Wound Retractor Laparoscopic Port System for Standing Laparoscopic Cryptorchidectomy in the Horse: A Case Report

This study evaluates a new multiport device with single access to the abdominal cavity produced with routine hospital supplies that could be applied to laparoscopically assisted cryptorchidectomy in standing horses. Initially, the new device was evaluated on five cadavers of bovine fetuses (n = 5), placed assisted in a minilaparotomy performed in the flank region. Subsequently, the device was evaluated in four cryptorchid horses treated during the hospital routine. During the evaluation of the new device, the possibilities of exploring the abdominal cavity, inspection, and intra-abdominal manipulation with two Babcock forceps were verified. The possibilities were described, and surgical time data were recorded and analyzed using descriptive statistics. In the cadavers, a wide exploration of the abdominal cavity was possible, with a laparoscopic inspection through the right paralumbar fossa and manipulation of intra-abdominal structures with Babcock forceps inserted by the new device. In cryptorchid horses, laparoscopically assisted cryptorchidectomy with a new device was feasible in two patients, and in the others, it allowed the diagnosis of adhesions and ectopic locations in the inguinal region of testicles retained in the cavity. Therefore, the new device was efficient in exploring the inguinal region of cryptorchid horses in the standing position. The present study is preliminary and can support future studies that aim to improve the developed prototype.

Section: Introductionmentioning

confidence: 99%

A Single-Port, Multiple-Access, Custom-Made Device Used in Laparoscopically Assisted Cryptorchidectomy in Standing Horses—A Preliminary Study

Silva,

Araújo,

Cardoso

et al. 2024

“…The use of laparoscopic wound retractors was described for the treatment of pyometra [21,22] and OVE/OVH [23], in several laparoscopically assisted procedures in dogs [23][24][25], and in cryptorchidectomy in horses [26]. The main advantage of this new technique is that the surgeon can easily interrupt the pneumoperitoneum by removing the cap, performing extracorporeal procedures, or removing a large specimen from the abdomen, and then easily resume the laparoscopic procedure after re-inserting the cap and re-insufflating the abdomen to induce pneumoperitoneum once more.…”

Section: Introductionmentioning

confidence: 99%

Wound Retractor Laparoscopic Port System for Laparoscopic Ovariectomy in Panthera leo

Lacitignola

Laricchiuta²,

Imperante

et al. 2022

Self Cite

The aim of this study was to assess the feasibility and intraoperative complications of performing ovariectomies in African lionesses (Panthera leo) using a wound retractor laparoscopic platform. Six lionesses (n = 6) were included. The surgical procedures were carried out through three portals, with a retractor platform positioned at the umbilical port and cannulas placed 3–4 cm from the cranial and caudal regions to the device at the level of the midline. An ovariectomy was performed with a vessel-sealing device. We evaluated the surgery time and the intraoperative and early postoperative complications. The mean weight was 172.83 kg. The total surgery time was 49.33 min. The installation step took a mean of 10.33 min to complete. The mean ovariectomy time was 20 min. Controlled bleeding was observed at the tip of the uterine horn in two cases due to excessive tissue thickness. The retrieval of dissected ovarian tissue and annexes was easily performed. No other complications were observed. The use of the laparoscopic platform during three-portal surgeries for laparoscopic ovariectomy in adult overweight lionesses is feasible and without intraoperative problems. The retractor meant that there were no entry-related issues due to the 25 mm mini-laparotomy. It also made it simpler to extract thick ovaries and promptly re-establish the pneumoperitoneum.

“…Moreover, another important issue discussed in the previous studies was the amount of fat in the subcutaneous tissue and falciform ligament that provided elongation of surgical time when laparoscopic OVE has been performed in adult obese patients in comparison with cubs or normal scored body condition [ 2 , 6 , 8 ]. The advantages of using the wound retractor (WRD) port system have been recently described in obese lionesses [ 15 ] and horses [ 16 ], consisting of surgical time saving, simple extraction of the ovaries and the possibility of interrupting and re-establishing the pneumoperitoneum.…”

Section: Introductionmentioning

confidence: 99%

Comparison of Two Radiofrequency Vessel-Sealing Device for Laparoscopic Ovariectomy in African Lionesses (Panthera Leo)

Lacitignola

Laricchiuta²,

Guadalupi

et al. 2022

Self Cite

To evaluate two vessel-sealing devices with different jaw lengths for dissecting ovaries in adult obese African lionesses undergoing laparoscopic ovariectomy. Twelve lionesses (n = 12) were recruited. The surgical procedures were performed through three portals, with a retractor platform positioned at the umbilical port and cannulas placed 3–4 cm cranial and caudal to the device at the level of the midline. Ovariectomy was performed using a vessel-sealing device according to a randomization list. We evaluated the surgery time the intra- and postoperative complications. The total surgery time was 49.3 min (range 40–61 min) in the Atlas group and significantly lower in the Caiman group (mean 31.8 min, range 26–51 min). The installation phase was similar between the groups. The ovariectomy time was significantly lower in the Caiman group (mean 7.8 min, range 4–11 min) than in the Atlas group (mean 20 min, range 16–30 min). Controlled bleeding was observed at the tip of the uterine horn in two cases in the Atlas group. No other complications were noted. The results of our study confirmed the significant advantages of employing the Caiman 12 vessel-sealing device in comparison with the LigaSure Atlas in terms of the time needed to complete ovariectomy, although both instruments could be considered safe. The use of the Caiman 12 is recommended when performing laparoscopic ovariectomies in adults with obesity.