Acesso cirúrgico transvaginal em NOTES (cirurgia endoscópica por orifício natural) / Transvaginal surgical access in NOTES (Natural Orificies Translumenal Endoscopic Surgery)

RESUMO

A cirurgia endoscópica por orifício natural (NOTES) é um novo conceito de cirurgia que combina a técnica de videolaparoscopia e endoscopia flexível, com o objetivo de criar uma nova técnica cirúrgica que evita incisões abdominais. Em nosso trabalho, utilizamos 6 (seis) cadelas adultas, pesando entre 10 e 20 kg para realizar a técnica NOTES por via vaginal. Demonstramos que a via transvaginal representa um acesso viável à cavidade abdominal com endoscópio flexível, para fins diagnósticos e terapêuticos, eliminando qualquer incisão abdominal e minimizando complicações pósoperatórias(AU)

ABSTRACT

Laparoscopic adrenalectomy (LA) is taken as the “gols standard” in surgical approach to adrenal pathologies in human medicine. Good results are achieved when LA is applied to treatment of Cushings syndrome as well as for functional adrenocortical adenocarcinomas/adenomas. Nevertheless, when adrenalectomy is indicated in veterinary practice, it is performed by open access, with a right level of complications when compared to LA in human medicine. No report was found in veterinary literature concerning LA application to any adrenal disorder. Hyperadrenocorticim is the indication for adrenalectomu in veterinary medine and the purpose of this article is review potential advantages and disadvantages of LA as routine procedure in surgical approach glands. The better esthetic effect, great facility in visualization, dissection and hemostasia, smaller preoperative time and smaller level of post-operatory complications represents potential advantages to LA applicability in veterinary practice. However, severe obesity, tumor with big sizes (>10 12 cm) and infiltrative and emboli producing adrenal tumors are considered portential complications for LA. Padronization of an LA technique suitable through models, as well as the need os surgeons to with the learning curve, are aspects that can make in future, LA the gold standard technique for adrenalectomy in veterinary medicine(AU)