using a surgical anchoring system. Methods: Standing laparoscopic IH was performed unilaterally in eight experimental stallions, using the contralateral inguinal canal (IC) as a control. A polyether ether ketone harpoon was anchored in the craniolateral aspect of the vaginal ring, and an extracorporeal knot was used to fix the device. Clinical evaluation, including testicular palpation and lameness examination, was conducted before and for 4 weeks after surgery. Repeat laparoscopy was performed 28 days later. Results: Standing laparoscopic IH was performed in all horses with a surgical time of 38 ± 12.85 minutes. In two animals, a small peritoneal tear occurred that did not require repair. No other complications were recorded. On repeat laparoscopy, all devices were in place, and the IC remained partially closed in all horses. Limitations: The procedure was performed on normal experimental horses and has not been employed on horses that have had an inguinal hernia. Conclusions: This new standing laparoscopic hernioplasty technique provides another potential method for simple partial closure of the IC in stallions at risk of or with history of inguinal herniation.
Cecal Cannulation in Horse; an Experimental Study
2017
Background: In order to analyze the cecum-colon ecosystem and the treatment of the cecal impaction and hindgut acidosis, cecal cannulation is needed. It is essential to select a simple, fast and inexpensive cecal cannulation method. Because of different complications in general anesthesia, the standing surgery is known as a better option for the horse emergency surgery. Objective: The objective of the present study was to design a simple, fast and inexpensive cecal cannulation method in standing horses.For the standing surgery, a new approach was designed and experimented on four horses. Materials and Methods: For this purpose, at first a cannula with approximately 7cm, 2cm and 2.6cm in length, internal and external diameters, respectively was designed. Immediately before the standing surgery, the horses were sedated with xylazine (1mg/kg) and morphine (0.3 mg/kg). After incising the subcutaneous tissue, the external abdominal oblique, internal abdominal oblique and transverse abdom...