Complications in Laparoscopic Access in Standing Horses Using Cannula and Trocar Units Developed for Human Medicine

Abstract

First cannulation is a critical manoeuvre in equine laparoscopy. This retrospective study aimed at the comparison of the frequency and type of complications detected when using different human laparoscopy devices for laparoscopic access in standing horses, and the influence of body condition in such complications. Forty-four procedures were included, and retrieved data comprised cannula insertion technique, body condition, and type and frequency of complications. Laparoscopic access techniques were classified into five groups: P: pneumoperitoneum created using Veress needle prior to cannulation; T: sharp trocar; D: direct access via surgical incision; V: Visiport optical trocar and H: optical helical cannula (OHC). In groups T, D, V and H, access was achieved without prior induction of pneumoperitoneum. Complications were registered in 13/44 procedures, of which retroperitoneal insufflation was the most common (6/13). Statistically significant association was found between the complication incidence and the type of access, with group D showing the highest complication frequency (80%) and group H the lowest frequency (0%). The majority of complications (9/13) were observed in overweight horses. We conclude that devices designed for human patients can be used for laparoscopic access in standing horses, with the use of OHC minimizing the appearance of complications, especially in overweight horses with OW.

Systematic review on techniques for the creation of pneumoperitoneum in laparoscopic surgeries

“…This approach has been clinically demonstrated to provide convenient and rapid port insertion while exhibiting a decreased incidence of complications compared to other procedures. 19 Six studies [28][29][30] have demonstrated that it is possible to perform LPS with minimal pneumoperitoneum pressure. None of the studies, however, evaluated the effects on recovery quality.…”

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

“…We believe that it is an important prototype; although this study is preliminary, this device can be improved and adapted to single-site laparoendoscopic (or LESS) approaches. Advances related to cryptorchidectomy in standing horses depend on improvements and discoveries using equipment such as this [1,9,10].…”

“…The new device evaluated in live animals proved to be efficient for cryptorchidectomy of testicles retained in the inguinal region in cases not complicated by adhesions [6,9]. Laparoscopy with a new device allowed a broad intra-abdominal inspection and tissue manipulation in the inguinal region of standing horses, a place where cryptorchid testicles are commonly retained, allowing easy identification of the gonadal and an immediate diagnosis of these testicles [1,7].…”

“…In recent decades, there have been many advances related to laparoscopic cryptorchidectomy in horses, the main benefits of which are the absence of general anesthesia and better visualization of the cryptorchid [1,6,7]. Standing horse laparoscopy is the best option to remove ectopic testicles, but complications can occur when the devices are not used during access to the abdominal cavity [8,9].…”

“…Related advances to laparoscopic surgery depend on improvements and related innovations to the technique and equipment [1,9,10]. The most recent studies demonstrate single access through an umbilical port for the removal of cryptorchid testicles and the use of devices such as wound retractors and resorbable self-locking loops [7,11,12].…”