Monopolar electrocautery use in minimally invasive urosurgery: Case report of ectopic ureter management in a bitch.

Background: Ureteral ectopy is a congenital anomaly, affecting young dogs, predominantly bitches. The main complication of the disease is urinary incontinence, which leads to low life quality for both animals and their owners. However, only two less invasive surgical management options are reported. Laser ablation is quite popular, while monopolar electrocautery use is very rare. Case Description: A 3-month and 1-week-old, 1.7 kg female Poodle was admitted to the Vetamicus clinic with severe urinary incontinence and moisture-associated dermatitis. After diagnosing intramural ectopy type during computed tomography scan and video cystoscopy, a search for surgical management options began. We proceeded with the monopolar cauterization technique, where a semirigid Karl Storz monopolar coagulating ball electrode is used to cut a mucous membrane partition between the ureter and urinary bladder. No complications occurred during or after the surgery. Ureter successfully healed and full continence was achieved together with sporadically using phenylpropanolamine syrup. Conclusion: The present case indicates that monopolar electrocautery use in intramural ectopy type management and possibly other urinary tract pathologies might be strongly beneficial.

Evaluation of the performance of an endoscopic 3-mm electrothermal bipolar vessel sealing device intended for single use after multiple use-and-resterilization cycles.

OBJECTIVE: To evaluate the performance of an endoscopic 3-mm electrothermal bipolar vessel sealing device (EBVS) intended for single use after multiple use-and-resterilization cycles. STUDY DESIGN: Ex vivo study. SAMPLE POPULATION: Eight 3-mm EBVS handpieces. METHODS: Handpieces were subjected to a maximum of 15 cycles of testing, including simulated surgery, sealing and burst pressure testing of porcine carotid arteries, reprocessing, and hydrogen peroxide plasma resterilization. Failure was defined as two sequential vascular seal leakage events occurring at <250 mm Hg. Histological evaluation, maximum external temperature of the jaws, sealing time, tissue adherence, jaw surface characterization, and mechanical deterioration were studied. Failure rate was analyzed by using a Kaplan-Meier curve. Linear and ordinal logistic mixed models were used to analyze sealing time, handpiece jaw temperature, and adherence score. RESULTS: Mean ± SD diameter of arteries was 3.22 ± 0.35 mm. Failure was observed starting at cycle 10 and going up to cycle 13 in 37.5% (3/8) of the handpieces. Tissue adherence increased after each cycle (P < .001). Maximum external temperature (79.8°C ± 13.9°C) and sealing time (1.8 ± 0.5 seconds) were not significantly different throughout cycles up to failure. A flatter surface and large scratches were observed microscopically throughout the jaw surface after repeated use and resterilization. CONCLUSION: The 3-mm EBVS handpiece evaluated in this study can be considered safe to use for up to nine reuse-and-resterilization cycles. CLINICAL SIGNIFICANCE: These data provide the basis for establishing preliminary guidelines for the reuse and hydrogen peroxide plasma resterilization of an endoscopic 3-mm EBVS handpiece.

Evaluation of transconjunctival thermal electrocautery for treatment of canine distichiasis: 88 eyelids (2013-2016).

OBJECTIVE: To describe a successful, simple treatment for canine distichiasis. ANIMALS STUDIED: Client-owned dogs presenting to Veterinary Specialty and Emergency Center, Levittown, Pennsylvania. PROCEDURE: Retrospective analysis of medical records for canine patients that underwent transconjunctival thermal electrocautery treatment (TCEC) for distichiasis alone or with concurrent eyelid surgery between 2013 and 2016. Fifty eyes of 26 dogs (n = 88 eyelids) were included in the study. Sixty-five eyelids (74%) were treated for distichia only, while 23 eyelids (26%) underwent concurrent eyelid surgery. Successful treatment was defined as resolution of clinical signs attributable to distichiasis. Forty-eight of 50 eyes (96%) were successfully treated with a single TCEC treatment (mean follow-up 187 ± 222 days). Sixty-one of 88 eyelids (69%) had no distichia at any follow-up time. Twenty-two eyelids (25%) had recurrence at or near a previously treated site (mean 150 ± 152 days). Of the eyes with recurrent distichia, all but 2 (91%) remained asymptomatic, requiring no further treatment. One dog with extensive TCEC treatment had significant recurrence on all eyelids requiring retreatment that resulted in focal entropion of 1 eyelid. Transient eyelid margin pigment loss and mild-to-moderate eyelid swelling were noted in all treated eyelids postoperatively. Suspected treatment site infection occurred 2 days postoperatively in 2/50 eyes (4%) of 1 patient. Two of 10 eyes (20%) with extensive eyelid treatment developed qualitative tear film deficiency OU (554 days postoperatively) and responded to topical tear stimulant therapy. CONCLUSION: TCEC is a successful, simple treatment for canine distichiasis.

Use of endoscopic-guided electrocautery ablation for treatment of tracheal liposarcoma in a dog.

CASE DESCRIPTION A 7-year-old 44-kg (97-lb) neutered male Great Pyrenees was referred for evaluation because of episodic dyspnea with cyanosis of 1 to 2 weeks' duration. Three days prior to evaluation, the clinical signs had worsened, including 1 episode of collapse. CLINICAL FINDINGS Thoracic radiography and CT revealed a well-delineated soft tissue mass, located approximately 1.5 cm cranial to the carina and occupying almost 90% of the tracheal lumen. A CBC and serum biochemical analysis were performed, and all results were within reference limits. TREATMENT AND OUTCOME Tracheoscopy confirmed the presence of a broad-based bilobate mass that was protruding from the right dorsal aspect of the trachea and occupied almost the entire tracheal lumen. The mass was successfully resected by endoscopic-guided electrocautery ablation. Findings of histologic evaluation were consistent with a diagnosis of liposarcoma. Immediately following the ablation procedure, the previously noted clinical signs of respiratory tract disease resolved. On follow-up examination 12 months later, no regrowth of the mass was evident on thoracic helical CT and tracheoscopy. CLINICAL RELEVANCE Endoscopic-guided electrocautery ablation of tracheal liposarcoma was a safe and effective minimally invasive treatment for the dog of this report. The procedure was brief and appeared to be well tolerated, resulting in immediate improvement of clinical signs.

Electrocautery technique for proximal tibial epiphysiodesis in Labrador retriever puppies: experimental study / Técnica de eletrocauterização para epifisiodese proximal da tíbia em cães filhotes da raça Labrador Retriever: estudo experimental

There are few studies about the treatment options for cranial cruciate ligament rupture in growing dogs, especially with epiphysiodesis techniques. The aim of this study was to evaluate the electrocautery technique for proximal tibial epiphysiodesis in Labrador retriever puppies. The novel electrocautery technique was compared with the screw technique regarding the efficacy for tibial plateau leveling in growing dogs. Six healthy Labrador retriever puppies were divided into two groups. The screw technique was used in one group and the electrocautery technique was used in the other group. Both proximal tibial epiphysiodesis techniques for tibial plateau leveling were effective in achieving reduced tibial plateau angle and did not cause significant joint changes. The screw technique was more invasive and caused slightly greater morbidity than the electrocautery technique. The electrocautery technique seems to be a good alternative for proximal tibial epiphysiodesis in young dogs.(AU)

São descritos poucos estudos sobre as opções de tratamento para a ruptura do ligamento cruzado cranial em cães na fase de crescimento, especialmente em relação às técnicas de epifisiodese. O objetivo deste estudo foi avaliar a técnica de eletrocauterização para epifisiodese proximal da tíbia em cães filhotes da raça Labrador Retriever. A nova técnica de eletrocauterização foi comparada com a do parafuso em relação à eficácia para nivelamento do platô tibial em cães na fase de crescimento. Seis filhotes saudáveis da raça Labrador foram selecionados e divididos aleatoriamente em dois grupos. A técnica do parafuso foi usada em um grupo, enquanto no outro foi usada a da eletrocauterização. Ambas as técnicas de epifisiodese proximal da tíbia para nivelamento do platô tibial foram eficazes na redução do ângulo do platô tibial e não causaram alterações articulares importantes. A técnica do parafuso foi considerada mais invasiva e causou morbidade um pouco mais acentuada do que a da eletrocauterização. Assim, a técnica da eletrocauterização parece ser uma boa alternativa para a epifisiodese proximal da tíbia em cães jovens.(AU)

Endoscopic treatment of an intrathoracic tracheal osteochondroma in a dog.

CASE DESCRIPTION: A 1.5-year-old spayed female Bernese Mountain Dog was examined for a 6-month history of intermittent vomiting, regurgitation, wheezing, and coughing. Initially, a diagnosis of gastroesophageal reflux disease with secondary aspiration pneumonitis was made but clinical signs did not resolve with treatment. CLINICAL FINDINGS: Thoracic and cervical radiography and CT revealed a sessile, irregularly marginated soft tissue opacity at the level of the fourth rib. Results of a CBC, serum biochemical analysis, and urinalysis were within reference limits. Results of abdominal ultrasonography were normal. TREATMENT AND OUTCOME: Tracheoscopy revealed a firm, irregularly marginated mass apparently originating from the ventral aspect of the trachea, occluding approximately one-half of the tracheal lumen, and located 2 cm cranial to the carina. Cytologic and histopathologic examination of fine-needle aspirate and biopsy samples suggested a benign etiology; therefore, endoscopic minimally invasive laser and electrocautery resection of the mass was scheduled. A total IV anesthetic protocol was administered with an oxygen-air mixture used to decrease the risk of fire during tracheal surgery. The mass was successfully resected, and histopathologic examination confirmed a diagnosis of osteochondroma. Clinical signs resolved, and at follow-up 32 months later, no regrowth of the mass was evident. CLINICAL RELEVANCE: Tracheoscopy-guided electrocautery and surgical diode laser resection was successful in removing an obstructive tracheal mass that was not resectable by means of a conventional open surgical approach. Minimally invasive procedures may decrease morbidity and mortality and improve outcome in appropriately selected small animal patients.

Vessel sealing versus suture ligation for canine ovarian pedicle haemostasis: a randomised clinical trial.

Vessel sealing (VS) is well established in laparoscopic ovariectomy (OVE) in dogs. The objectives of this study were to evaluate the efficacy of ovarian pedicle haemostasis by VS using a commercially available VS tool in open OVE and compare it with suture ligation (SL). A prospective, randomised clinical trial including 20 female dogs was designed. Open OVE was performed via a standard mid-line celiotomy by a single surgeon using a standardised protocol. At random, the right ovarian pedicle was sealed (VS) or ligated (SL) whereas the left pedicle was treated by the alternative technique. Surgical times for procedural stages and intra-operative complications were recorded and statistically evaluated. Total surgical time was 29.28±11.13 minutes (range 12.50-62.13 minutes) and time from identification to removal of the ovary was significantly less when sealing (VS 2.22±0.58 minutes) than when ligating (SL 4.10±1.13 minutes P=0.0001). Intra-operative complications were rare for both techniques (failure of the electrode of the VS device (n=3); ovarian pedicle haemorrhage due to ligature slippage (n=1)). The results of the current study indicate that ovarian pedicle haemostasis achieved by VS is significantly faster than by placement of ligatures without appearing to compromise safety.

Comparison of tissue effects in rabbit muscle of surgical dissection devices.

While some energy-based surgical dissection and coagulation modalities may offer excellent cutting and coagulation abilities, the impact on healing may differ among devices. We compared the tissue effects of three of these modalities with those of the standard surgical scalpel in rabbit muscle at 24 h and 14 days after surgery by evaluating radiographic and histological data. Linear incisions were made with each device in the dorsal lumbar musculature of rabbits using monopolar electrocautery in cut mode (MPE-Cut) and coagulation mode (MPE-Coag), a ferromagnetic induction loop (FMI), and a traditional scalpel. Magnetic resonance imaging scans and histological sampling were done at 24 h and 14 days. Subjective cutting and coagulation characteristics for each device were also recorded during surgery. The scalpel and FMI appeared to cause the least tissue damage adjacent to the incisions in rabbit dorsal lumbar musculature. The scalpel showed the best healing, while the FMI and MPE-Cut demonstrated good healing. The MPE-Coag showed the worst tissue healing. The scalpel, FMI, and MPE-Cut all exhibited favorable subjective characteristics during surgery. It appears that the FMI may be a better choice for surgical dissection and coagulation in muscle tissue than the MPE coagulation mode because it shows less tissue damage and offers better tissue healing.

Distichiasis in a ferret (Mustela putorius furo).

A 4-year-old intact male ferret was presented to the Ophthalmology Service of the Department of Clinical Sciences of Companion Animals of Utrecht University with chronic blepharospasm, epiphora, and conjunctivitis of the right eye. Examination of the eye revealed mild conjunctivitis and three hairs protruding from the openings of meibomian glands in the upper eyelid, providing the clinical diagnosis of distichiasis. The distichia were removed by transconjunctival unipolar electrocautery. Recovery was uneventful, but the original signs recurred 10 weeks after surgery. Ophthalmic examination revealed another distichia at a different location in the same eyelid and it was removed by full-thickness wedge excision. Histopathological examination failed to reveal the exact origin of the distichia. To our knowledge, this is the first reported case of distichiasis in a ferret.

Multiple inflammatory gastric polyps treated by endoscopic polypectomy with argon plasma coagulation in a dog.

An 11-year-old spayed female miniature dachshund was evaluated for a 2-month history of chronic vomiting. Abdominal ultrasonography revealed a heterogeneous mass in the pyloric region. Contrast upper gastrointestinal radiography demonstrated impairment of gastric outflow. Endoscopic examination revealed multiple polyps at the gastric pylorus. The pyloric polyps were variable in size, sessile-shaped and pedunculated. Initially, endoscopic polypectomy was attempted, but all the polyps could not be completely resected. Thus, endoscopic polypectomy with argon plasma coagulation was performed to cauterise the lesions. The histopathological diagnosis of the lesions was inflammatory polyps, and a moderate number of Helicobacter spp. was revealed. After the argon plasma coagulation treatment, the dog did not vomit, and improvement of clinical signs was maintained for 13 months. Endoscopic polypectomy with argon plasma coagulation may be useful for mixtures of sessile and pedunculated polyps. The present report may provide a basis for further studies of argon plasma coagulation treatment for canine gastrointestinal polyps.

Removal of a nasogastric tube fragment from the stomach of a standing horse.

An 82-cm fragment of nasogastric tube was removed from the stomach of an adult horse under standing sedation by use of an endoscope and electrocautery snare. This is the first report of successful non-surgical removal of a nasogastric tube fragment from the stomach of a horse.

Successful treatment of distichiasis in a cat using transconjunctival electrocautery.

A 2-year-old male castrated Domestic Short-haired cat presented to the Ophthalmology Service at the Matthew J. Ryan Veterinary Hospital at the University of Pennsylvania for evaluation of chronic bilateral ocular discharge and blepharospasm. Initial ophthalmic examination revealed severe conjunctivitis and keratitis and the presence of upper eyelid distichiae bilaterally. Initial therapy for suspected feline herpesviral infection provided moderate, but not complete, resolution of the clinical signs. Over the subsequent year, the cat suffered from recurrent, severe, ulcerative keratitis in both eyes despite appropriate medical therapy. Approximately 13 months after the initial presentation, the distichiae were surgically removed using transconjunctival electrocautery, which resulted in complete resolution of the clinical signs. This report documents bilateral distichiasis in a cat, a condition that is considered rare in this species.

Feasibility of single-portal access laparoscopic ovariectomy in 17 cats.

Laparoscopic ovariectomy (LapOVE) using single-portal access was attempted in 17 client-owned cats of different breeds admitted for elective ovariectomy. A 12 mm umbilical portal was placed 1 cm caudal to the umbilicus with the cat in dorsal recumbency. Then, a laparoscope with an operating channel was introduced into the portal with the cat in lateral recumbency. The right ovary was pulled to the abdominal wall using grasping forceps and fixed to the abdominal wall by a transabdominal suspension suture. The ovarian vasculature, suspensory ligament and proper ligament were progressively cauterised and transected with multifunction bipolar electrocoagulation forceps. The resected right ovary was exteriorised through the umbilical portal cannula. The left ovary was then removed from the abdomen in a similar fashion. Surgical time, intraoperative haemorrhage, amount of fat in the ovarian ligament, surgical complications and postoperative pain were recorded. The mean (sd) surgical time was 23 minutes and seven seconds (five minutes and 55 seconds). Intraoperative blood loss and fat deposition of the ovarian ligament were minimal. No intra- and postoperative complications were encountered. No cats needed rescue analgesia within 24 hours postsurgery.

Comparative use of CO2 laser, diode laser and monopolar electrocautery for resection of the soft palate in dogs with brachycephalic airway obstructive syndrome.

Clinical results, complications and the outcome of using either a carbon dioxide (CO2) laser, diode laser or electrocautery (ELEC) for resection of the soft palate with an extended palatoplasty technique in brachycephalic dogs with upper airway obstructive syndrome were compared. Dogs were randomly allocated into three groups (n=20 in each group): ELEC, diode and CO2 groups. The palatoplasty was made at the rostral aspect of the tonsils. A respiratory clinical score, ranging from 0 (normal) to 4 (cyanosis), was attributed to each dog before surgery and at 0 hours, 24 hours, two weeks and six months after surgery. A favourable outcome was defined as a one point or greater decrease in score 24 hours after surgery. The proportion of dogs with a favourable outcome was significantly higher in the CO2 (n=15) and ELEC groups (n=15) in comparison with the diode group (n=7) (OR=5.6, 95 per cent confidence interval 1.4 to 21.9). Surgical time was significantly shorter (P<0.001; mean [sd] 510 [178] seconds), and bleeding was less common (P<0.001; 30 per cent of cases) in the CO2 group. Complications were most frequent with the diode group (two cases of death and two cases of tracheostomy). The final outcome for all groups (n=57) was considered excellent in 79 per cent of cases and was considered good in 21 per cent.

[Ultrasonographic findings and treatment in a cow with a haemangiosarcoma of the urinary bladder]. / Ultraschallbefunde und Therapie bei einer Kuh mit einem Hämangiosarkom in der Harnblase.

A 4.5-year-old Swiss Braunvieh cow was presented to the Department of Farm Animals, University of Zurich, because of severe haematuria. All other clinical findings were within normal ranges. Transrectal ultrasonography revealed a 1 cm x 1 cm echogenic, irregularly-shaped, raised mass in the wall of the urinary bladder. Endoscopy identified the mass as a proliferation, approximately 0.5 cm in diameter, which was bleeding continuously. Thermocautery of the bleeding site was carried out twice five days apart via endoscopy. Clinical signs resolved for the remainder of the cow's life; she was slaughtered 15 months later because of infertility. Histological examination of the mass revealed a haemangiosarcoma.

Comparison of beak-trimming methods on early broiler breeder performance.

Beak trimming is necessary in commercial broiler breeders to prevent or decrease trauma as they mature. Two common beak-trimming methods were evaluated by early performance comparison with nontrimmed chicks (NBT). The robotic electrocautery device (ECD) trims and cauterizes the beak tip. The robotic infrared beak-trimming device (IBT) applies an infrared light beam to destroy the live basal tissue while leaving the hard corneum intact for the first approximately 10 d. In 2 experiments, day-of-hatch Ross 708 by-product chicks were obtained from a local hatchery, where 1/3 of the chicks were trimmed using IBT. All chicks were then transported to another hatchery where 1/3 were trimmed using ECD and 1/3 were NBT. Personnel at each hatchery were highly experienced and skilled with their respective technique. All chicks were then transported to University of Arkansas facilities. Before placement in each experiment, chicks were individually neck-tagged and weighed, and in experiment 1, beaks were measured using a digital caliper. A small but significant transient reduction in BW gain was observed at 14 d due to ECD as compared with NBT controls, although ECD was not different than IBT in experiment 1. In experiment 2, IBT birds were significantly heavier at 11 d by 7.8 and 8.7 g than the NBT or ECD, respectively. However, at d 21 and 42, no significant differences in BW or BW gain were observed. When beak trimming was performed on day of hatch by skilled and experienced personnel, little measurable effect on early performance was observed during the first 6 wk of life. Decreased broiler performance is generally considered a sensitive indication of physical or psychogenic stress. Given the marked reduction in beak-inflicted trauma with beak trimming birds as they reach sexual maturity, these results suggest that when properly performed, neither of these beak-trimming methods causes sufficient physical or psychogenic stress to markedly affect early growth rate.

Canine laparoscopic and laparoscopic-assisted ovariohysterectomy and ovariectomy.

As the benefits of minimally invasive surgery are more widely recognized by veterinarians and their clients, laparoscopic sterilization of female dogs is growing in popularity. Laparoscopic ovariohysterectomy and ovariectomy procedures in dogs are associated with less postoperative pain and a faster return to normal activity versus open sterilization procedures. The advent of newer laparoscopic electrocoagulation devices has further increased the technical feasibility and popularity of these procedures.

Unilateral and bilateral laparoscopic ovariectomy of mares by electrocautery.

Twelve horses underwent standing laparoscopic ovariectomy using electrocoagulation and fine dissection as the only means of achieving haemostasis of the severed ovarian pedicle. Four mares had bilateral ovariectomy performed as a treatment for aggressive behaviour thought to be associated with the oestrous cycle. Eight mares had unilateral ovariectomy performed for removal of a granulosa thecal cell tumour (GCT). Electrocoagulation provided an effective means of haemostasis in both normal and pathological ovaries. Only one case (removal of a GCT) had mild haemorrhage following electrocoagulation, necessitating the need for the application of endoscopic clips to achieve haemostasis. Six of the horses developed minor wound complications (none of them requiring any additional treatment). Long-term follow-up information showed complete resolution of abnormal behaviour in all eight horses with GCTs, but in one of the four horses with normal ovaries the aggressive behaviour had not been completely resolved.