Abstract
The present report describes a novel approach to and presents the surgical results for laparoscopic hepatectomy of the left lobes in small dogs. A purely laparoscopic four-port approach was used in seven beagles. The left triangular ligament was cut first, then the base of the left medial lobe (LMB) was ligated with silk thread using a needle, and the liver parenchyma of the LMB approximately 0.5 cm above the ligation site was removed with LigaSure. The left lateral lobe (LLB) was removed in the same manner. Blood was collected on postoperative days 1, 3, 7, and 14 for laboratory testing. Left hepatic lobe resection was successfully completed in all dogs, with an average operation time of 102.53 ± 9.07 min and an average blood loss of 32.10 ± 6.43 ml. Serious postoperative complications were not observed. The white blood cell (WBC) count and alkaline phosphatase (ALP) level were significantly increased in experimental dogs 1 day after surgery (P< 0.05); aspartate transferase (AST) and alanine transaminase (ALT) were significantly different before and after surgery (P< 0.01); and all the indicators were basically normal seven days after the operation. Exploratory laparoscopy at 28 days revealed adhesion of the surface of the liver section to the omentum or the gastric wall, but there were no other abnormal findings. The combined application of liver pedicle ligation and LigaSure for liver lobectomy provides a simple and effective method for generating liver lobectomy models for research on liver disease and regeneration and a feasible laparoscopic liver lobectomy operation scheme for small dogs (10–15 kg).
Highlights
The white blood cell (WBC) count and alkaline phosphatase (ALP) level were significantly increased in experimental dogs 1 day after surgery (P < 0.05); aspartate transferase (AST) and alanine transaminase (ALT) were significantly different before and after surgery (P < 0.01); and all the indicators were basically normal seven days after the operation
Hepatectomy is widely used in medical research and experimental surgery, for studying liver failure (Imai et al 2019; Meyer et al 2019; Shirata et al 2019), regeneration (Schadde et al 2017; Tsai et al 2018), and transplantation (Etheredge et al 2019; Lué et al 2019; Majd et al 2019), and is one of the common hepatic procedures performed on companion animals (Boothe 2015; Zhang et al 2014)
Laparoscopic hepatectomy often requires both an experienced surgeon and expensive equipment, such as the Endo-GIA stapling system (Consten et al 2008; Scuderi and Troisi 2014; Yao and Wu 2016), a saline-coupled bipolar sealer (Sastry et al 2019), an ultrasonic scalpel (Chai et al 2018; Kim et al 2017), a laparoscopic laser (Ellebrecht et al 2018) and a microwave applicator (Chong et al 2018; Dimitri et al 2019; Shen et al 2018). These factors restrict the widespread use of hepatic lobectomy in veterinary clinics
Summary
Hepatectomy is widely used in medical research and experimental surgery, for studying liver failure (Imai et al 2019; Meyer et al 2019; Shirata et al 2019), regeneration (Schadde et al 2017; Tsai et al 2018), and transplantation (Etheredge et al 2019; Lué et al 2019; Majd et al 2019), and is one of the common hepatic procedures performed on companion animals (Boothe 2015; Zhang et al 2014). The successful establishment of hepatectomy models could promote technological advances and the development of new methods for the treatment of hepatic diseases. Laparoscopic methods can be used to establish experimental animal models as well as to perform liver surgery (Chen et al 2018; Liu et al 2019; Takahara et al 2016; Zhang et al 2014a). In this study, we selected beagles as the experimental surgical model for developing and testing a simple and effective new method for liver lobectomy, and to provide a reference for the establishment of animal models for research on treatment of liver disease in small animals
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