The Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, 601 Vernon L. Tharp St, Columbus, OH, 43210, USA.
Comparative Hepatobiliary and Intestinal Research Program (CHIRP), College of Veterinary Medicine, The Ohio State University, 601 Vernon L. Tharp St, Columbus, OH, 43210, USA.
BMC Vet Res. 2021 Jan 21;17(1):43. doi: 10.1186/s12917-021-02753-9.
Transanal colonoscopy using the single-incision laparoscopic surgical port is routinely used in human patients but has not been described in veterinary literature. The purpose of this study was to describe a novel access technique elucidating its endoscopic clinical potential and benefits. Additionally, its challenges, limitations, and clinical usability will be discussed and critiqued. The aim of this study was to describe the feasibility of the single-incision laparoscopic surgical port (SILS) as a transanal access technique in canine cadavers and compare its technical capabilities and economic value when compared to the traditional approaches of digital pressure and purse string.
The overall time to reach an intraluminal pressure of 10 mmHg was faster for digital pressure versus purse string (p = 0.05) and faster for single-incision laparoscopic surgical port versus purse string (p < 0.02). Maximum luminal pressure was significantly higher between single-incision laparoscopic surgical port and purse string (p = 0.001). Mean pressure for both the complete 60 s trial and during the last 45 s of insufflation were highest with the SILS port and were significantly different between the single-incision laparoscopic surgical port versus purse string (p = 0.0001, p < 0.0001) and digital pressure versus purse string (p < 0.005, p < 0.01) respectively. Complete luminal distention and visualization was observed in all trials.
The SILS port in a cadaveric canine model allowed good visualization of the rectal and colonic mucosa, provided constant insufflation of the colon and was feasible and subjectively easy to perform. Technical differences between techniques were observed with the use of the SILS port allowing for potentially lower personnel requirements, less procedural associated cost, less variability versus the digital pressure technique between assistants, and the ability of additional instruments to be used for procedures.
经单一切口腹腔镜手术端口的经肛门结肠内镜检查在人类患者中常规使用，但尚未在兽医文献中描述。本研究的目的是描述一种新的入路技术，阐明其内镜临床潜力和益处。此外，还将讨论和批评其挑战、局限性和临床可用性。本研究旨在描述单一切口腹腔镜手术端口（SILS）作为犬尸体经肛门入路技术的可行性，并比较其技术能力和经济价值与传统的数字压迫和荷包缝合方法。
达到 10mmHg 腔内压力的总时间，数字压迫法比荷包缝合法更快（p=0.05），单一切口腹腔镜手术端口比荷包缝合法更快（p<0.02）。单一切口腹腔镜手术端口和荷包缝合法之间的最大腔压显著更高（p=0.001）。在整个 60 秒试验和最后 45 秒充气期间，SILS 端口的平均压力最高，SILS 端口与荷包缝合法（p=0.0001，p<0.0001）和数字压迫法与荷包缝合法（p<0.005，p<0.01）之间的压力差异有统计学意义。所有试验均观察到完全的腔扩张和可视化。
在犬尸体模型中，SILS 端口允许良好地观察直肠和结肠黏膜，提供结肠持续充气，并且是可行的，主观上易于操作。使用 SILS 端口观察到技术之间存在技术差异，这可能需要更少的人员要求、更少的程序相关成本、与数字压迫技术相比助手之间的差异更小，并且能够使用额外的仪器进行手术。
