Partial cystectomy with a bipolar sealing device in seven dogs with naturally occurring bladder tumors

Abstract

Objective: To describe the use of a bipolar sealing device (BSD) for partial cystectomy in dogs undergoing excision of bladder tumors. Study design: Multicenter, prospective, clinical pilot study.Sample population: Seven client-owned dogs with nontrigonal urinary bladder lesions.

Feasibility of laparoscopic stapled partial cystectomy in canine cadavers

“…Furthermore, during urodynamic testing, plateau of intravesicular pressure was most commonly seen with development of normograde leakage from the clamped vulva (female dogs) or sutured urethra (male dogs), suggesting that the stapled cystectomy site was sufficiently strong to resist large volume leakage at higher pressures. The authors suspect that the small volume of leakage observed at the caudal staple line is clinically similar to small volume urine leakage through the needle holes observed with sutured cystotomies and partial cystectomies 6,7 . No catastrophic failures of the cystectomy site were observed during this study; however, it is important to note that our ability to detect catastrophic failure may have been limited by the use of in situ leak pressure testing rather than explanting the urinary bladder and ligating the urethra and ureters to create maximal intravesical pressure by preventing urine outflow through the urethra.…”

“…The authors suspect that the small volume of leakage observed at the caudal staple line is clinically similar to small volume urine leakage through the needle holes observed with sutured cystotomies and partial cystectomies. 6,7 No catastrophic failures of the cystectomy site were observed during this study; however, it is important to note that our ability to detect catastrophic failure may have been limited by the use of in situ leak pressure testing rather than explanting the urinary bladder and ligating the urethra and ureters to create maximal intravesical pressure by preventing urine outflow through the urethra. The decision to use a CMG to evaluate leakage pressures in situ was based on the desire to mimic the setting in clinical patients.…”

“…In a cadaveric model, inconsistent separation was observed along the edges of the sealed cystectomy site where the edges of the urinary bladder failed to seal 6 . In a clinical case series, all cystectomy sites were oversewn with a simple continuous pattern to reinforce the seal and one clinical case experienced necrosis along the cystectomy site and subsequent uroabdomen despite a suture oversew 7 . Needle holes from this suture oversew could negate the benefits of sealed cystectomy by allowing urine leakage, and the need for a suture oversew presents an additional challenge in performing a sealed partial cystectomy via a laparoscopic approach.…”

“…5 Use of a bipolar sealing device for partial cystectomy in dogs undergoing excision of apical urinary bladder masses, termed sealed partial cystectomy, has been theorized to minimize exposure of the abdomen to neoplastic cells, although this hypothesis has not yet been evaluated ex vivo or in clinical patients. 6,7 Use of a vessel sealing device for partial cystectomy, however, has several limitations. In a cadaveric model, inconsistent separation was observed along the edges of the sealed cystectomy site where the edges of the urinary bladder failed to seal.…”

Augmentation cystoplasty in dogs: A comparative study of different tunica vaginalis grafts

“…Cystectomy is recommended for a number of urinary bladder (UB) affections, including cystic neoplasia, patent urachus excision, iatrogenic injuries, bladder necrosis, recurrent interstitial cystitis, devitalized tissue following bladder rupture, and neurogenic bladder ( Granger et al., 2020 ; Lipscomb, 2018 ; Milovancev et al., 2020 ; Sivacolundhu & Withrow, 2013 ; Tobias, 2011 ). Furthermore, studies reported that more than 30% of incontinent dogs, particularly those who had undergone ovariohysterectomy, had reduced bladder storage function ( Berent & Mayhew, 2017 ; Burrow et al., 2005 ).…”