RESUMO
OBJECTIVE: To describe the technique, complications, and outcome of the laparoscopic extra-abdominal transfascial suturing method for diaphragmatic rupture repair in a cat. STUDY DESIGN: Case report. ANIMALS: A 10 year old, female domestic shorthair cat. METHODS: An acute traumatic diaphragmatic rupture was diagnosed in a cat. Following initial stabilization, 3-port laparoscopic surgery was performed. After the laparoscopic reduction of herniating organs, a circumferential diaphragmatic tear was diagnosed, which was repaired using a multiple extra-abdominal transfascial suture technique. The total surgical time was 50 min with no intraoperative complications encountered. RESULTS: The successful procedure was confirmed by normalization of chest radiography, clinical signs, and blood gas analysis in the perioperative and postoperative periods. Mild skin irritation occurred 3 weeks after surgery but was resolved following the removal of sutures. The cat recovered well without major complications; the final reexamination was performed 3 months postoperatively. CONCLUSION: The laparoscopic extra-abdominal transfascial suturing technique appears to be a feasible, and effective technique for feline diaphragmatic circumferential rupture repair. This technique may be an alternative option to intracorporeal suturing for diaphragmatic rupture treatment in the cat.
Assuntos
Doenças do Gato , Laparoscopia , Gatos , Animais , Feminino , Laparoscopia/métodos , Laparoscopia/veterinária , Diafragma/cirurgia , Abdome/cirurgia , Ruptura/cirurgia , Ruptura/veterinária , Técnicas de Sutura/veterinária , Técnicas de Sutura/efeitos adversos , Doenças do Gato/cirurgiaRESUMO
OBJECTIVE: To describe the technique, complications, and outcome of laparoscopic portosystemic shunt attenuation (LPSSA) in dogs. STUDY DESIGN: Retrospective study. ANIMALS: Twenty client-owned dogs. METHODS: Medical records were searched for dogs with a single congenital extrahepatic portosystemic shunt (CEPSS) that was treated with LPSSA. Signalment, clinical signs, CEPSS location, diagnostic imaging, laparoscopic approach, operative technique, complications, and clinical outcome were reviewed. RESULTS: Fourteen dogs with CEPSS located in the epiploic foramen had a right (13/14) or left (1/14) paramedian approach. In 6 dogs a CEPSS was not located in the epiploic foramen, and a left paramedian approach was used. A 3 or 4-port technique was used in 7 and 13 dogs, respectively. A thin film band was used for CEPSS attenuation in all dogs. The median operating time for LPSSA was 62 min (range 27-98 min). Intraoperative complications requiring conversion to an open technique occurred in 5 dogs. Mild perioperative self-limiting portal hypertension occurred in 3 dogs, while severe portal hypertension with surgical revision occurred in 1 case. The complications were resolved, and all dogs had a good outcome. CONCLUSION: Laparoscopic portosystemic shunt attenuation can be performed in dogs, in particular for a CEPSS located in the epiploic foramen using a right paramedian approach. For CEPSS not located in the epiploic foramen, a left paramedian approach is recommended. Conversion to open celiotomy was required in around a third of cases. CLINICAL SIGNIFICANCE: Laparoscopic attenuation of CEPSSs can be performed in dogs and has a good clinical outcome, particularly for CEPSS located in the epiploic foramen.