Laparoscopic nephron-sparing surgery for the treatment of canine dioctophymosis.

This paper reports on two cases of laparoscopic nephrotomy employed in the treatment of canine dioctophymosis, which is considered a unusual procedure and a new treatment proposal heretofore not performed in veterinary medicine. Two patients were treated, one with a history of hematuria and the other with incidental finding of the parasite in the abdominal cavity during elective ovariohysterectomy. Both dogs were subjected to abdominal ultrasound, which produced images indicating the presence of the parasite in the right side kidney, but with partial parenchymal preservation. The patients were therefore subjected to laparoscopic nephrotomy. The surgical procedure was effective in treating dioctophymosis and enabled minimum tissue invasion during surgery, in addition to preservation of the kidney.

Intraoperative fluid therapy for video-assisted ovariohysterectomy in dogs.

BACKGROUND: Intraoperative fluids are still poorly studied in veterinary medicine. In humans the dosage is associated with significant differences in postoperative outcomes. OBJECTIVES: The aim of this study is to verify the influence of three different fluid therapy rates in dogs undergoing video-assisted ovariohysterectomy. METHODS: Twenty-four female dogs were distributed into three groups: G5, G10, and G20. Each group was given 5, 10, and 20 mL·kg-1·h-1 of Lactate Ringer, respectively. This study evaluated the following parameters: central venous pressure, arterial blood pressure, heart rate, respiratory rate, temperature, acid-base balance, and serum lactate levels. Additionally, this study evaluated the following urinary variables: urea, creatinine, protein to creatinine ratio, urine output, and urine specific gravity. The dogs were evaluated up to 26 h after the procedure. RESULTS: All animals presented respiratory acidosis during the intraoperative period. The G5 group evidenced intraoperative oliguria (0.80 ± 0.38 mL·kg-1·h-1), differing from the G20 group (2.17 ± 0.52 mL·kg-1·h-1) (p = 0.001). Serum lactate was different between groups during extubation (p = 0.036), with higher values being recorded in the G5 group (2.19 ± 1.65 mmol/L). Animals from the G20 group presented more severe hypothermia at the end of the procedure (35.93 ± 0.61°C) (p = 0.032). Only the members of the G20 group presented mean potassium values below the reference for the species. Anion gap values were lower in the G20 group when compared to the G5 and G10 groups (p = 0.017). CONCLUSIONS: The use of lactated Ringer's solution at the rate of 10 mL·kg-1·h-1 seems to be beneficial in the elective laparoscopic procedures over the 5 or 20 mL·kg-1·h-1 rates of infusion.

CÉLULAS-TRONCO MESENQUIMAIS ADULTAS: CARACTERÍSTICAS E APLICAÇÕES EXPERIMENTAIS EM ANIMAIS

As células-tronco mesenquimais (CTMs) adultas são células-tronco somáticas presentes em pequenas quantidades em regiões perivasculares de todos os tecidos adultos, incluindo a medula óssea (MO), o tecido adiposo, o periósteo, o tecido muscular e os órgãos parenquimatosos. Por ser o tecido mais utilizado e caracterizado para o estudo das propriedades das células-tronco e por ter sido o primeiro empregado em terapia celular, a medula óssea é um dos principais tecidos para a obtenção de CTMs. Estudos contemporâneos vêm sendo realizados, descrevendo a utilização alógena e autógena das MSC para a reparação de diversos tecidos. Além da terapia celular em animais domésticos, sua importância em Medicina Veterinária deve-se também à geração de modelos experimentais aplicáveis a paciente humanos. A presente revisão objetivou trazer as características e os usos atuais das MSCs adultas derivadas da MO, do tecido adiposo e polpa dentária, bem como os protocolos laboratoriais e experimentos in vivo desenvolvidos em um laboratório de cirurgia experimental visando a aplicação destas células em pacientes veterinários e a pesquisa translacional.

CÉLULAS-TRONCO MESENQUIMAIS ADULTAS: CARACTERÍSTICAS E APLICAÇÕES EXPERIMENTAIS EM ANIMAIS

As células-tronco mesenquimais (CTMs) adultas são células-tronco somáticas presentes em pequenas quantidades em regiões perivasculares de todos os tecidos adultos, incluindo a medula óssea (MO), o tecido adiposo, o periósteo, o tecido muscular e os órgãos parenquimatosos. Por ser o tecido mais utilizado e caracterizado para o estudo das propriedades das células-tronco e por ter sido o primeiro empregado em terapia celular, a medula óssea é um dos principais tecidos para a obtenção de CTMs. Estudos contemporâneos vêm sendo realizados, descrevendo a utilização alógena e autógena das MSC para a reparação de diversos tecidos. Além da terapia celular em animais domésticos, sua importância em Medicina Veterinária deve-se também à geração de modelos experimentais aplicáveis a paciente humanos. A presente revisão objetivou trazer as características e os usos atuais das MSCs adultas derivadas da MO, do tecido adiposo e polpa dentária, bem como os protocolos laboratoriais e experimentos in vivo desenvolvidos em um laboratório de cirurgia experimental visando a aplicação destas células em pacientes veterinários e a pesquisa translacional.

Linfadenectomia laparoscópica em cadela com neoplasia mamária

The laparoscopic lymphadenectomy is routinely performed in medicine, but not in veterinary medicine. This report describes a case of female canine with tumors in the left mammary chain (M4 and M5), which was subjected to intra-dermal application of sterile methylene blue, around the largest tumor (M5) which tried to demarcate the lymphatic vessels and regional lymph nodes. After 15 minutes, laparoscopic lymphadenectomy involving the abdominal in the left pelvic region started, followed by laparoscopic ovariohysterctomy (OVH) using three portals access. It was also performed an unilateral left total mastectomy. For histology, two abdominal lymph nodes were free of tumor cells. The patient had no recurrence in 60 days.

A linfadenectomia laparoscópica é realizada de forma rotineira na medicina, contudo é pouco utilizada na veterinária. Neste relato, um canino fêmea apresentando tumores na cadeia mamária esquerda (M4 e M5), foi submetido à aplicação intradérmica do azul de metileno estéril, ao redor do maior tumor (M5), buscando-se demarcação dos vasos linfáticos e linfonodos regionais. Após 15 minutos, iniciou-se a linfadenectomia abdominal videolaparoscópica na região inguinal esquerda, seguida da ovário-histerectomia (OVH) lapararoscópica com três portais. Realizou-se ainda mastectomia total unilateral esquerda. Pela histologia, obtiveram-se dois linfonodos abdominais livres de células tumorais. A paciente não apresentou recidiva em 60 dias.

Biomecânica óssea e ensaios biomecânicos: fundamentos teóricos

The knowledge of the mechanical properties of bone and fractures is important in health sciences. Although, the concepts and principles that determine their understandings often are not clear to the professionals that working in the medical fields. This review aims to bring basic concepts and information about the biomechanics of bones, and some types of biomechanical tests. Through these tests, surveys are developed for evaluation and/or comparison of different fixation devices and orthopaedic implants using cadaveric bones, mathematical models, as well as synthetic bones, all alternatives to animal experimentation. Although, the biomechanical tests are widely known and disseminated in other countries, but it is underutilized in Brazilian orthopaedics research.

O conhecimento das propriedades mecânicas do osso e das fraturas é importante nas ciências da saúde. Entretanto, os conceitos e princípios que determinam seu entendimento geralmente não são claros para os profissionais atuantes na área médica. Esta revisão objetiva trazer conceitos básicos e informações acerca da biomecânica dos ossos, assim como algumas modalidades de ensaios biomecânicos. Por meio desses últimos, são realizadas pesquisas para avaliação e/ou comparação de diferentes dispositivos de fixação e implantes ortopédicos, utilizando ossos de cadáveres, modelos matemáticos, assim como ossos sintéticos, todos métodos alternativos à experimentação animal. Embora os ensaios biomecânicos sejam amplamente conhecidos e difundidos em alguns países, observa-se em território nacional a subutilização de pesquisas nessa área da ortopedia.

Linfadenectomia laparoscópica em cadela com neoplasia mamária

The laparoscopic lymphadenectomy is routinely performed in medicine, but not in veterinary medicine. This report describes a case of female canine with tumors in the left mammary chain (M4 and M5), which was subjected to intra-dermal application of sterile methylene blue, around the largest tumor (M5) which tried to demarcate the lymphatic vessels and regional lymph nodes. After 15 minutes, laparoscopic lymphadenectomy involving the abdominal in the left pelvic region started, followed by laparoscopic ovariohysterctomy (OVH) using three portals access. It was also performed an unilateral left total mastectomy. For histology, two abdominal lymph nodes were free of tumor cells. The patient had no recurrence in 60 days.

A linfadenectomia laparoscópica é realizada de forma rotineira na medicina, contudo é pouco utilizada na veterinária. Neste relato, um canino fêmea apresentando tumores na cadeia mamária esquerda (M4 e M5), foi submetido à aplicação intradérmica do azul de metileno estéril, ao redor do maior tumor (M5), buscando-se demarcação dos vasos linfáticos e linfonodos regionais. Após 15 minutos, iniciou-se a linfadenectomia abdominal videolaparoscópica na região inguinal esquerda, seguida da ovário-histerectomia (OVH) lapararoscópica com três portais. Realizou-se ainda mastectomia total unilateral esquerda. Pela histologia, obtiveram-se dois linfonodos abdominais livres de células tumorais. A paciente não apresentou recidiva em 60 dias.

Radical prostatectomy with Van Velthoven Suture to canine perineal / Prostatectomia radical com sutura de Van Velthoven na herniorrafia perineal de canino

Background: Prostatectomy excision is indicated for patients with neoplasm, trauma or recurrent prostatic abscess; Van Velthoven suture have been used in urethrovesical laparoscopic anastomosis in humans. This report aimed to describe the use of Van Velthoven suture after excisional prostatectomy in a canine, which suffered partial loss and deformation of the urinary bladder after complications of perineal hernia.Case: A thirteen-year-old male dog presented dyschezia, hypophagia and had increased water ingestion; furthermore, owner verifi ed a swelling lateral to the anus. On clinical examination it was observed left perineal hernia with incarcerated content, and peritonitis was diagnosed by ultrasonography exam. Antimicrobial and fl uid therapy were initiated, and one day after the patient was referred to surgery. Through perineal access was observed retrofl exed urinary bladder partially necrotic and multiple prostatic cysts; due to great extent of the necrotic urinary bladder, associated with impossibility of complete necrotic bladder tissue removal, prostate and urinary vesicle were placed in the peritoneal cavity. It was proceeded hernia reconstruction using polypropylene mesh and monofi lament nylon suture. Through median celiotomy, the bladder necrotic tissue was removed; due to hemodynamic patient instability, the total prostatectomy that was initiated was postponed, pe

Background: Prostatectomy excision is indicated for patients with neoplasm, trauma or recurrent prostatic abscess; Van Velthoven suture have been used in urethrovesical laparoscopic anastomosis in humans. This report aimed to describe the use of Van Velthoven suture after excisional prostatectomy in a canine, which suffered partial loss and deformation of the urinary bladder after complications of perineal hernia.Case: A thirteen-year-old male dog presented dyschezia, hypophagia and had increased water ingestion; furthermore, owner verifi ed a swelling lateral to the anus. On clinical examination it was observed left perineal hernia with incarcerated content, and peritonitis was diagnosed by ultrasonography exam. Antimicrobial and fl uid therapy were initiated, and one day after the patient was referred to surgery. Through perineal access was observed retrofl exed urinary bladder partially necrotic and multiple prostatic cysts; due to great extent of the necrotic urinary bladder, associated with impossibility of complete necrotic bladder tissue removal, prostate and urinary vesicle were placed in the peritoneal cavity. It was proceeded hernia reconstruction using polypropylene mesh and monofi lament nylon suture. Through median celiotomy, the bladder necrotic tissue was removed; due to hemodynamic patient instability, the total prostatectomy that was initiated was postponed, pe

Prosthesis nozzle for defect correction in Gnatotheca parrot charão (Amazona pretrei) / Uso de prótese de bico na correção de defeito em gnatoteca de papagaio charão (Amazona pretrei)

Background: Birds beaks can be affected by a lot of abnormalities due to nutritional problems, infections, changes related to the development and trauma. Considering the treatment of fractures or other birds beaks injuries, the use of prosthesis can be an alternative treatment. Among the numerous kind of prosthetics for this propose, homologous, synthetic and mixedare frequently used. Birds cadavers are the suppliers of homologous prostetic. This study aims to report the treatment of a gnatotheca disjunction in a parrot (Amazona pretrei) using homologous gnatotheca prosthesis.Case: A red-spectacled parrot (Amazona pretrei) was sent to the zoo after an apprehension conducted by IBAMA, at this moment the animal was in a good clinical condition. After a few months, in a routine check of the birds for deworming and coproparasitological exam, it was observed a gnatotheca bifurcation. The specifi c cause was not identifi ed. Bifurcation of gnatotheca was diagnosed in one parrot. For surgery reconstruction it was implanted homologous gnatotheca prosthesis. After pre anesthetic medication with cetamine (5 mg.kg-1, IM) and midazolam (0.25 mg.kg-1, IM), the animal was kept under inhalational anesthesia with isofl urane vaporized in 100% oxygen in an open circuit, using a mask. It was administered butorphanol (0.5 mg.kg-1, IM, TID, for two days). The prosthesis was implanted using the

Background: Birds beaks can be affected by a lot of abnormalities due to nutritional problems, infections, changes related to the development and trauma. Considering the treatment of fractures or other birds beaks injuries, the use of prosthesis can be an alternative treatment. Among the numerous kind of prosthetics for this propose, homologous, synthetic and mixed are frequently used. Birds cadavers are the suppliers of homologous prostetic. This study aims to report the treatment of a gnatotheca disjunction in a parrot (Amazona pretrei) using homologous gnatotheca prosthesis.Case: A red-spectacled parrot (Amazona pretrei) was sent to the zoo after an apprehension conducted by IBAMA, at this moment the animal was in a good clinical condition. After a few months, in a routine check of the birds for deworming and coproparasitological exam, it was observed a gnatotheca bifurcation. The specifi c cause was not identifi ed. Bifurcation of gnatotheca was diagnosed in one parrot. For surgery reconstruction it was implanted homologous gnatotheca prosthesis. After pre anesthetic medication with cetamine (5 mg.kg-1, IM) and midazolam (0.25 mg.kg-1, IM), the animal was kept under inhalational anesthesia with isofl urane vaporized in 100% oxygen in an open circuit, using a mask. It was administered butorphanol (0.5 mg.kg-1, IM, TID, for two days). The prosthesis was implanted using the

Linfadenectomia laparoscópica em cadela com neoplasia mamária

The laparoscopic lymphadenectomy is routinely performed in medicine, but not in veterinary medicine. This report describes a case of female canine with tumors in the left mammary chain (M4 and M5), which was subjected to intra-dermal application of sterile methylene blue, around the largest tumor (M5) which tried to demarcate the lymphatic vessels and regional lymph nodes. After 15 minutes, laparoscopic lymphadenectomy involving the abdominal in the left pelvic region started, followed by laparoscopic ovariohysterctomy (OVH) using three portals access. It was also performed an unilateral left total mastectomy. For histology, two abdominal lymph nodes were free of tumor cells. The patient had no recurrence in 60 days.

A linfadenectomia laparoscópica é realizada de forma rotineira na medicina, contudo é pouco utilizada na veterinária. Neste relato, um canino fêmea apresentando tumores na cadeia mamária esquerda (M4 e M5), foi submetido à aplicação intradérmica do azul de metileno estéril, ao redor do maior tumor (M5), buscando-se demarcação dos vasos linfáticos e linfonodos regionais. Após 15 minutos, iniciou-se a linfadenectomia abdominal videolaparoscópica na região inguinal esquerda, seguida da ovário-histerectomia (OVH) lapararoscópica com três portais. Realizou-se ainda mastectomia total unilateral esquerda. Pela histologia, obtiveram-se dois linfonodos abdominais livres de células tumorais. A paciente não apresentou recidiva em 60 dias.

Biomecânica óssea e ensaios biomecânicos: fundamentos teóricos

The knowledge of the mechanical properties of bone and fractures is important in health sciences. Although, the concepts and principles that determine their understandings often are not clear to the professionals that working in the medical fields. This review aims to bring basic concepts and information about the biomechanics of bones, and some types of biomechanical tests. Through these tests, surveys are developed for evaluation and/or comparison of different fixation devices and orthopaedic implants using cadaveric bones, mathematical models, as well as synthetic bones, all alternatives to animal experimentation. Although, the biomechanical tests are widely known and disseminated in other countries, but it is underutilized in Brazilian orthopaedics research.

O conhecimento das propriedades mecânicas do osso e das fraturas é importante nas ciências da saúde. Entretanto, os conceitos e princípios que determinam seu entendimento geralmente não são claros para os profissionais atuantes na área médica. Esta revisão objetiva trazer conceitos básicos e informações acerca da biomecânica dos ossos, assim como algumas modalidades de ensaios biomecânicos. Por meio desses últimos, são realizadas pesquisas para avaliação e/ou comparação de diferentes dispositivos de fixação e implantes ortopédicos, utilizando ossos de cadáveres, modelos matemáticos, assim como ossos sintéticos, todos métodos alternativos à experimentação animal. Embora os ensaios biomecânicos sejam amplamente conhecidos e difundidos em alguns países, observa-se em território nacional a subutilização de pesquisas nessa área da ortopedia.

Prosthesis nozzle for defect correction in Gnatotheca parrot charão (Amazona pretrei) / Uso de prótese de bico na correção de defeito em gnatoteca de papagaio charão (Amazona pretrei)

Background: Birds beaks can be affected by a lot of abnormalities due to nutritional problems, infections, changes related to the development and trauma. Considering the treatment of fractures or other birds beaks injuries, the use of prosthesis can be an alternative treatment. Among the numerous kind of prosthetics for this propose, homologous, synthetic and mixedare frequently used. Birds cadavers are the suppliers of homologous prostetic. This study aims to report the treatment of a gnatotheca disjunction in a parrot (Amazona pretrei) using homologous gnatotheca prosthesis.Case: A red-spectacled parrot (Amazona pretrei) was sent to the zoo after an apprehension conducted by IBAMA, at this moment the animal was in a good clinical condition. After a few months, in a routine check of the birds for deworming and coproparasitological exam, it was observed a gnatotheca bifurcation. The specifi c cause was not identifi ed. Bifurcation of gnatotheca was diagnosed in one parrot. For surgery reconstruction it was implanted homologous gnatotheca prosthesis. After pre anesthetic medication with cetamine (5 mg.kg-1, IM) and midazolam (0.25 mg.kg-1, IM), the animal was kept under inhalational anesthesia with isofl urane vaporized in 100% oxygen in an open circuit, using a mask. It was administered butorphanol (0.5 mg.kg-1, IM, TID, for two days). The prosthesis was implanted using the

Background: Birds beaks can be affected by a lot of abnormalities due to nutritional problems, infections, changes related to the development and trauma. Considering the treatment of fractures or other birds beaks injuries, the use of prosthesis can be an alternative treatment. Among the numerous kind of prosthetics for this propose, homologous, synthetic and mixed are frequently used. Birds cadavers are the suppliers of homologous prostetic. This study aims to report the treatment of a gnatotheca disjunction in a parrot (Amazona pretrei) using homologous gnatotheca prosthesis.Case: A red-spectacled parrot (Amazona pretrei) was sent to the zoo after an apprehension conducted by IBAMA, at this moment the animal was in a good clinical condition. After a few months, in a routine check of the birds for deworming and coproparasitological exam, it was observed a gnatotheca bifurcation. The specifi c cause was not identifi ed. Bifurcation of gnatotheca was diagnosed in one parrot. For surgery reconstruction it was implanted homologous gnatotheca prosthesis. After pre anesthetic medication with cetamine (5 mg.kg-1, IM) and midazolam (0.25 mg.kg-1, IM), the animal was kept under inhalational anesthesia with isofl urane vaporized in 100% oxygen in an open circuit, using a mask. It was administered butorphanol (0.5 mg.kg-1, IM, TID, for two days). The prosthesis was implanted using the

Radical prostatectomy with Van Velthoven Suture to canine perineal / Prostatectomia radical com sutura de Van Velthoven na herniorrafia perineal de canino

Background: Prostatectomy excision is indicated for patients with neoplasm, trauma or recurrent prostatic abscess; Van Velthoven suture have been used in urethrovesical laparoscopic anastomosis in humans. This report aimed to describe the use of Van Velthoven suture after excisional prostatectomy in a canine, which suffered partial loss and deformation of the urinary bladder after complications of perineal hernia.Case: A thirteen-year-old male dog presented dyschezia, hypophagia and had increased water ingestion; furthermore, owner verifi ed a swelling lateral to the anus. On clinical examination it was observed left perineal hernia with incarcerated content, and peritonitis was diagnosed by ultrasonography exam. Antimicrobial and fl uid therapy were initiated, and one day after the patient was referred to surgery. Through perineal access was observed retrofl exed urinary bladder partially necrotic and multiple prostatic cysts; due to great extent of the necrotic urinary bladder, associated with impossibility of complete necrotic bladder tissue removal, prostate and urinary vesicle were placed in the peritoneal cavity. It was proceeded hernia reconstruction using polypropylene mesh and monofi lament nylon suture. Through median celiotomy, the bladder necrotic tissue was removed; due to hemodynamic patient instability, the total prostatectomy that was initiated was postponed, pe

Background: Prostatectomy excision is indicated for patients with neoplasm, trauma or recurrent prostatic abscess; Van Velthoven suture have been used in urethrovesical laparoscopic anastomosis in humans. This report aimed to describe the use of Van Velthoven suture after excisional prostatectomy in a canine, which suffered partial loss and deformation of the urinary bladder after complications of perineal hernia.Case: A thirteen-year-old male dog presented dyschezia, hypophagia and had increased water ingestion; furthermore, owner verifi ed a swelling lateral to the anus. On clinical examination it was observed left perineal hernia with incarcerated content, and peritonitis was diagnosed by ultrasonography exam. Antimicrobial and fl uid therapy were initiated, and one day after the patient was referred to surgery. Through perineal access was observed retrofl exed urinary bladder partially necrotic and multiple prostatic cysts; due to great extent of the necrotic urinary bladder, associated with impossibility of complete necrotic bladder tissue removal, prostate and urinary vesicle were placed in the peritoneal cavity. It was proceeded hernia reconstruction using polypropylene mesh and monofi lament nylon suture. Through median celiotomy, the bladder necrotic tissue was removed; due to hemodynamic patient instability, the total prostatectomy that was initiated was postponed, pe

Células-tronco mesenquimais adultas: características e aplicações experimentais em animais

As células-tronco mesenquimais (CTMs) adultas são células-tronco somáticas presentes em pequenas quantidades em regiões perivasculares de todos os tecidos adultos, incluindo a medula óssea (MO), o tecido adiposo, o periósteo, o tecido muscular e os órgãos parenquimatosos. Por ser o tecido mais utilizado e caracterizado para o estudo das propriedades das células-tronco e por ter sido o primeiro empregado em terapia celular, a medula óssea é um dos principais tecidos para a obtenção de CTMs. Estudos contemporâneos vêm sendo realizados, descrevendo a utilização alógena e autógena das MSC para a reparação de diversos tecidos. Além da terapia celular em animais domésticos, sua importância em Medicina Veterinária deve-se também à geração de modelos experimentais aplicáveis a paciente humanos. A presente revisão objetivou trazer as características e os usos atuais das MSCs adultas derivadas da MO, do tecido adiposo e polpa dentária, bem como os protocolos laboratoriais e experimentos in vivo desenvolvidos em um laboratório de cirurgia experimental visando a aplicação destas células em pacientes veterinários e a pesquisa translacional.

Células-tronco mesenquimais adultas: características e aplicações experimentais em animais

As células-tronco mesenquimais (CTMs) adultas são células-tronco somáticas presentes em pequenas quantidades em regiões perivasculares de todos os tecidos adultos, incluindo a medula óssea (MO), o tecido adiposo, o periósteo, o tecido muscular e os órgãos parenquimatosos. Por ser o tecido mais utilizado e caracterizado para o estudo das propriedades das células-tronco e por ter sido o primeiro empregado em terapia celular, a medula óssea é um dos principais tecidos para a obtenção de CTMs. Estudos contemporâneos vêm sendo realizados, descrevendo a utilização alógena e autógena das MSC para a reparação de diversos tecidos. Além da terapia celular em animais domésticos, sua importância em Medicina Veterinária deve-se também à geração de modelos experimentais aplicáveis a paciente humanos. A presente revisão objetivou trazer as características e os usos atuais das MSCs adultas derivadas da MO, do tecido adiposo e polpa dentária, bem como os protocolos laboratoriais e experimentos in vivo desenvolvidos em um laboratório de cirurgia experimental visando a aplicação destas células em pacientes veterinários e a pesquisa translacional.

Pure-transvaginal natural orifice transluminal endoscopic surgery (NOTES) ovariohysterectomy in bitches: a preliminary feasibility study

Natural orifice transluminal endoscopic surgery (NOTES) is a relatively new surgical access for minimally invasive surgery, which is being widely studied in human medicine. However, few studies focusing on its applicability in the small animal practice have been performed so far. The aim of the current study was to evaluate the feasibility of pure-NOTES transvaginal ovariohysterectomy in bitches. Five bitches were evaluated. The abdomen was accessed through an 11mm trocar inserted through a vaginal incision. Using a rigid endoscope with working channel, the ovarian pedicles were coagulated and sectioned using bipolar diathermy. The uterine horn was pulled into the trocar and exteriorized along with the cannula. The uterine body and vessels were coagulated or ligated. The uterine stump was replaced into the abdominal cavity and the pneumoperitoneum drained. Pure-NOTES OHE was successfully accomplished in four out of five bitches. In the first try, it was converted to a hybrid-NOTES technique due to instrument failure. Mean surgical time was 52.1 (SD±11.5 minutes) for the pure-NOTES technique. Pure-NOTES OHE is feasible in bitches, which may result in no major complications and excellent surgical recovery.

Cirurgia endoscópica por orifícios naturais (NOTES) constitui um acesso cirúrgico relativamente novo para abordagem minimamente invasiva, a qual vem sendo amplamente estudada na medicina humana. Porém, poucos estudos envolvendo sua aplicação na prática cirúrgica de pequenos animais foram realizados até o momento. O objetivo do presente estudo foi avaliar a factibilidade da ovário-histerectomia transvaginal por NOTES pura em cadelas. Cinco cadelas foram avaliadas. A cavidade abdominal foi acessada por um trocarte de 11mm introduzido por uma incisão vaginal. Empregando-se um endoscópio rígido com canal de trabalho, os pedículos ovarianos foram coagulados e seccionados usando-se diatermia bipolar. O corno uterino foi tracionado para o interior do trocarte e exteriorizado juntamente com a cânula. O corpo e vasos uterinos foram coagulados ou ligados com sutura. O coto uterino foi reposicionado na cavidade abdominal e o pneumoperitônio, drenado. O procedimento foi realizado com sucesso em quatro das cinco cadelas. Na primeira tentativa, houve conversão para uma técnica de NOTES-híbrida, devido à quebra de uma pinça de coagulação. O tempo cirúrgico médio foi 52,1 (DP±11,5 minutos) para a técnica de NOTES pura. A OHE por NOTES pura é factível em cadelas, sem resultar em complicações maiores e proporcionando excelente recuperação pós-operatória.

Biopsia hepática endoscópica transvaginal em cadelas

A technique of hepatic biopsy by transvaginal approach (NOTES - Natural Orifice Transluminal Endoscopic Surgery) is proposed. Seven dogs were used, and the experiment was divided into two stages including the liver biopsy and the evaluation of laparoscopic abdominal conditions after biopsy (53 days after). The animals were submitted to vaginal incision after exposition through the vulva. Through the vaginal incision was introduced a flexible endoscope of 11mm with two working channels, was introduced through the vaginal incision and used to obtain liver samples. The variables analyzed to verify the feasibility of the proposed biopsy were: operative time, surgical complications, technical difficulties, the quality of sample collected, the formation of vaginal adhesions and their characteristics and the biochemical condition of the liver. In conclusion, the liver biopsy by endoscopic transvaginal access is feasible in dogs. It permits to take appropriated hepatic samples for histological studies without changinghepatic parameters and intraperitoneal adhesions.

Esse trabalho teve o objetivo de propor uma técnica de biopsia hepática endoscópica transvaginal em cadelas, evitando-se o acesso através da parede abdominal, técnica essa internacionalmente conhecida por NOTES (natural orifice transluminal endoscopic surgery). Para tanto, foram utilizadas sete cadelas, as quais foram submetidas a dois procedimentos. O primeiro constou de biopsia hepática pela técnica proposta. Para isso, realizou-se a incisão vaginal após exteriorização através da vulva. Pela ferida vaginal foi introduzido um endoscópio flexível de 11mm de diâmetro com dois canais de trabalho. Este foi empregado na obtenção das amostras hepáticas. O segundo procedimento foi de avaliação laparoscópica aos 53 dias após a biopsia. As variáveis analisadas para a verificação de viabilidade, segurança e qualidade dessa técnica foram: as dificuldades técnicas, as complicações cirúrgicas, o tempo operatório, a qualidade do material coletado, a formação de aderências vaginais e as alterações bioquímicas hepáticas. Conclui-se que a biópsia hepática por NOTES flexível transvaginal é viável em cães, pois permite a obtenção de fragmentos apropriados para o exame histológico sem ocasionar alterações significativas dos parâmetros de avaliação hepática e formação de aderências intraperitoneais.

Colopexia videoassistida com dois portais para o tratamento de prolapso retal recidivante

This report describes a two portals video-assisted colopexy technique in a case of dog with recurrent rectal prolapse. After laparoscopic approach, the descending colon was pulled in a caudocranial direction to promote the prolapse reduction. The prepubic laparoscopic access was enlarged for the exteriorization of colon's antimesenteric border, which was incised in its seromuscular layer with a similar size of the muscular wall incision, creating a 2,5cm wound. The colopexy on the internal muscular sheath was performed using a simple continuous pattern with 2-0 polyglycolic acid. There were no transoperative complications, as well as evidence of recurrence or episodes of tenesmus and dyschezia for at least six months after surgery. The video-assisted colopexy described is an alternative to the conventional technique of recurrent rectal prolapse treatment in dogs.

O presente relato descreve a utilização da colopexia videoassistida por meio de dois portais de acesso em um caso de cão com prolapso retal recidivante. Após abordagem laparoscópica, o cólon descendente foi tracionado em sentido caudocranial, promovendo-se a redução do prolapso. O acesso pré-púbico foi ampliado, exteriorizando-se o bordo antimesentérico do cólon, no qual se realizou incisão seromuscular de tamanho correspondente à realizada na parede muscular, criando uma ferida de aproximadamente 2,5cm de extensão. A fixação à bainha muscular interna se deu através de sutura contínua simples empregando fio de ácido poliglicólico n° 2-0. Não houve complicações no trans-operatório, bem como indícios de recidiva ou episódios de tenesmo e disquesia após seis meses da intervenção cirúrgica. A colopexia videoassistida descrita é uma alternativa à técnica convencional na correção de prolapso retal recidivante em cães.

Pure-transvaginal natural orifice transluminal endoscopic surgery (NOTES) ovariohysterectomy in bitches: a preliminary feasibility study

Natural orifice transluminal endoscopic surgery (NOTES) is a relatively new surgical access for minimally invasive surgery, which is being widely studied in human medicine. However, few studies focusing on its applicability in the small animal practice have been performed so far. The aim of the current study was to evaluate the feasibility of pure-NOTES transvaginal ovariohysterectomy in bitches. Five bitches were evaluated. The abdomen was accessed through an 11mm trocar inserted through a vaginal incision. Using a rigid endoscope with working channel, the ovarian pedicles were coagulated and sectioned using bipolar diathermy. The uterine horn was pulled into the trocar and exteriorized along with the cannula. The uterine body and vessels were coagulated or ligated. The uterine stump was replaced into the abdominal cavity and the pneumoperitoneum drained. Pure-NOTES OHE was successfully accomplished in four out of five bitches. In the first try, it was converted to a hybrid-NOTES technique due to instrument failure. Mean surgical time was 52.1 (SD±11.5 minutes) for the pure-NOTES technique. Pure-NOTES OHE is feasible in bitches, which may result in no major complications and excellent surgical recovery.

Cirurgia endoscópica por orifícios naturais (NOTES) constitui um acesso cirúrgico relativamente novo para abordagem minimamente invasiva, a qual vem sendo amplamente estudada na medicina humana. Porém, poucos estudos envolvendo sua aplicação na prática cirúrgica de pequenos animais foram realizados até o momento. O objetivo do presente estudo foi avaliar a factibilidade da ovário-histerectomia transvaginal por NOTES pura em cadelas. Cinco cadelas foram avaliadas. A cavidade abdominal foi acessada por um trocarte de 11mm introduzido por uma incisão vaginal. Empregando-se um endoscópio rígido com canal de trabalho, os pedículos ovarianos foram coagulados e seccionados usando-se diatermia bipolar. O corno uterino foi tracionado para o interior do trocarte e exteriorizado juntamente com a cânula. O corpo e vasos uterinos foram coagulados ou ligados com sutura. O coto uterino foi reposicionado na cavidade abdominal e o pneumoperitônio, drenado. O procedimento foi realizado com sucesso em quatro das cinco cadelas. Na primeira tentativa, houve conversão para uma técnica de NOTES-híbrida, devido à quebra de uma pinça de coagulação. O tempo cirúrgico médio foi 52,1 (DP±11,5 minutos) para a técnica de NOTES pura. A OHE por NOTES pura é factível em cadelas, sem resultar em complicações maiores e proporcionando excelente recuperação pós-operatória.

Síndrome do ovário remanescente em pequenos animais / Ovarian remnant syndrome in small animals

A síndrome do ovário remanescente (SOR) é um distúrbio iatrogênico em cadelas e gatas caracterizado pelo retorno do estro após contracepção cirúrgica devido à presença de fragmento de tecido ovariano na cavidade abdominal. Frequentemente, o ovário remanescente está situado no pedículo ovariano direito, sobretudo devido a sua posição topográfica mais profunda e cranial em comparação ao ovário esquerdo. Os principais sinais clínicos de SOR em pequenos animais são cio e presença de edemaciamento/secreção vulvar/vaginal, especialmente em caninos. O diagnóstico deve ser realizado por meio de citologia vaginal quando detecta-se o interesse dos machos pela cópula com a fêmea acometida, dosagem sérica de estrógeno e progesterona e/ou por meio do teste provocativo com administração de GnRH ou hCG. Contudo, citologia vaginal constitui a opção de melhor custo-benefício para o diagnóstico. Atualmente, o tratamento de escolha é cirúrgico por meio de laparotomia exploratória ou laparoscopia, seguido pela remoção do ovário remanescente. O tratamento cirúrgico tem maiores taxas de sucesso quando realizado com o animal em diestro (i.e., entre 15 e 60 dias após detectada a atração dos machos). Ademais, a realização de um procedimento cirúrgico preciso, auxiliado por técnicas avançadas de visualização durante a ovário-histerectomia ou ovariectomia constitui a melhor forma de prevenção SOR em anim

The ovarian remnant syndrome (ORS) is an iatrogenic disorder in bitches and queens, which is characterized by recurrence of estrus following surgical spay, due to the presence of a piece of ovarian tissue within the abdominal cavity. In most cases, the remnant ovary is found in the right ovarian pedicle, due to its topographic position, deeper and more cranial than the left ovary. The main clinical signs of ORS in small animals are the heat behavior and the presence of vaginal swelling/secretion, especially in canines. The diagnosis should be performed by means of vaginal cytology when attraction of males is detected, serum estrogen and progesterone levels and/or by challenging test with GnRH or hCG administration. However, vaginal citology is the most suitable and less expensive diagnostic tool. Nowadays the treatment of choice is a new laparotomy or laparoscopy, followed by removal of the remnant ovarian tissue. The surgical treatment has more chances of success if it is performed in the diestrus (i.e., between 15 and 60 days after the detection of attraction of males). Furthermore, a careful and accurate surgical procedure aided by advanced visualization techniques during ovariohysterectomy or ovariectomy is the best way to prevent ORS in companion animals.