Feasibility of single‐port retroperitoneoscopic adrenalectomy in dogs

Abstract

ObjectiveTo evaluate the feasibility of single‐port retroperitoneoscopic adrenalectomy (SPRA) in dogs.Study DesignA pilot experimental study.AnimalsEight healthy beagle dogs.MethodsSPRA was performed on the left and right sides (4 dogs each). Resection of the adrenal gland was performed through a SILS port using a retroperitoneal approach. Operative time was defined from skin incision to the completion of skin suture. Postoperative pain was evaluated by using 3 pain scores. Integrity of the adrenal gland capsule was evaluated by histologic assessment.ResultsMean time taken to complete the SPRA was 44.1 minutes (range, 37‐51) and was significantly longer on the right side than on the left side (P < .05). There were no complications intraoperatively or during 14 days of postoperative monitoring. The adrenal gland capsule was found to be injured in 3 of the 8 dogs by histologic assessment.ConclusionThis is the first report of SPRA in the veterinary literature. With this technique it is possible to perform adrenalectomy with some risk of capsule penetration and with excellent visibility.Clinical significanceThis study suggests that SPRA is feasible and can be used to resect small adrenal tumors with minimal complications.

CT variants of the caudal vena cava in 121 small breed dogs

“…Recently, retroperitoneal access procedures have been attempted in veterinary medicine . The CVC, aorta, and renal vessels can be used as anatomic landmarks in retroperitoneal laparoscopy .…”

“…Recently, retroperitoneal access procedures have been attempted in veterinary medicine. 24,[26][27][28][35][36][37] The CVC, aorta, and renal vessels can be used as anatomic landmarks in retroperitoneal laparoscopy. 26 Awareness of the CVC location is also crucial to prevent hemorrhage in ultrasound-guided fine needle aspiration of medial iliac lymph nodes and resection of masses near the CVC tributaries.…”

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

“…To maximize the gravitational retraction of the intraperitoneal organs, the authors of that study adopted the sternal position with the abdomen unsupported. In another study, total retroperitoneoscopic adrenalectomy was experimentally performed at a pressure of 5 mmHg in healthy Beagle dogs [20]. However, these canine studies involving retroperitoneal insufflation did not document the cardiopulmonary changes induced by different insufflation pressures in the sternal position with the abdomen unsupported [16,20].…”

“…In another study, total retroperitoneoscopic adrenalectomy was experimentally performed at a pressure of 5 mmHg in healthy Beagle dogs [20]. However, these canine studies involving retroperitoneal insufflation did not document the cardiopulmonary changes induced by different insufflation pressures in the sternal position with the abdomen unsupported [16,20]. The characteristic retroperitoneal space development pattern at a low insufflation pressure (≤15 mmHg) in dogs has not been observed in humans and pigs.…”

“…The characteristic retroperitoneal space development pattern at a low insufflation pressure (≤15 mmHg) in dogs has not been observed in humans and pigs. In addition, previous hemodynamic studies in humans and other species involved evaluations at high insufflation pressures (15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30) in a variety of positions, including the jackknife position and the lateral position with table flexion [5,8,10,22]. Therefore, it can be inferred that different consequences might be observed in healthy dogs positioned in sternal recumbency with the abdomen unsupported.…”