Cardiopulmonary Effects of Laparoscopic Ovariectomy of Variable Duration in Cats

Shih, Andre; Case, J. Brad; Coisman, James G.; Isaza, Natalie; Amora‐Junior, Dorli; Maisenbacher, Herbert W.

doi:10.1111/j.1532-950x.2014.12241.x

Cited by 28 publications

(23 citation statements)

References 27 publications

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“…Although pneumoperitoneum pressure of 10 mmHg has been previously recommended [12,17], the 4 mmHg pressure used in this study enabled excellent visualization and manipulation of the organs, similarly to previous reports [5,7,18]. It is known that the greater the intra-abdominal pressure, the greater the CO 2 absorption by the peritoneum and, consequently, the greater the cardiorespiratory alterations observed [13]. Thus, the minimal pressure required for good organ visualization should be preconized.…”

Section: Discussionsupporting

confidence: 57%

Description and Executability of a Novel Pre-tied Mini Ligature (Miniloop) in Laparocopic Ovariectomy in Cats

Conceição

Mariano

Crivelaro

et al. 2017

Acta Scientiae. Vet.

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Background: Ovariectomy(OVE) and ovariohysterectomy (OVH) are the most performed surgical procedures in Veterinary Medicine. In videosurgery, both in stray animals at sterilization campaigns and in the increasing demand of tutors to perform the technique. Laparoscopy results in reduced tissue damage, due to minimal organ manipulation and surgical access hemostasis can be performed by several methods, such as electro-coagulation, clips, and intra and extracorporeal ligatures. A pre-tied ligature system, or endoloop, is a haemostatic technique comprised of a slipknot and knot pusher, which is inserted into the abdominal cavity through one of the laparoscopic ports. The aim of this study was to describe a novel OVE technique in cats, in which haemostasis was performed using miniloop, aimed at reducing the number of ports needed for knot tying.Material, Methods & Results: Ten healthy not spayed female cats, aged 6 months to 5 years, were selected for this study. They were submitted to an OVE using miniloop as haemostasis method. Access to the peritoneal cavity was through two 5 mm ports on the midline of the ventral abdomen, 5 cm apart, with one immediately caudal to the umbilical scar and the other in between the last pair of teats. The first trocar was inserted at the caudal incision using the Hasson technique and a 5 mm zero-degree optics attached to a camera was introduced through it. The placement of the second access port was video assisted. For ovary exposure, the patients were positioned in lateral recumbency on the contralateral side to the ovary being removed. The miniloop was composed of a 2 mm diameter minitrocar, a 1.8 mm knot pusher, and a pre-tied slipknot. It was introduced percutaneously at the lateral abdominal wall. It was inserted attached to a pre-tied loop ligature. A Babcock forceps was used to guide the slipknot until it enveloped the ovarian vessels and the proximal part of the uterine horn. Subsequently, the knot was tightened with the aid of the knot pusher. A second miniligature was applied. The forceps was removed and a Metzenbaum scissors inserted to cut between the ligatures, releasing the ovary with the nylon ligature but keeping the PDS knot. It was performed at both ovary. Mean (±SD) surgical time was 44.8 min (± 13.4) and varied significantly (P = 0.0006) between animals, with the shortest time being 29 min and the longest 66 min. Positioning of the patients in lateral decubitus allowed for good ovarian exposure, without the need for excessive manipulation of the intestinal loops or other abdominal organs. Rupture of the suture thread was the only trans-operative complication observed and occurred in two animals. A second ligature (miniloop) was needed to ensure haemostasis. One cat showed eventration at the site of the caudal port on the second day post-operative.Discussion: The mean surgical time in the present study was lower than reported by some authors, but longer than anothers. Furthermore, the surgical time from this study is similar to that of other studies in cats in which haemostasis of the OAVC was achieved using bipolar electrocoagulation. Surgical team expertise is of outmost importance in minimizing complications and overcoming problems during videosurgical procedures in order to reduce surgical time, such as gas leakage, extensive incision, and difficulty in manipulating surgical instruments.

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Section: Discussionsupporting

confidence: 57%

Description and Executability of a Novel Pre-tied Mini Ligature (Miniloop) in Laparocopic Ovariectomy in Cats

Conceição

Mariano

Crivelaro

et al. 2017

Acta Scientiae. Vet.

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“…Another canine study involving laparoscopy documented comparable increases in PaCO 2 with no increase in HR [14], whereas other studies in dogs [4] and cats [32] attributed an increase in HR to reflex tachycardia for the compensation of a decreased stroke volume and maintenance of the cardiac output, which was not observed in the current study. [4,31].…”

Section: Discussionmentioning

confidence: 99%

Cardiopulmonary changes induced by retroperitoneal insufflation in healthy dogs in sternal recumbency with the abdomen unsupported

Son

Jeong

et al. 2020

The Journal of Veterinary Medical Science

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This study assessed the effects of retroperitoneal carbon dioxide (CO 2 ) insufflation on cardiopulmonary variables and intra-abdominal pressure (IAP) in mechanically ventilated dogs in sternal recumbency with the abdomen unsupported, following placement of a positioning kit and towels under the pectoral and pelvic regions. General anesthesia was induced in eight healthy adult male Beagles. A Swan-Ganz catheter was placed in the pulmonary artery via the jugular vein for cardiac output measurements. A Foley urethral catheter was placed to monitor transvesical IAP. A 10 mm balloon blunt-tip trocar was inserted into the retroperitoneal space. With a fixed respiratory rate and tidal volume by mechanical ventilation, insufflation pressure was sequentially increased from 0 to 10 mmHg in 5 mmHg increments, followed by desufflation. All variables were measured before insufflation, 5 min after the establishment of each insufflation pressure, and after desufflation. At 10 mmHg, the IAP was nearly equal to insufflation pressure. Cardiopulmonary function was not compromised at any point, although the cardiac index (CI), heart rate, mean arterial pressure (MAP), and mean pulmonary arterial pressure increased within normal ranges. End-tidal CO 2 concentration, arterial CO 2 partial pressure, and oxygen delivery index (DO 2 I) increased, whereas pH decreased, at 10 mmHg. CI, MAP, and DO 2 I did not recover to baseline after decompression. Thus, retroperitoneal CO 2 insufflation up to 10 mmHg is well tolerated by mechanically ventilated dogs positioned in sternal recumbency with the abdomen unsupported, although sympathetic changes may occur with an insufflation pressure increase.

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“…This approach did not affect abdominal insufflation for laparoscopy due to loss of pneumoperitoneum between the device and the WRD. One should note that negative cardiopulmonary effects can occur in cats with prolonged CO 2 insufflation . Based on those results, if MISETB method is chosen, the laparoscopic explore should be both accurate and efficient.…”

Section: Discussionmentioning

confidence: 99%

“…One should note that negative cardiopulmonary effects can occur in cats with prolonged CO 2 insufflation . Based on those results, if MISETB method is chosen, the laparoscopic explore should be both accurate and efficient. Once the laparoscopic portion of the procedure was complete, the single‐port device was removed, and a finger‐assisted intestinal exploration was performed through the WRD.…”

Section: Discussionmentioning

confidence: 99%

Minimally invasive small intestinal exploration and targeted abdominal organ biopsy with a wound retraction device in 42 cats (2005‐2015)

et al. 2017

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Objective: To describe the surgical technique and evaluate short-term outcome after minimally invasive small intestinal exploration and targeted organ biopsy with a wound retractor device (WRD) in cats.Study design: Multi-institutional retrospective study. Animals: Forty-two cats.Methods: A wound retractor was inserted into the abdomen on the ventral midline through a 2-4 cm incision at the level of the umbilicus. Short segments (6-10 cm long) of intestinal tract were sequentially exteriorized and explored through the WRD. Full thickness, small intestinal biopsies were obtained extracorporeally via the WRD. A commercially available single-port device was inserted through the WRD for laparoscopic exploration of the abdomen.Results: The majority of the small intestine could be exteriorized and explored through the WRD. In all cases, full thickness biopsies of the small intestine of diagnostic quality were obtained. The most common histological findings were inflammatory bowel disease (n 5 16), intestinal lymphoma (n 5 14), and eosinophilic enteritis (n 5 7). Two cases required conversion to a traditional open laparotomy due to abdominal pathology diagnosed after placement of the WRD (abdominal adhesions and need for a splenectomy). Postoperative complications occurred in 4 of 39 cats (10.3%), leading to 2 deaths after discharge from the hospital.Conclusions and clinical relevance: MISIETB with a WRD alone or combined with laparoscopy is a safe technique for small intestinal exploration and targeted abdominal organ biopsy in cats. Single-port laparoscopy can effectively be performed through the WRD for complete abdominal exploration and biopsy of abdominal organs.

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Cardiopulmonary Effects of Laparoscopic Ovariectomy of Variable Duration in Cats

Abstract: Duration of insufflation was associated with worsening of negative cardiopulmonary effects; however, these effects were reversible and resolved by the end of the procedure.

Cited by 28 publications

References 27 publications

Description and Executability of a Novel Pre-tied Mini Ligature (Miniloop) in Laparocopic Ovariectomy in Cats

Description and Executability of a Novel Pre-tied Mini Ligature (Miniloop) in Laparocopic Ovariectomy in Cats

Cardiopulmonary changes induced by retroperitoneal insufflation in healthy dogs in sternal recumbency with the abdomen unsupported

Minimally invasive small intestinal exploration and targeted abdominal organ biopsy with a wound retraction device in 42 cats (2005‐2015)

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