Becher-Deichsel Anja, Aurich Jörg E, Schrammel Nadine, Dupré Gilles
Division for Obstetrics, Gynecology and Andrology, Department of Small Animals and Horses, Vetmeduni, Vienna, 1210, Austria.
Division for Obstetrics, Gynecology and Andrology, Department of Small Animals and Horses, Vetmeduni, Vienna, 1210, Austria.
Theriogenology. 2016 Jul 15;86(2):619-25. doi: 10.1016/j.theriogenology.2016.02.010. Epub 2016 Feb 24.
The objective of the study was to describe the feasibility of a glove port technique for laparoscopic-assisted surgical treatment of canine pyometra. In this retrospective case series, a total of 10 female dogs (median age 7 years, range 5.5-10.5 years; median weight 37.0 kg, range 12.9-64.0 kg) with pyometra were included. A multiaccess port was created from a surgical glove attached to an Alexis wound retractor and placed in the ventral midline between the middle and caudal third of the distance between umbilicus and pubic rim. A vessel sealing device was used for transection of the ovarian pedicle. The port size was selected on the basis of maximum uterine diameter determined by ultrasound. Median incision length was 5.0 cm (range 3.1-7.7 cm) for a maximum uterine diameter of 4.0 cm (range 2.0-7.0 cm). Median surgical time was 57 minutes (range 48-65 minutes). No case had to be converted to open celiotomy. Complications included one case of minor, self-limiting splenic trauma by the endoscope. In eight dogs, the distended uterine horns endangered safe access to the ovarian pedicle, and the vessel sealing device was inserted through a second cannula placed periumbilically. Extension of the original incision was necessary to exteriorize organs in two dogs. All dogs recovered quickly and were discharged either on the day of surgery or 1 day thereafter. In conclusion, a surgical glove port technique in combination with an Alexis wound retractor is feasible for surgical laparoscopic treatment of canine pyometra up to a diameter of 7 cm.
本研究的目的是描述手套端口技术用于腹腔镜辅助手术治疗犬子宫蓄脓的可行性。在这个回顾性病例系列中,共纳入了10只患有子宫蓄脓的雌性犬(中位年龄7岁,范围5.5 - 10.5岁;中位体重37.0 kg,范围12.9 - 64.0 kg)。将一只手术手套连接到Alexis伤口牵开器上制成多通道端口,并放置在脐部与耻骨联合上缘连线中、下三分之一交界处的腹中线处。使用血管闭合装置切断卵巢蒂。根据超声测定的最大子宫直径选择端口尺寸。最大子宫直径为4.0 cm(范围2.0 - 7.0 cm)时,中位切口长度为5.0 cm(范围3.1 - 7.7 cm)。中位手术时间为57分钟(范围48 - 65分钟)。没有病例需要转为开腹手术。并发症包括1例由内镜导致的轻微、自限性脾损伤。在8只犬中,扩张的子宫角危及安全进入卵巢蒂,血管闭合装置通过脐周放置的第二个套管插入。有2只犬需要延长原切口以取出器官。所有犬恢复迅速,均在手术当天或术后1天出院。总之,手术手套端口技术联合Alexis伤口牵开器对于直径达7 cm的犬子宫蓄脓的腹腔镜手术治疗是可行的。