Jones Kelly, Case J Brad, Evans Brian, Monnet Eric
J Am Vet Med Assoc. 2017 Apr 1;250(7):795-800. doi: 10.2460/javma.250.7.795.
OBJECTIVE To evaluate the economic and clinical feasibility of introducing rigid endoscopy and laparoscopy to a small animal general practice. DESIGN Prospective study. SAMPLE A single 2-veterinarian small animal practice in southern California. PROCEDURES In early 2012, endoscopic equipment was purchased, and both veterinarians in the practice undertook training in rigid endoscopic and laparoscopic procedures. Subsequently, information for client-owned animals that underwent endoscopic and laparoscopic procedures during a 12-month period (2012 to 2013) was collected. Cost of equipment and training, revenue generated, specific procedures performed, surgery time, complications, and client satisfaction were evaluated. RESULTS 78 endoscopic procedures were performed in 73 patients, including 71 dogs, 1 cat, and 1 rabbit. Cost of endoscopic and laparoscopic equipment and training in the first year was $14,809.71; most equipment was financed through a 5-year lease at a total cost of $57,507.70 ($ 10,675.20/y). Total revenue generated in the first year was $50,423.63. The most common procedures performed were ovariectomy (OVE; n = 49), prophylactic gastropexy (6), and video otoscopy (12). Mean ± SD surgery times for OVE (n = 44) and for OVE with gastropexy (5) were 63.7 ± 19.7 minutes and 73.0 ± 33.5 minutes; respectively. Twelve of 54 patients undergoing laparoscopic procedures experienced minor intraoperative complications. Conversion to laparotomy was not required in any patient. There were no major complications. All 49 clients available for follow-up were satisfied. CONCLUSIONS AND CLINICAL RELEVANCE With appropriate training and equipment, incorporation of basic rigid endoscopy and laparoscopy may be feasible in small animal general practice. However, results of the present study are not applicable to all veterinarians and practice settings, and patient safety considerations should always be paramount.
目的 评估在小型动物全科医疗中引入硬式内镜和腹腔镜检查的经济及临床可行性。 设计 前瞻性研究。 样本 加利福尼亚州南部一家由两名兽医组成的小型动物诊所。 程序 2012年初，购置了内镜设备，该诊所的两名兽医均接受了硬式内镜和腹腔镜手术培训。随后，收集了2012年至2013年这12个月期间接受内镜和腹腔镜手术的客户拥有动物的相关信息。评估了设备和培训成本、产生的收入、实施的具体手术、手术时间、并发症及客户满意度。 结果 73只患者接受了78例内镜手术，其中包括71只犬、1只猫和1只兔。第一年的内镜和腹腔镜设备及培训成本为14,809.71美元；大部分设备通过5年期租赁融资，总成本为57,507.70美元（每年10,675.20美元）。第一年产生的总收入为50,423.63美元。最常实施的手术是卵巢切除术（OVE；n = 49）、预防性胃固定术（6例）和视频耳镜检查（12例）。OVE（n = 44）及OVE联合胃固定术（5例）的平均±标准差手术时间分别为63.7±19.7分钟和73.0±33.5分钟。54例接受腹腔镜手术的患者中有12例出现轻微术中并发症。所有患者均无需转为剖腹手术。无重大并发症。所有49例可进行随访的客户均表示满意。 结论及临床意义 经过适当培训并配备合适设备后，在小型动物全科医疗中引入基本的硬式内镜和腹腔镜检查可能是可行的。然而，本研究结果并不适用于所有兽医及执业环境，患者安全考量应始终放在首位。
