Vázquez Francisco José, Vitoria Arantza, Gómez-Arrue Javier, Fuente Sara, Barrachina Laura, de Blas Ignacio, Romero Antonio
Equine Surgery and Medicine Service, Veterinary Hospital (HVUZ), Universidad de Zaragoza, C/Miguel Servet 177, 50013 Zaragoza, Spain.
Department of Animal Pathology, Faculty of Veterinary, Universidad de Zaragoza, C/Miguel Servet 177, 50013 Zaragoza, Spain.
Vet Sci. 2023 Jan 15;10(1):61. doi: 10.3390/vetsci10010061.
First cannulation is a critical manoeuvre in equine laparoscopy. This retrospective study aimed at the comparison of the frequency and type of complications detected when using different human laparoscopy devices for laparoscopic access in standing horses, and the influence of body condition in such complications. Forty-four procedures were included, and retrieved data comprised cannula insertion technique, body condition, and type and frequency of complications. Laparoscopic access techniques were classified into five groups: P: pneumoperitoneum created using Veress needle prior to cannulation; T: sharp trocar; D: direct access via surgical incision; V: Visiport optical trocar and H: optical helical cannula (OHC). In groups T, D, V and H, access was achieved without prior induction of pneumoperitoneum. Complications were registered in 13/44 procedures, of which retroperitoneal insufflation was the most common (6/13). Statistically significant association was found between the complication incidence and the type of access, with group D showing the highest complication frequency (80%) and group H the lowest frequency (0%). The majority of complications (9/13) were observed in overweight horses. We conclude that devices designed for human patients can be used for laparoscopic access in standing horses, with the use of OHC minimizing the appearance of complications, especially in overweight horses with OW.
首次套管插入术是马腹腔镜检查中的关键操作。这项回顾性研究旨在比较在站立的马匹中使用不同的人类腹腔镜设备进行腹腔镜穿刺时检测到的并发症的频率和类型，以及身体状况对这些并发症的影响。纳入了44例手术，收集的数据包括套管插入技术、身体状况以及并发症的类型和频率。腹腔镜穿刺技术分为五组：P：在套管插入前使用韦尔斯针建立气腹；T：锐性套管针；D：通过手术切口直接穿刺；V：可视端口光学套管针；H：光学螺旋套管针（OHC）。在T、D、V和H组中，无需预先建立气腹即可完成穿刺。44例手术中有13例出现并发症，其中腹膜后充气是最常见的（6/13）。发现并发症发生率与穿刺类型之间存在统计学上的显著关联，D组并发症频率最高（80%），H组频率最低（0%）。大多数并发症（9/13）出现在超重马匹中。我们得出结论，为人类患者设计的设备可用于站立马匹的腹腔镜穿刺，使用OHC可将并发症的发生率降至最低，尤其是在超重的肥胖马匹中。
