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站立位马匹腹腔镜双侧卵巢切除术的谐波手术刀评估

Evaluation of the harmonic scalpel for laparoscopic bilateral ovariectomy in standing horses.

作者信息

Düsterdieck Katja F, Pleasant R Scott, Lanz Otto I, Saunders Geoffrey, Howard Rick D

机构信息

Department of Large Animal Clinical Sciences, Virginia-Maryland Regional College of Veterinary Medicine, Virginia Tech, Blacksburg, VA 24061, USA.

出版信息

Vet Surg. 2003 May-Jun;32(3):242-50. doi: 10.1053/jvet.2003.50022.

Abstract

OBJECTIVE

To evaluate use of the Harmonic Scalpel (Ethicon Endo-Surgery Inc., Cincinnati, OH) for performing laparoscopic bilateral ovariectomy in standing horses.

STUDY DESIGN

Experimental study.

ANIMALS

Eight mares aged 2-20 years and weighing 410-540 kg.

METHODS

Standing laparoscopic bilateral ovariectomy was performed in 8 mares with normal reproductive tract anatomy. The Harmonic Scalpel (an ultrasonically activated instrument) was used to simultaneously transect and obtain hemostasis of the ovarian pedicle. Necropsy was performed on 4 mares 3 days after surgery and 4 mares 30 days after surgery. Gross and histopathologic evaluation of the ovarian pedicles was performed to characterize tissue reaction.

RESULTS

Complete hemostasis of the ovarian pedicles was obtained in all mares. Median transection time for the ovarian pedicle was 28 minutes. Postoperative complications included transient fever, moderate subcutaneous emphysema, and incisional seroma formation. On necropsy examination, there were no signs of generalized peritonitis, postoperative hemorrhage, or adhesion formation. Mild to moderate acute inflammation and scar formation with moderate chronic inflammation at the ovarian pedicle was found at 3 and 30 days. Median depth of coagulation necrosis at 3 days was 2.87 mm.

CONCLUSIONS

The Harmonic Scalpel appears to provide reliable hemostasis of the ovarian pedicle during elective laparoscopic ovariectomy in horses. Clinical Relevance-The Harmonic Scalpel represents a safe alternative to other methods of hemostasis during elective laparoscopic ovariectomy in horses.

摘要

目的

评估使用超声刀(爱惜康内镜外科公司,俄亥俄州辛辛那提市)对站立位马匹进行腹腔镜双侧卵巢切除术的效果。

研究设计

实验研究。

动物

8匹年龄在2至20岁、体重410至540千克的母马。

方法

对8匹生殖道解剖结构正常的母马进行站立位腹腔镜双侧卵巢切除术。使用超声刀(一种超声激活器械)同时切断卵巢蒂并实现止血。术后3天对4匹母马进行尸检,术后30天对另外4匹母马进行尸检。对卵巢蒂进行大体和组织病理学评估以确定组织反应特征。

结果

所有母马的卵巢蒂均实现完全止血。卵巢蒂的中位切断时间为28分钟。术后并发症包括短暂发热、中度皮下气肿和切口血清肿形成。尸检时,未发现全身性腹膜炎、术后出血或粘连形成的迹象。在术后3天和30天时,发现卵巢蒂处有轻度至中度急性炎症和瘢痕形成,并伴有中度慢性炎症。术后3天凝固性坏死的中位深度为2.87毫米。

结论

在对马匹进行择期腹腔镜卵巢切除术时,超声刀似乎能为卵巢蒂提供可靠的止血效果。临床意义——超声刀是马匹择期腹腔镜卵巢切除术时其他止血方法的一种安全替代方案。

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