Ultrasonic shears and bipolar vessel-sealing system for three-port laparoscopic ovariohysterectomy in dogs

N Guizzo-Júnior,G Brambatti,F.V Tomazzoni,F.R Santos,M.V Brun,J.P.S Feranti,L.W Sartori,R.L Guedes,M.C Bairros,M.A.M Silva,M Bortoluzzi,A.C Motta

doi:10.1590/1678-7457

Abstract

In the current experimental study, two different instruments were compared for prophylactic hemostasis during a 3-port technique of laparoscopic ovariohysterectomy (OVH) in bitches. Moreover, the need for port enlargement for specimen retrieval using 5mm or 10mm trocartes, technical difficulties and complications were assessed. Ultrasonic energy and a vascular sealing system were tested. Duration of surgery, patient weight and diameter of the uterine arteries and veins were compared among the groups. Fifteen dogs randomly divided into three groups (GI, GII, GIII) were submitted to ovariohysterectomy with hemostasis from the use of ultrasonic scalpel or vascular sealing equipment. In GI and GII the LigaSure(tm)impedance-controlled bipolar vessel-sealing device was used, differing in the size of trocartes used between groups, and in GIII Autosonix(tm) was used. Patients' weight, duration of surgery, technical difficulties and complications were compared among the groups. Statistical analysis showed no difference between the data analyzed among the groups. In conclusion, both methods of hemostasis were effective for 3-port total laparoscopic ovariohysterectomy in bitches. However, 5mm trocartes were not adequate for retrieval of the uterus and ovaries without need for enlargement of the port incision.

Highlights

Invasive laparoscopic surgery (MILS) has changed the traditional concept of surgery in Human Medicine, not as a substitute for conventional techniques, but as a modern surgical and diagnostic tool
Group II (GII) was submitted to the same approach, though using a 10mm trocarte placed on the right side instead of a 5mm portal
Group III (GIII) was submitted to the same procedure and port placement employed on the GII; the ultrasonic shear (Autosonix - Convidien Surgical Inc., São Paulo, SP, Brazil) was used for prophylactic hemostasis

Summary

Introduction

Invasive laparoscopic surgery (MILS) has changed the traditional concept of surgery in Human Medicine, not as a substitute for conventional techniques, but as a modern surgical and diagnostic tool. Endoscopic techniques have been increasingly used in veterinary patients, especially for dog spay (Brun et al, 2000; Austin et al, 2003; Hancock et al, 2005; Mayhew et al, 2007). Maneuvers such as traction, electrocoagulation of the ovarian pedicles and uterine ligaments/vessels and application of extracorporal ligatures require adequate training and may affect surgical time (Malm et al, 2004; Silva et al, 2011). Mean surgical time may be similar (Devitt et al, 2005) or longer (Malm et al, 2004; Hancock et al, 2005) using the laparoscopic approach, while intra-operative bleeding and post-operative pain is usually reduced in comparison to the conventional technique of ovariohysterectomy (OVH) (Hancock et al, 2005; Devitt et al, 2005).

Objectives

Methods

Results

Conclusion