Equis ISSN 2398-2977

Abdomen: laparoscopy

Contributor(s): Graham Munroe, Jarred Williams

Introduction

  • An endoscopic surgical technique similar to arthroscopy Joint: arthroscopy - overview that involves the use of a rigid fiberoptic telescope coupled to a light source for viewing, and specialized instruments for surgical manipulation based on the principle of triangulation.
  • Indicated for some types of abdominal surgery and for diagnostic purposes (following full clinical examination, haematology, fluid/aspirate analysis and ultrasonography), eg:
    • Recurrent or acute colic.
    • Persistent weight loss.
    • Peritonitis.
    • Urogenital disease.
    • Rectal injuries.

Uses

Diagnostic

Surgical

  • Cryptorchidectomy:
  • Ovariectomy:
    • Standing flank or ventral abdominal Ovary: ovariectomy - laparotomy approach.
    • Each ovary is routinely removed from the ipsilateral side, though a report of bilateral ovariectomy via left sided approach has been published.
    • The ovarian pedicle may be infiltrated with local anesthetic or a caudal epidural Anesthesia: epidural performed in the standing patient.
    • The ovary is usually removed after dissection of the ovarian pedicle and application of 1 or 2 Endoloop® sutures or via coagulation.
    • Alternatives include laser transection or use of a laparoscopic stapling device.
  • Inguinal hernia repair:
    • General anesthesia and ventral abdominal laparoscopy or standing flank with sedation.
    • Repair with automated stapling devices for mesh implantation to close vaginal ring, polypropylene mesh stapled in place sub-peritoneally, barbed suture, peritoneal flap or cyanoacrylate.
  • Ruptured bladder:
  • Reproductive system:

Advantages

  • Good visualization of the abdominal or thoracic cavity under exploration.
  • Unique visualization of dorsal abdominal organs and conditions, eg duodenal adhesions.
  • Short post-operative convalescent period due to minimal surgical trauma.
  • Fewer complications than with laparotomy.
  • Standing laparoscopy does not require general anesthesia.

Disadvantages

  • Amount and expense of instrumentation.
  • Requirement for new skills.
  • Some procedures technically difficult or not possible, eg intestinal biopsy.
  • Inaccessibility of some abdominal organs.
  • Increased number of false negatives in diagnostic procedures compared with laparotomy.

Requirements

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Preparation

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Procedure

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Aftercare

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Outcomes

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Prognosis

  • For elective procedures (ovariectomy, cryptorchidectomy, hernia repair, nephrosplenic space closure) prognosis is good.
  • For reasons of disease or biopsy, the prognosis is dependent upon underlying condition or results of the biopsy.

Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Jones A R E, Ragle C A, Anderson D & Scott C (2017) Laparoscopic evaluation of the small intestine in the standing horse: Technique and effects. Vet Surg 46 (6), 812-820 WileyOnline.
  • Colbath A C, Hackett E S, Lesser C S & Hendrickson D A (2017) Left paralumbar laparoscopic bilateral ovariectomy in mares. Vet Surg 46 (4), 574-579 PubMed.
  • van Bergen T, Wiemer P, Bosseler L, Ugahary F & Martens A (2016) Development of a new laparoscopic Foramen Epiploicum Mesh Closure (FEMC) technique in 6 horses. Equine Vet J 48(3), 331-337 PubMed.
  • Nelson B B, Ruple-Czerniak A A, Hendrickson D A & Hackett E S (2016) Laparoscopic closure of the nephrosplenic space in horses with nephrosplenic colonic entrapment: Factors associated with survival and colic recurrence. Vet Surg 45 (S1), O60-O69 PubMed.
  • Katzman S A, Vaughan B, Nieto J E & Galuppo L D (2016) Use of a laparoscopic specimen retrieval pouch to facilitate removal of intact or fragmented cystic calculi from standing sedated horses: 8 cases (2012-2015). J Am Vet Med Assoc 249 (3), 304-310 PubMed.
  • Rossignol F, Mespoulhes-Rivière C, Vitte A, Lechartier A & Boening K J (2014) Standing laparoscopic inguinal hernioplasty using cyanoacrylate for preventing recurrence of acquired strangulated inguinal herniation in 10 stallions. Vet Surg 43 (1), 6-11 PubMed.
  • Ragle C A, Yiannikouris S, Tibary A A & Fransson B A (2013) Use of a barbed suture for laparoscopic closure of the internal inguinal rings in a horse. J Am Vet Med Assoc 242 (2), 249-253 PubMed.
  • Mueller E & Epstein K (2009) A view into the 'black box': peering through the window with ultrasound and laparoscopy. Equine Vet Educ 21 (1), 31-35 VetMedResource.
  • Walmsley J P (2007) Laparoscopy in horses with abdominal pain. Equine Vet Educ 19 (2), 64-66 VetMedResource.
  • Walmsley J P (1999) Review of equine laparoscopy and an analysis of 158 laparoscopies in the horse. Equine Vet J 31 (6), 456-464 PubMed.
  • Boure L et al (1998) Use of laparoscopic equipment to divide abdominal adhesions in a filly. JAVMA 212 (6), 845-847 PubMed.
  • Collier D et al (1998) Laparoscopy in the horse - comparative keyhole surgery. Equine Vet J 30(2), 91-92 PubMed.
  • Fischer A T & Vachon A M (1998) Laparoscopic intra-abdominal ligation and removal of cryptorchid testes in horses. Equine Vet J 30 (2), 105-108 PubMed.
  • Ragle C A et al (1998) Ventral abdominal approach for laparoscopic cryptorchidectomy in horses. Vet Surg 27 (2), 138-142 PubMed.
  • Davis E W (1997) Laparoscopic cryptorchidectomy in standing horses. Vet Surg 26 (4), 326-331 PubMed.
  • Fischer A T Jr (1997) Advances in diagnostic techniques for horses with colic. Vet Clin North Am Equine Pract 13 (2), 203-219 PubMed.
  • Hendrickson D A et al (1997) Laparoscopic cryptorchid castration in standing horses. Vet Surg 26 (4), 335-339 PubMed.
  • Hendrickson D A et al (1996) Instrumentation and techniques for laparoscopic and thoracoscopic surgery in the horse. Vet Clin North Am Equine Pract 12 (2), 235-259 PubMed.
  • Galuppo L D Snyder J R & Pascoe J R (1995) Laparoscopic anatomy of the equine abdomen. Am J Vet Res 56 (4), 518-531 PubMed.


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