Laparoscopy

GENERAL MEDICINE DOGS AND CATS

Minimally invasive video surgery: laparoscopy, thoracoscopy, arthroscopy. Video-laparoscopic surgery is a surgical technique that allows for the execution of an operation using a micro camera inserted into the body; this captures images, enlarges them, and an optical fibre system transfers them to a monitor where the operator and their staff can observe them.

This type of procedure allows for the creation of small access points (from 3 to 10 mm) through which the instruments are manoeuvred from the outside.

The introduction of carbon dioxide creates a large working chamber that is illuminated by a light source present on the camera.

This same equipment is very useful for video laparoscopy, which is a technique that allows the surgeon to observe the organs with their own eyes, in their anatomical location and with natural colours; biopsy sampling is targeted to the lesion even when it is small; conversely, other diagnostic means can highlight deep lesions in the parenchyma that are not visible in laparoscopy.

It is therefore the combination of different techniques that allows for the best diagnostic result. To be able to adopt these techniques, surgical equipment, mechanical ventilation, next-generation monitoring, and a cohesive team of surgeons and anaesthetists are used.

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ADVANTAGES OF LAPAROSCOPIC TECHNIQUE COMPARED TO TRADITIONAL SURGERY

  • Reduction of hospitalisation time
  • Better observation of viscera in their anatomical location
  • Reduction of postoperative pain due to decreased manipulation of viscera and less trauma to the muscular wall
  • Healing of small surgical wounds without the need for protective aids (Elizabethan collar)
  • Greater sterility due to lack of exposure of viscera to the external environment
  • Reduction of adhesions due to limited manipulation of viscera and omentum
  • Possibility to visualise anatomical regions that are difficult to reach by an operator under traditional surgical conditions
  • Possibility to biopsy areas with localised lesions with extreme precision
  • Reduction or absence of internal stitches and fewer inflammatory reactions to foreign material
  • Reduced bleeding and humoral losses due to less traction on the viscera

DISADVANTAGES OF THE LAPAROSCOPIC TECHNIQUE

  • Obesity
  • Severe heart failure, renal failure
  • Peritonitis
  • Internal bleeding
  • Multiple adhesions

THE MOST COMMON DIAGNOSTIC APPLICATIONS IN LAPAROSCOPY

  • Sterilisation of the female (ovariectomy and ovariohysterectomy)
  • Recovery of ovarian remnants
  • Extraction of retained testicle
  • Preventive gastropexy
  • Laparoassisted cystoscopy for removal of calculi or nodules
  • Biopsies of the liver, kidney, pancreas, intestine, masses, prostate, lymph nodes
  • Treatment of paraprostatic cysts
  • Colposuspension for urinary incontinence
  • Adrenalectomy

THORACOSCOPY

  • Diagnostic and therapeutic indications
  • Pulmonary biopsies, masses, lymph nodes
  • Pericardiectomy
  • Pulmonary lobectomy
  • Persistent aortic arch
  • Aspiration of emphysematous bullae in recurrent spontaneous pneumothorax
  • Search for foreign bodies in the chest.
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