Galuppo L D, Snyder J R, Pascoe J R, Stover S M, Morgan R
Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, USA.
Am J Vet Res. 1996 Jun;57(6):923-31.
To provide an accurate and detailed description of the laparoscopic anatomy of the abdomen of horses positioned in dorsal recumbency and to compare those observations with laparoscopic anatomy of standing horses. The effects of laparoscopy and positional changes on arterial blood pressure and blood gas values also were investigated.
Descriptive anatomic study.
Laparoscopy was performed on 6 horses (2 mares, 2 geldings, and 2 stallions) to record the normal laparoscopic anatomy of the abdomen in dorsal recumbency.
Feed was withheld from all horses for 36 hours. Horses, under general anesthesia, were examined in horizontal and inclined positions (head-up and head-down). Intermittent positive-pressure ventilation was used, arterial blood pressure was continuously monitored, and samples for arterial blood gas measurements were taken at intervals.
The main structures of diagnostic relevance observed in the caudal region of the abdomen were the urinary bladder, mesorchium and ductus deferens (left and right), left and right vaginal rings, insertion of the pre-pubic tendon, random segments of jejunum and descending colon, pelvic flexure of the ascending colon, body of the cecum, and cecocolic fold. The main structures observed in the cranial region of the abdomen were ventral surface of the diaphragm, falciform ligament and round ligaments of the liver, ventral portion of the left lateral, left medial, quadrate, and right lateral lobes of the liver, spleen, right and left ventral colons, sternal flexure of the ascending colon, apex of the cecum, and stomach.
Alterations in cardiovascular and respiratory function in response to pneumoperitoneum and various positional changes indicated the need for continuous and thorough anesthetic monitoring and support. Comparison of anatomic observations made in dorsally recumbent, inclined horses with those reported for standing horses should enable practitioners to make patient positioning decisions that best suit access to specific visceral structures. Development of special instrumentation for manipulation of the viscera in horses, particularly the intestinal tract, would increase the diagnostic and therapeutic capabilities of laparoscopy during dorsal recumbency.
准确、详细地描述处于仰卧位的马腹部的腹腔镜解剖结构,并将这些观察结果与站立位马的腹腔镜解剖结构进行比较。还研究了腹腔镜检查和体位变化对动脉血压和血气值的影响。
描述性解剖学研究。
对6匹马(2匹母马、2匹去势公马和2匹种马)进行腹腔镜检查,以记录仰卧位时腹部正常的腹腔镜解剖结构。
所有马匹禁食36小时。在全身麻醉下,对马匹进行水平位和倾斜位(头高位和头低位)检查。采用间歇正压通气,持续监测动脉血压,并定期采集动脉血气测量样本。
在腹部尾侧区域观察到的主要具有诊断意义的结构有膀胱、睾丸系膜和输精管(左右)、左右阴道环、耻骨前腱的附着点、空肠和降结肠的随机节段、升结肠的骨盆曲、盲肠体和盲结肠襞。在腹部头侧区域观察到的主要结构有膈的腹侧面、肝镰状韧带和圆韧带、肝左外侧叶、左内侧叶、方叶和右外侧叶的腹侧部分、脾脏、左右腹侧结肠、升结肠的胸骨曲、盲肠尖和胃。
气腹和各种体位变化引起的心血管和呼吸功能改变表明需要持续、全面的麻醉监测和支持。将仰卧位、倾斜位马匹的解剖学观察结果与站立位马匹的报告结果进行比较,应能使从业者做出最适合接近特定内脏结构的患者体位决策。开发用于操作马内脏,特别是肠道的特殊器械,将提高仰卧位时腹腔镜检查的诊断和治疗能力。