Gilles Dupré

Laparoscopic ovariectomy in dogs: comparison between single portal and two-portal access.

OBJECTIVE To compare surgical times and perioperative complication rates of single portal access and 2-portal laparoscopic ovariectomy (LapOVE) in dogs using a bipolar vessel sealer/divider device, and to evaluate the performance of novice laparoscopists for right ovariectomy. STUDY DESIGN Controlled clinical trial. ANIMALS Female dogs (n=42). METHODS Dogs were divided into groups: 1=single portal and 2=2 portal. LapOVE was performed using a 5 mm vessel sealer/divider device and a 10 mm operating laparoscope (Group 1) or a 5 mm laparoscope (Group 2). Dog characteristics (weight, body condition score, ovarian ligament fat score), operative time, and perioperative complication rate were compared between groups. Right ovariectomy duration was evaluated for 2 novice laparoscopists. RESULTS No significant difference was found in mean total surgical time between group 1 (21.07 min/s) and group 2 (19.06 min/s). Factors significantly affecting times included body condition scores, ovarian ligament fat score, ovarian bleeding, and surgeon expertise. Minor complications (bleeding from ovaries or after splenic trauma) occurred and were similar in both groups. Bleeding was correlated to body condition score and ovarian ligament fat score. Interindividual differences were found among surgeons for right ovariectomy time. CONCLUSIONS Single portal access LapOVE using vessel sealer/divider device is feasible, safe, and does not significantly increase total surgical time in comparison with 2-portal approach. Laparoscopic skills may play a role in ability to perform single portal LapOVE. CLINICAL RELEVANCE LapOVE can be performed using single portal access.

Laparoscopic adrenalectomy for treatment of unilateral adrenocortical carcinomas: technique, complications, and results in seven dogs.

OBJECTIVE To investigate the feasibility of, and outcome after, laparoscopic adrenalectomy in dogs with unilateral adrenocortical carcinoma. STUDY DESIGN Case series. ANIMALS Dogs (n=7) with Cushings syndrome caused by unilateral adrenocortical carcinoma. METHODS Laparoscopic adrenalectomy with the dog in lateral recumbency on the unaffected side. Three 5-mm portals (1 laparoscopic portal, 2 instrument portals) were placed in the paralumbar fossa. A fourth instrumental portal (5-12 mm) was placed above the kidney. After dissection and hemostatic control of the phrenicoabdominal vein, the adrenal gland was carefully dissected or when there was capsule fragility, necrotic content was partially aspirated. The remaining glandular tissue was removed through the 12-mm trocar site. RESULTS Dogs with unilateral adrenocortical carcinoma (3 right-sided, 4 left-sided) without invasion of the caudal vena cava were successfully operated by laparoscopic approach. There were no significant intraoperative complications; 2 dogs died within 48 hours of surgery because of respiratory complications. Five dogs were discharged 72 hours after surgery, and signs of hyperadrenocorticism disappeared thereafter (survival time ranged from 7 to 25 months). CONCLUSIONS Laparoscopic adrenalectomy is feasible in dogs with either right- or left-sided adrenocortical carcinoma not involving the caudal vena cava. CLINICAL RELEVANCE When performed by experienced surgeons, laparoscopic adrenalectomy offers a minimally invasive alternative to open laparotomy or retroperitoneal surgery for the treatment of unilateral adrenocortical carcinoma in dogs.

Innovative approach to laparoscopic adrenalectomy for treatment of unilateral adrenal gland tumors in dogs

Objective To report a technique for, and short-term outcome of unilateral laparoscopic adrenalectomy in dogs positioned in sternal recumbency without abdominal support. Study Design Experimental and prospective clinical study. Animals Healthy dogs (n = 5) and dogs with unilateral adrenal gland tumor (n = 9). Methods Anesthetized dogs were positioned in sternal recumbency with 2 cushions placed under the dog to elevate the chest and pelvic area so that the abdomen was not in contact with the surgical table allowing gravitational displacement of the abdominal viscera. Three 5-mm portals were located in the paralumbar fossa. Adrenal glands were carefully dissected and surrounding tissues sealed and cut using a vessel-sealing device. A retrieval bag or part of a surgical glove finger was used to remove the adrenal gland from the abdomen. Surgical time and complications were recorded, and short-term outcome assessed. Results Adrenal glands in normal dogs and unilateral adrenal tumors (8 left, 1 right) not involving the caudal vena cava in affected dogs were successfully removed laparoscopically. There were no major intraoperative complications. Of the dogs with adrenal tumors, 1 dog died within 24 hours of surgery from unrelated causes. Eight dogs recovered within 1 day and were discharged within 72 hours. Surgical times ranged from 42 to 117 minutes and were significantly shorter than those reported previously. Conclusions Positioning anesthetized dogs in sternal recumbency with the abdomen suspended to facilitate gravitational displacement of the abdominal viscera improves access to, and visibility of, the adrenal gland for laparoscopic removal.OBJECTIVE To report a technique for, and short-term outcome of unilateral laparoscopic adrenalectomy in dogs positioned in sternal recumbency without abdominal support. STUDY DESIGN Experimental and prospective clinical study. ANIMALS Healthy dogs (n = 5) and dogs with unilateral adrenal gland tumor (n = 9). METHODS Anesthetized dogs were positioned in sternal recumbency with 2 cushions placed under the dog to elevate the chest and pelvic area so that the abdomen was not in contact with the surgical table allowing gravitational displacement of the abdominal viscera. Three 5-mm portals were located in the paralumbar fossa. Adrenal glands were carefully dissected and surrounding tissues sealed and cut using a vessel-sealing device. A retrieval bag or part of a surgical glove finger was used to remove the adrenal gland from the abdomen. Surgical time and complications were recorded, and short-term outcome assessed. RESULTS Adrenal glands in normal dogs and unilateral adrenal tumors (8 left, 1 right) not involving the caudal vena cava in affected dogs were successfully removed laparoscopically. There were no major intraoperative complications. Of the dogs with adrenal tumors, 1 dog died within 24 hours of surgery from unrelated causes. Eight dogs recovered within 1 day and were discharged within 72 hours. Surgical times ranged from 42 to 117 minutes and were significantly shorter than those reported previously. CONCLUSIONS Positioning anesthetized dogs in sternal recumbency with the abdomen suspended to facilitate gravitational displacement of the abdominal viscera improves access to, and visibility of, the adrenal gland for laparoscopic removal.

Right Intercostal Insertion of a Veress Needle for Laparoscopy in Dogs

Objective To evaluate right intercostal Veress needle (VN) insertion for laparoscopy in dogs. Study Design Longitudinal cohort study. Animals Female dogs (n = 56). Methods The VN was inserted in the last palpable right intercostal space, either 1/3 (Group T; 28 dogs) or mid distance (Group H; 28 dogs) from the xiphoid cartilage to the most caudal extent of the costal arch. Problems encountered during VN insertion and injuries were recorded, graded, and compared between groups, and also between the first and last 20 insertions. Results Pneumoperitoneum was successfully achieved by VN insertion in 49 (88%) dogs after a single (45 dogs) or 2nd attempt (4 dogs). Frequency of complications was as follows: 20 grade 1 (subcutaneous emphysema, omentum, or falciform injuries); 6 grade 2 (liver or spleen injury), and 1 grade 3 complication (pneumothorax occurred). No significant difference was found between the 2 groups or between the first and last 20 dogs. Conclusions Right intercostal VN insertion facilitates pneumoperitoneum in dogs with few consequential complications. No significant difference was found between entry sites; however, the mid distance insertion site in the last palpable intercostal space with dog positioned in dorsal recumbency is likely to result in less complications.OBJECTIVE To evaluate right intercostal Veress needle (VN) insertion for laparoscopy in dogs. STUDY DESIGN Longitudinal cohort study. ANIMALS Female dogs (n = 56). METHODS The VN was inserted in the last palpable right intercostal space, either 1/3 (Group T; 28 dogs) or mid distance (Group H; 28 dogs) from the xiphoid cartilage to the most caudal extent of the costal arch. Problems encountered during VN insertion and injuries were recorded, graded, and compared between groups, and also between the first and last 20 insertions. RESULTS Pneumoperitoneum was successfully achieved by VN insertion in 49 (88%) dogs after a single (45 dogs) or 2nd attempt (4 dogs). Frequency of complications was as follows: 20 grade 1 (subcutaneous emphysema, omentum, or falciform injuries); 6 grade 2 (liver or spleen injury), and 1 grade 3 complication (pneumothorax occurred). No significant difference was found between the 2 groups or between the first and last 20 dogs. CONCLUSIONS Right intercostal VN insertion facilitates pneumoperitoneum in dogs with few consequential complications. No significant difference was found between entry sites; however, the mid distance insertion site in the last palpable intercostal space with dog positioned in dorsal recumbency is likely to result in less complications.

Autologous Platelet Gel to Treat Chronic Decubital Ulcers: A Randomized, Blind Controlled Clinical Trial in Dogs

OBJECTIVE To determine the efficacy of topical application of the autologous platelet gel (PG) in canine chronic protracted decubital ulcers. STUDY DESIGN Prospective, randomized, blind controlled clinical trial. ANIMALS Dogs (n = 18) with bilateral chronic wounds caused by protracted decubitus ulcers. METHODS For each dog, wound side was randomized to receive either platelet gel (group PG) every 5 days for 5 dressing changes, or paraffin gauzes dressings (group C), as negative control. Wound healing and wound surfaces were compared at admission and then evaluated every 5th day, until day 25. Outcome variables were: open wound area, reduction of open wound surface compared to admission and to each preceding dressing change, time to complete epithelialization. RESULTS Significant differences in healing process were observed at day 5 and continued throughout the entire study period (P < .00001). At 25 days, mean percent reduction in wound area was 93.5% in group PG and 13.2% in group C (P < .00001). CONCLUSIONS Appropriately prepared autologous PG, an inexpensive, readily available blood derivative, applied topically results in more rapid healing of chronic non-healing decubital ulcers in dogs than those treated by use of paraffin-impregnated gauzes.

Intercostal insertion of Veress needle for canine laparoscopic procedures: a cadaver study.

OBJECTIVE To record and compare the frequency of organ penetration after insertion of a Veress needle (VN) in 6 different intercostal spaces (ICS) for creation of pneumoperitoneum in canine cadavers. STUDY DESIGN Descriptive study. ANIMALS Canine cadavers (n = 15). METHODS In 15 cadavers positioned in dorsal recumbency, VN insertion in the right and left 8th-10th ICS was performed, the abdomen insufflated, and VN position and any visceral penetration recorded. The frequency of viscus penetration was assessed in all insertion sites. RESULTS In cadavers, the right 9th ICS was associated with the lowest number of organ penetrations after VN insertion. CONCLUSION In cadavers, the position associated with the lowest frequency of penetrating any intraabdominal structure was the 9th ICSon the right side.Objective To record and compare the frequency of organ penetration after insertion of a Veress needle (VN) in 6 different intercostal spaces (ICS) for creation of pneumoperitoneum in canine cadavers. Study Design Descriptive study. Animals Canine cadavers (n = 15). Methods In 15 cadavers positioned in dorsal recumbency, VN insertion in the right and left 8th–10th ICS was performed, the abdomen insufflated, and VN position and any visceral penetration recorded. The frequency of viscus penetration was assessed in all insertion sites. Results In cadavers, the right 9th ICS was associated with the lowest number of organ penetrations after VN insertion. Conclusion In cadavers, the position associated with the lowest frequency of penetrating any intraabdominal structure was the 9th ICSon the right side.

Conservative treatment of partial gastrocnemius muscle avulsions in dogs using therapeutic ultrasound -- A force plate study.

OBJECTIVES In this report two cases of partial gastrocnemius muscle avulsion treated with pulsed therapeutic ultrasound are described. METHODS The outcome in these two dogs was evaluated using ultrasonographic imaging and the measurement of ground reaction forces with a force plate. RESULTS Both dogs showed an amelioration of the clinical signs within one month after commencement of the ultrasound therapy. The follow-up time for these cases was one year and six months respectively. Both of the dogs were free of lameness and had returned to their normal amount of exercise. Palpation of the fabella associated with the muscle injury did not produce any signs of pain. Ultrasonographic imaging did not detect any signs of haemorrhage or oedema, although scarring of muscle fibres was present. The force-plate analyses revealed an improvement. CLINICAL SIGNIFICANCE These results suggest that therapeutic ultrasound could be a beneficial treatment modality for this kind of muscle injury.

Thoracoscopic en bloc thoracic duct sealing and partial pericardectomy for the treatment of chylothorax in two cats

Two cats with intractable idiopathic chylothorax and a history of unsuccessful medical management were treated thoracoscopically with en bloc thoracic duct sealing and subtotal pericardectomy using a bipolar feedback-controlled vessel sealing device. No surgical complications were observed. Twenty-four and 26 months after surgery, both cats were free of thoracic effusion and clinical signs.

Use of latissimus dorsi and abdominal external oblique muscle for reconstruction of a thoracic wall defect in a cat with feline osteochondromatosis

A 4-year-old, male castrated European shorthair cat was presented with a firm mass palpable on the right caudal rib cage. Lateral and ventrodorsal radiographs of the thorax revealed a 4×3×2 cm large, expansile and radiodense mass originating from the distal part of the 13th rib. After removal of the tumour, which was histopathologically confirmed as feline osteochondromatosis, the diaphragm, omentum, external abdominal oblique and latissimus dorsi muscles were used to reconstruct the defect. Feline osteochondromatosis is induced by retroviruses, eg, feline leukaemia virus, for which the cat tested positive. The tumour was removed for palliative reasons, because such tumours have the tendency to transform into osteosarcomas. Six months after the surgical excision the cat showed no clinical signs of reoccurrence.

Thymomas in Rabbits: Clinical Evaluation, Diagnosis, and Treatment

Thymomas are rarely recorded in rabbits, and the literature includes comparatively few cases. Medical records were reviewed to identify all pet rabbits in which a mediastinal mass was diagnosed between Feb 2007 and Jan 2010. Signalment, history, clinical signs, diagnostic work-up (including laboratory data, diagnostic imaging, and ultrasound-guided fine-needle aspiration of the mediastinal mass), treatment modalities, survival time, and histologic findings were evaluated. Cytologic and/or histopathologic examinations revealed thymomas in all rabbits with mediastinal masses (n=13). Rabbits with thymomas showed clinical signs of dyspnea (76.9%), exercise intolerance (53.9%), and bilateral exophthalmos (46.2%). In seven rabbits the thymoma was removed surgically. Two rabbits were treated conservatively, and four rabbits were euthanized because of their poor clinical condition. The two rabbits that underwent surgery were euthanized 6 mo and 34 mo later. Mediastinal masses in rabbits appear to be more common than previously believed and consist primarily of thymomas rather than thymic lymphomas. Cytology of samples collected by ultrasound-guided fine-needle aspiration is an accurate diagnostic tool for the identification of thymomas in rabbits. Due to a high rate of perioperative mortality, intensive perioperative care and the provision of a low-stress environment are recommended for a successful thoracotomy.