Evaluation of minimally invasive small intestinal exploration and targeted abdominal organ biopsy with use of a wound retraction device in dogs: 27 cases (2010–2017)

Abstract

OBJECTIVE To describe surgical technique, biopsy sample quality, and short-term outcome of minimally invasive small intestinal exploration and targeted abdominal organ biopsy (MISIETB) with use of a wound retraction device (WRD) in dogs. ANIMALS 27 client-owned dogs that underwent MISIETB with a WRD at 1 of 4 academic veterinary hospitals between January 1, 2010, and May 1, 2017. PROCEDURES Medical records were retrospectively reviewed, and data collected included signalment; medical history; findings from physical, ultrasonographic, laparoscopic, cytologic, and histologic evaluations; surgical indications, procedures, duration, and complications; and short-term (14-day) outcomes. The Shapiro-Wilk test was used to evaluate the normality of continuous variables, and descriptive statistics were calculated for numeric variables. RESULTS Laparoscopic exploration was performed through a multicannulated single port (n = 18), multiple ports (5), or a single 6-mm cannula (4). Median length of the incision for WRD placement was 4 cm (interquartile [25th to 75th percentile] range, 3 to 6 cm). All biopsy samples obtained had sufficient diagnostic quality. The 2 most common histologic diagnoses were lymphoplasmacytic enteritis (n = 14) and intestinal lymphoma (5). Twenty-five of 27 (93%) dogs survived to hospital discharge, and 3 (12%) dogs had postsurgical abnormalities unrelated to surgical technique. CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that MISIETB with WRD was an effective method for obtaining diagnostic biopsy samples of the stomach, small intestine, pancreas, liver, and mesenteric lymph nodes in dogs. Prospective comparison between MISIETB with WRD and traditional laparotomy for abdominal organ biopsy in dogs is warranted.

Single Incision Laparoscopic Surgery (SILS) in Small Animals: A Systematic Review and Meta-Analysis of Current Veterinary Literature

“…Otomo et al [ 40 ] compared the outcomes in dogs that underwent SILS-assisted intestinal surgery and open laparotomy for simple foreign body removal using the SILS port. After the exploration, the single-incision port was removed, and the access incision was extended to a minilaparotomy of an approximate length of 5–7 cm centered on the umbilicus, which was retracted with WR.…”

“…The WR and SILS port require only a 2-to 4-cm incision length; however, correct positioning should be planned carefully to allow adequate visualization of the target organs or their exteriorization when needed [ 40 ]. A combination of WR with SILS or other WR-based platforms also prevents gas leakage, which is reported especially when using an Endocone or when an incision enlargement or two-portal connection requires organ exteriorization.…”

Influence of barbed suture oversew of the transverse staple line during functional end‐to‐end stapled anastomosis in a canine jejunal enterectomy model

“…Barbed suture is an attractive option for gastrointestinal closure due to its ready availability and increased familiarity among small animal surgeons. 28 Oversewing of the transverse staple line using barbed suture following FEESA to establish a watertight seal is critical to determine the safety and efficacy of these sutures. This information is important to allow informed suture use for gastrointestinal applications in dogs.…”

“…To date, use of barbed suture for oversew of the transverse staple line following FEESA has not been evaluated. Barbed suture is an attractive option for gastrointestinal closure due to its ready availability and increased familiarity among small animal surgeons 28 . Oversewing of the transverse staple line using barbed suture following FEESA to establish a watertight seal is critical to determine the safety and efficacy of these sutures.…”

Retrospective assessment of the clinical relevance of surgical biopsies of abdominal lymph nodes in cats: 51 cases (2014–2018)

“…Biopsy sampling of tissues during abdominal exploratory laparotomy and subsequent histological examination is a common technique that provides valuable diagnostic information. 1,2 Intra-abdominal lymph node (LN) enlargement is commonly seen in both inflammatory and neoplastic conditions in feline patients, and it is recognised that differentiation between benign and malignant lymphadenopathy requires LN evaluation by either cytology or histopathology. 3…”