Maneuverability of the Scope and Instruments within Three Different Single-Incision Laparoscopic Ports: An Experimental Pilot Study.

Single-port access systems (SPASs) are currently used in human and veterinary surgeries. However, they pose technical challenges, such as instrument crowding, intra- and extracorporeal instrument collision, and reduced maneuverability. Studies comparing the maneuverability of the scopes and instruments in different SPASs are lacking. This study aimed to compare the maneuverability of three different SPASs: the Covidien SILS-port, Storz Endocone, and glove port. A clear acrylic box with artificial skin placed at the bottom was used to mimic the abdominal wall and cavity. The three SPASs were placed from below, and a 10-mm endoscope and 5-mm instrument were introduced. A motion analysis system consisting of 18 cameras and motion analysis software were used to track the movement of the endoscope and instrument, to determine the volume of the cone-shaped, three-dimensional figures over which movement was possible, with higher values indicating greater maneuverability. The Mann-Whitney U test was used for the analysis. The maneuverability of the endoscope alone was significantly higher in the glove port system than in the other two SPASs. When inserting an additional instrument, the maneuverability significantly decreased in the SILS-port and Endocone, but not in the glove port. The highest maneuverability overall was found in the glove port.

Enteroplication in cats with intussusception: a retrospective study (2001-2016).

OBJECTIVES: The aim of this study was to report complications, as well as short- and long-term clinical outcomes of cats suffering from surgically reduced intussusception with and without enteroplication. METHODS: Medical records of cats presented at our institution with intussusception between 2001 and 2016 were reviewed. The following data were retrieved: signalment; history; physical examination; diagnostic imaging, surgical and histological findings; and outcomes. Animals were grouped as with or without enteroplication. Duration of surgery, survival, complication and recurrence rates, duration of hospitalisation, and short- and long-term outcomes were compared. RESULTS: Cats with intussusception presented with unspecific type and duration of clinical signs. Male or male castrated cats and Maine Coons were over-represented in both groups. Enteroplication was performed in 48% (10/21) of the cats. Cats in the enteroplication group were significantly younger than those in the non-enteroplication group ( P = 0.023). Duration of surgery, time of hospitalisation, complication rate and outcomes did not differ between the two groups. Two complications in the short term and one complication in the long term were possibly associated with enteroplication. A recurrence of intussusception was seen in 2/17 cats approximately 12 months after initial surgery, both previously treated with enteroplication. CONCLUSIONS AND RELEVANCE: Although the number of cases was limited, our results suggest that enteroplication should be cautiously performed in cats with intussusception as it may be associated with major complications in the short and long term, and its efficacy remains unclear. Based on this study, the need for enteroplication in cats following a correction of intussusception could be questioned.

Postoperative complications and owner assessment of single portal laparoscopic ovariectomy in dogs.

The aim of this retrospective study and owner survey was to record the postoperative complication rate, pain score and owners' satisfaction rates of single portal laparoscopic ovariectomy in dogs using an operating laparoscope and to compare our results with data in the veterinary literature on other laparoscopic methods. Therefore, the medical records of all bitches that were spayed using a laparoscopic single port ovariectomy with an operating laparoscope between November 2007 and November 2014 were reviewed. A minimum follow-up period of 12 months was required for study inclusion. One hundred and thirty two adult, healthy, femal dogs were included in our study. The information collected included breed, bodyweight, age at ovariectomy and postoperative complications detected during follow-up 9-14 days after surgery. Furthermore, an electronic questionnaire was implemented, and the owners of the dogs were asked to report on long-term complications and to retrospectively evaluate postoperative pain and overall satisfaction. Sixty-two different and mixed breed dogs with weights ranging from 1.9 to 50 kg and ages ranging from 0.5 to 10.8 years were included. Short-term complications were detected in 21 out of 132 cases, mostly at the surgical site (15.9 per cent). According to our questionnaire (n=65), 10 dogs developed urinary incontinence categorised as a major complication (15.4 per cent). The owner's evaluated pain score was less than 300 on a 1000-unit visual analogue scale for 56 out of 65 dogs (86.2 per cent) and less than 500 in 63 dogs (96.9 per cent). The dog owners' satisfaction rate was 95.3 per cent (87.5 per cent evaluated the surgery as excellent and 7.8 per cent as good). Altogether, our study suggests that single port access using an operating laparoscope for ovariectomy has minor complication rates comparable to other laparoscopic techniques but has the advantages of a low postoperative pain level as evaluated by the owner and a very high owner's satisfaction rate.

Influence of 2 Veress needles and 4 insertion sites on Veress needle penetration depth: A comparative study in cadaveric dogs.

OBJECTIVE: To evaluate the penetration depth (VNPD) of 2 disposable Veress needles (VN) at 4 insertion sites in the abdomen. STUDY DESIGN: Descriptive study. SAMPLE POPULATION: Canine cadavers (n = 22, 6 for confirmation of the test methods and 16 for the comparative study). METHODS: Two disposable VN (VN A and VN B) were inserted at 4 sites (9th intercostal space [ICS] and preumbilical, paraumbilical, and subumbilical sites) in dorsally recumbent dogs by using a hand-cranked jig. The VNPD was measured as the distance traveled by the VN between the subcutaneous tissue and the perforation of the peritoneum on the basis of audible clicks and visible feedback from the VN. The effects of the VN type and insertion site on the VNPD were analyzed by using a linear mixed-effects model. RESULTS: VNPD varied between insertion sites (P = .01) and VN (P < .01). The VNPD was less at the 9th ICS than at the preumbilical, paraumbilical, and subumbilical sites. The maximal magnitude of change was 7.4 mm. Veress needle B (with a low spring rate, lower forces, and a back-cut bevel design) penetrated farther than VN A (with a high spring rate, high forces, and a lancet-type bevel) at 3 of 4 insertion sites. The maximal magnitude of change was 6.8 mm. CONCLUSION: Veress needle penetration depth varied between VN designs but was the least at the 9th ICS in canine cadavers. CLINICAL SIGNIFICANCE: Insertion of a VN at the 9th ICS is recommended to minimize its penetration into the abdomen. Associations between VNPD and mechanical factors, such as the sharpness and spring rate of VN, warrant additional research.

IMAGING DIAGNOSIS-RADIOGRAPHY AND COMPUTED TOMOGRAPHY OF RADIOULNAR ISCHEMIC NECROSIS IN A JACK RUSSELL TERRIER.

A 7-year-old Jack Russell Terrier with a history of minor trauma was presented for lameness of the left forelimb. Radiography and computed tomography demonstrated a localized radioulnar osteolytic lesion with cortical bone loss and enthesiophytes. Based on results of diagnostic imaging and histopathological examination, the final diagnosis was radioulnar ischemic necrosis (RUIN), complicated by pathologic fracture. A rare disorder of unknown etiology, RUIN may be secondary to tearing of the interosseous ligament and potential ischemia. It should be differentiated from neoplastic or fungal disease. To the authors´ knowledge, this is the first canine case report describing RUIN.

Mapping system for portal placement in laparoscopic procedures of small animals.

BACKGROUND: Current recommendations for portal placement in laparoscopy are often imprecise. The aim of this study was to establish and evaluate a mapping system for portal placement during laparoscopic procedures in small animals. Sixty-four final-year veterinary students took part in this in papyro study. Descriptions of portal placements of two recent veterinary laparoscopic papers were randomly chosen as templates. The students performed portal placement based either on the description in the papers or based on the orthogonal mapping system for portal placement developed by the authors in a previous pilot study. The participants were randomly divided into two groups and asked to virtually chart positions of the portals on two photographs of a dog's abdomen. Group A (n = 31) placed the portals using the mapping system, and Group B (n = 33) placed the portals based on the explanations provided in two randomly selected studies. RESULTS: Group A achieved an overall correct placement rate of 94.91 % (87.1-100.0 %) with an overall mean distance of 1.31 mm (0.00-3.61 mm) from the desired placement points. Group B achieved an overall correct placement rate of 40.8 % (3.1-93.3 %) with an overall mean distance of 16.97 mm (7.17-27.63 mm) from the desired placement points. The students in Group A performed significantly better than did students in Group B (P < .05). CONCLUSIONS: Use of the mapping system significantly improved correct portal placement in a dog photograph model. Use of such systems in laparoscopy may help facilitate correct portal placement and improve the repeatability of procedures, especially for the novice surgeon.

Effects of rotation and osteotomy angulation on patellar tendon insertion position during circular tibial tuberosity osteotomy.

OBJECTIVE: To evaluate the influence of rotation of the tibial tuberosity (TT) in the sagittal plane and angulation of osteotomy in the frontal plane (FPA) on the displacement of patellar tendon (PT) insertion. STUDY DESIGN: Ex vivo biomechanical study. SAMPLE POPULATION: Canine tibiae (n = 36). METHODS: Nine groups of 4 tibiae each had a circular osteotomy of the TT at an FPA from -20° to +20° with increments of 5° for each group. The osteotomized TT was rotated by angles of rotation (AORs) of 10°, 20°, or 30° in the sagittal plane. The craniocaudal (CCD), distoproximal (DPD), and mediolateral (MLD) displacements of a marker located at the PT insertion on the TT were evaluated radiographically. Differences between groups were analyzed by Mann-Whitney U test and Friedman 2-way ANOVA. RESULTS: There was a significant correlation between the AOR and CCD. A positive FPA resulted in a high CCD and lateral shift of the TT at every AOR. Performing an osteotomy at an FPA of 0° produced the maximum amount of DPD. CONCLUSIONS: FPA and AOR during circular osteotomy of the TT influence the final displacement of the PT insertion in all 3 planes.

Fourier analysis of vertical ground reaction forces in dogs with unilateral hind limb lameness caused by degenerative disease of the hip joint and in dogs without lameness.

OBJECTIVE: To evaluate the applicability of Fourier analysis for assessment of ground reaction forces (GRFs) and differentiation between dogs with unilateral hind limb lameness caused by degenerative joint disease of the hip (DJD-H) and dogs without lameness. ANIMALS: 37 dogs with or without unilateral DJD-H. PROCEDURES: Data were obtained from other studies and analyzed retrospectively. Among the 37 dogs, 20 had unilateral DJD-H and 9 (non-Belgian Malinois breeds) had no lameness; another 8 were nonlame Belgian Malinois (radiographically confirmed Fédération Cinologique International classification A [ie, no hip dysplasia or DJD-H]). Gait data acquisition was performed as dogs walked on a treadmill with integrated force platforms. The peak vertical force, mean vertical force, and vertical impulse were compared among the 3 groups. Fourier analysis was performed on the force-time curves for the vertical GRF, and calculated Fourier coefficients were compared within and between groups. RESULTS: Lameness in the hind limbs with DJD-H was detectable via conventional analysis of the GRF as well as via Fourier analysis. However, subtle gait aberrations in the forelimbs of the dogs with DJD-H were detected solely via Fourier analysis of GRFs and remained undetected via conventional analysis. CONCLUSIONS AND CLINICAL RELEVANCE: Results support the applicability of Fourier analysis for evaluation of force-time curves of GRFs. Fourier analysis can reveal subtle alterations of gait that might otherwise remain inapparent; however, further investigation is necessary before this method can be routinely applied for lameness detection in dogs.