Laparoscopic adhesiolysis in a mini pony

Background: Intraperitoneal adhesions are common in equines, especially following exploratory celiotomy. Adhesiolysis is the treatment of choice for patients presenting postsurgical adhesions. Laparoscopic approach for adhesiolysis presents several advantageous aspects in human patients. The aim of the current study was to report a case of successful laparoscopic adhesiolysis in a mini pony horse. Case: A male Shetland Pony, weighing 140 kg, was admitted under complaint of right hind limb trauma and treated surgically for metatarsal fracture reduction. The patient has also had intermittent episodes of colic and was always treated clinically without major complications. The pony had no history of previous abdominal surgery and no episodes of acute abdomen were seen during hospital stay. Three months following ostheosynthesis, an exploratory laparoscopic approach was carried out to assess the possible cause or consequences of the episodes of acute abdomen. The patient was submitted to general anesthesia, positioned in dorsal recumbency and the abdomen was clipped and aseptically prepared for surgery. During the laparoscopic inspection, there were adhesions involving the ventral abdominal wall and a ventral mesogastric segment of duodenum. Laparoscopic adhesiolysis was performed using a two-port approach, by gently breaking the adhesion bands using meticulous traction with a 10-mm laparoscopic atraumatic Babcock forceps. Afterwards, the intestinal loop was rinsed with heparin sodium solution diluted in normal saline. The pneumoperitoneum was completely drained and the trocars sequentially withdrawn from the abdominal wall. The synthesis of the muscular layer was carried out using an interrupted cross mattress pattern, followed by synthesis of the skin with an interrupted cushion pattern. Total surgical time was 58 min. the patient was able to recover without complications. In the early postoperative period, the surgical recovery was considered excellent. No apparent adhesion involving the previously affected intestinal loop was found during the ultrasound exam following 15 days of surgery. Furthermore, the surgical wounds had healed completely, with no complications. Discussion: In the current case report, the primary cause of the acute abdomen episodes was not determined since the patient had never undergone abdominal surgery. It was hypothesized that an acute inflammation of the duodenal loop that was involved by the adhesion bands may have triggered the adhesiogenesis. Laparoscopy was efficient and presented a short operative time, due to magnification of image and adequate observation of structures surrounded by adhesion bands. Although the use of Babcock forceps is not usually recommended for adhesiolysis in the current literature, it was both effective in manipulating the bowel and performing the adhesiolysis. The heparin solution diluted in normal saline was effective in preventing the recurrence of new adhesions, which was evidenced by ultrasonography following 15 days. The laparoscopic approach usually minimizes the new formation of adhesions as trauma to the peritoneal surfaces is minimized by the use of delicate instruments, as observed in the current study. In addition, laparoscopy reduces the possibility of contact among the peritoneal surfaces and foreign bodies, such as gauze, glove powder and room air particles. Moreover, it maintains the abdominal surfaces in adequate humidity environment.

Effects of laparoscopy on the cardiorespiratory system of brown brocket deer (Mazama gouazoubira) anesthetized with ketamine/ xylazine/ midazolam combination and isoflurane / Efeitos da laparoscopia sobre o sistema cardiorrespiratório de veados-catingueiro (Mazama gouazoubira) anestesiados com a associação cetamina/xilazina/midazolam e isofluorano

Laparoscopy is not widely used as a tool to perform assisted reproduction techniques in South American cervids; thus, scarce information in literature is available regarding its effects and appropriate anesthetic protocols to perform it. This study evaluated the effect of laparoscopy on heart rate (HR), respiration rate (RR), saturation of oxyhemoglobin (SpO2) and rectal temperature (RT) of six female brown brocket deer (Mazama gouazoubira) anesthetized with ketamine (5mg/kg), xylazine (0.3mg/kg), midazolam (0.5mg/kg) combination i.v. and isoflurane. Twelve laparoscopies were performed and each animal was used twice with a 40-day interval. After anesthetized, the animals were placed in dorsal recumbency to perform laparoscopy procedure using abdominal CO2 insufflations (14.2 ± 2.39mmHg; M ± SE). The main events of the laparoscopy procedure were divided into three periods: animal without (P1) and with abdominal insufflation (P2) and abdominal insufflation with the hips raised at 45º (P3). As a control, the animals were anesthetized again 40 days after the last laparoscopy, and were maintained in a dorsal recumbency for the same average duration of the previous anesthesia and no laparoscopy procedure was conducted. The period of anesthesia for the controls was also divided into P1, P2, and P3 considering the average duration of these periods in previous laparoscopies performed. Data were analyzed through the (ANOVA) variance analysis followed by Tukey test and values at P<0.05 were considered significant. No significant differences were observed in the parameters evaluated at P1, P2 and P3 between the animals submitted to laparoscopy and control. However, the RR mean between P1 (38.8 ± 4.42) and P3 (32.7 ± 4.81); and the RT mean between the P1 (38.2ºC ± 0.17), P2 (37.6ºC ± 0.19) and P3 (37.0ºC ± 0.21) varied significantly, independent of the laparoscopy. These data indicated that laparoscopy didn't cause any significant alterations in the...(AU)

A laparoscopia ainda é pouco utilizada como ferramenta para técnicas de reprodução assistida em cervídeos sul-americanos, não havendo informações sobre seus efeitos e protocolos anestésicos seguros para sua realização. Objetivaramse avaliar as possíveis alterações na freqüência cardíaca (FC), respiratória (FR), saturação de oxihemoglobina (SpO2) e temperatura retal (TR) durante a laparoscopia para visualização dos órgãos reprodutivos de seis fêmeas de veado-catingueiro (Mazama gouazoubira) anestesiadas com a associação cetamina (5mg/kg), xilazina (0,3mg/kg), midazolam (0,5mg/kg) e isofluorano. Cada animal, após anestesiado, foi posicionado em decúbito dorsal para realização de duas laparoscopias com insuflação abdominal de CO2 (14,2 ± 2,39mmHg; M ± EPM) com intervalo de 40 dias. Para avaliar os principais eventos da laparoscopia, esta foi dividida em três períodos: animal sem insuflação abdominal (P1), com insuflação abdominal (P2) e insuflação abdominal com os quadris elevados a 45º (P3). O controle foi realizado após 40 dias da última laparoscopia, para isto, cada animal foi novamente anestesiado e mantido em decúbito dorsal por um período de tempo igual ao tempo médio de duração das anestesias realizadas nas laparoscopias, sem que o procedimento laparoscópico fosse realizado. O tempo de anestesia dos controles foi também dividido em P1, P2 e P3, respeitando o tempo médio de duração de cada um destes períodos das laparoscopias. Para análise dos dados foi usado o teste de análise de variância (ANOVA) seguido do teste de Tukey e valores de P<0,05 considerados significativos. Não houve diferença significativa nos parâmetros estudados em nenhum dos períodos estabelecidos para o controle e laparoscopia. Porém, a FR média entre P1 (38,8 ± 4,42) e P3 (32,7 ± 4,81) e a TR média entre P1 (38,2ºC ± 0,17), P2 (37,6ºC ± 0,19) e P3 (37,0ºC ± 0,21) variaram significativamente, independente da laparoscopia. Tais dados permitiram concluir que a laparoscopia...(AU)

Estudo das alterações cardiopulmonares e hematológicas em eqüinos premedicados com flunitrazepam e levomepromazina e anestesiados pela cetamina

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