| 1. |
- Badman, Märit, et al.
(författare)
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Student Perceptions of the Use of a Laser Pointer for Intra-Operative Guidance in Feline Castration
- 2016
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Ingår i: Journal of Veterinary Medical Education. - 0748-321X .- 1943-7218. ; 43, s. 222-224
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Tidskriftsartikel (refereegranskat)abstract
- In veterinary clinical education, students perform surgery under guided supervision. This study aimed to determine if students' perception of how well they understood verbal guidance could be improved by using a laser pointer during feline castration. It was assumed that a teacher's use of a laser pointer could help students identify structures of importance during surgery. The hypothesis was that use of a laser pointer would improve student understanding of verbal guidance during surgery. Eighteen privately owned male cats were electively neutered by fourth-and fifth-year veterinary students at the Swedish University of Agricultural Sciences, Uppsala, Sweden. Each student performed orchiectomy on one cat. One testis was removed while the student received verbal guidance combined with a laser pointer, and the other testis was removed while the student received only verbal guidance. The use of a laser pointer alternated between first and second testis. After surgery, students rated how well they understood verbal guidance on a visual-analog scale (100 mm) for each instructional method. The two ratings were compared in a student's two-sided t-test. The median score with or without guidance with a laser pointer was 81 (59-96) and 54 (25-86), respectively (p < .001). This study showed that laser pointers enhanced verbal guidance given to students during surgery. The suggested mechanism of explanation is that the technology enabled a more precise guidance of location and identification of anatomic structures.
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| 2. |
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| 3. |
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| 4. |
- Höglund, Odd, et al.
(författare)
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Blood pressure and heart rate during ovariohysterectomy in pyometra and control dogs: a preliminary investigation
- 2016
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Ingår i: Acta Veterinaria Scandinavica. - : Springer Science and Business Media LLC. - 0044-605X .- 1751-0147. ; 58
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Tidskriftsartikel (refereegranskat)abstract
- Background: Surgery causes a stress response, a physiologic response to trauma. The intraoperative surgical stress response in dogs diagnosed with pyometra has not previously been described. The aim of this study was to investigate the intraoperative surgical stress response, assessed by blood pressure and heart rate measurements, in dogs diagnosed with pyometra and healthy controls. All dogs were premedicated with acepromazine and methadone, anaesthesia was induced with propofol and maintained with isoflurane, where after the dogs were subjected to ovariohysterectomy.Results: Eight dogs diagnosed with pyometra and eight healthy controls were used. Systolic blood pressure and heart rate were measured to assess the surgical stress response. Additionally propofol dosage at induction of anaesthesia and the end-tidal isoflurane concentration were investigated. The surgery was split into four phases. Phase 0 was the period 10 min before the skin incision, phase 1 was skin incision and opening of abdomen, phase 2 was manipulation of uterine horns, lifting of the ovary with stretching of the mesovarium, ligation and transection of mesovarium and phase 3 was ligation and transection of cervix, removal of organs and closing of the abdomen. Dosage of propofol at induction of anaesthesia was 3.6 +/- 1 mg/kg in dogs with pyometra and 4.1 +/- 1 in healthy controls (P = 0.37). In both groups, systolic blood pressure increased between phase 1 and 2, from 87 +/- 15 to 114 19 mmHg in dogs with pyometra, and from 88 +/- 18 to 106 +/- 20 mmHg in healthy controls, (both P < 0.0001). Systolic blood pressure did not differ significantly between groups in any of the phases. Heart rate and end-tidal concentration of isoflurane did not differ significantly between phases or between groups.Conclusions: The increased blood pressure at removal of ovaries during ovariohysterectomy suggests a pronounced noxious stimulus at this part of the procedure. In principle, the study parameters and response to surgery did not differ significantly between dogs with pyometra and healthy controls.
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| 5. |
- Höglund, Odd, et al.
(författare)
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Effect of non-steroidal anti-inflammatory drugs on postoperative respiratory and heart rate in cats subjected to ovariohysterectomy
- 2018
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Ingår i: Journal of Feline Medicine and Surgery. - 1098-612X .- 1532-2750. ; 20, s. 980-984
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Tidskriftsartikel (refereegranskat)abstract
- Objectives The use of physiological parameters such as respiratory rate and heart rate to assess pain has long been discussed. The aim of the study was to compare postoperative respiratory rate and heart rate in cats subjected to flank ovariohysterectomy treated with a preoperative non-steroidal anti-inflammatory drug (NSAID) or no NSAID, and determine whether these parameters are suitable for postoperative pain assessment in cats. We hypothesised that cats without an NSAID would experience more postoperative pain, which may increase heart rate and respiratory rate.Methods A total of 168 female privately owned cats were studied. All cats were premedicated with medetomidine (0.08 mg/kg) and butorphanol (0.4 mg/kg) subcutaneously and anaesthesia was induced with intramuscular ketamine (5 mg/kg). Cats were divided into subgroups; controls (no NSAID) or cats given an NSAID, carprofen (4 mg/kg) or meloxicam (0.3 mg/kg), at premedication or induction of anaesthesia. Cats were subjected to flank ovariohysterectomy by the same surgeon. Atipamezole was administered 2.5 h after induction of anaesthesia. Respiratory rate and heart rate were measured 3.5 h after the induction of anaesthesia. Data were analysed using one-way ANOVA with mixed procedure and Tukey's adjustment method for multiplicity.Results The postoperative respiratory rate and heart rate per minute for all cats were 34.0 8.6 and 167.5 +/- 27.4, respectively. Neither respiratory rate nor heart rate differed significantly between the control group and the NSAID groups or between different time points of administration of NSAIDs.Conclusion and relevance Assuming there was less postoperative pain in the group administered NSAIDs, the results of the study presented no support for use of respiratory rate and heart rate as parameters for postoperative pain assessment in individual cats. Study limitations included a lack of pain scoring and baseline data for respiratory rate and heart rate.
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| 6. |
- Srithunyarat, Thanikul, et al.
(författare)
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Evaluation of an ELISA for metanephrines in feline urine
- 2018
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Ingår i: Journal of Veterinary Diagnostic Investigation. - : SAGE Publications. - 1040-6387 .- 1943-4936. ; 30, s. 887-893
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Tidskriftsartikel (refereegranskat)abstract
- Catecholamines can be used to evaluate neuroendocrine tumors, stress, and potentially pain, but catecholamines degrade rapidly. Their metabolites normetanephrine (NME) and metanephrine (ME) have better stability in urine. In cats, urine sampling in a home environment would be beneficial to reduce effects of clinical stress and simplify sampling. We evaluated a human urine ELISA for analysis of NME and ME in feline urine, and investigated the effects of acidification, cat tray pellets, and storage time at room temperature up to 8.5 h. In 26 feline urine samples, mean NME concentration was 192 +/- 80 ng/mL, mean intra- and inter-assay CV was 6.5% and 4.2%, respectively, and spike recovery was 98-101%, but dilutional recovery was unsatisfactory. For ME, mean intra- and inter-assay CV was 10.2% and 4.1%, respectively. Mean urine ME concentration was 32.1 +/- 18.3 ng/mL, close to the kit's lowest standard, and spike recovery was 65-90%; the ELISA could not be validated for ME. The stability study, performed for NME on 12 urine samples, did not identify differences between acidified and non-acidified samples, cat tray pellets, or storage time, and no interaction effects. The ME ELISA was not suitable for feline urine; performance of the NME ELISA was acceptable, except for dilution recovery. For analysis of NME, feline urine can be sampled at home using cat tray pellets and stored at room temperature up to 8.5 h without acidification.
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| 7. |
- Aminlashgari, Nina, et al.
(författare)
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Degradation profile and preliminary clinical testing of a resorbable device for ligation of blood vessels
- 2013
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Ingår i: Acta Biomaterialia. - : Elsevier BV. - 1742-7061 .- 1878-7568. ; 9:6, s. 6898-904
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Tidskriftsartikel (refereegranskat)abstract
- A resorbable device for ligation of blood vessels was developed and tested in vitro to reveal the degradation profile of the device and to predict the clinical performance in terms of adequate mechanical support during a healing period of I week. In addition, preliminary clinical testing was performed that showed complete hemostasis and good tissue grip of renal arteries in five pigs. The device was made by injection molding of poly(glycolide-co-trimethylene carbonate) triblock copolymer, and it consisted of a case with a locking mechanism connected to a partly perforated flexible band. A hydrolytic degradation study was carried out for 7, 30 and 60 days in water and buffer medium, following the changes in mass, water absorption, pH and mechanical properties. A new rapid matrix-free laser desorption ionization-mass spectrometry (LDI-MS) method was developed for direct screening of degradation products released into the degradation medium. The combination of LDI-MS and electrospray ionization-mass spectrometry analyses enabled the comparison of the degradation product patterns in water and buffer medium. The identified degradation products were rich in trimethylene carbonate units, indicating preferential hydrolysis of amorphous regions where trimethylene units are located. The crystallinity of the material was doubled after 60 days of hydrolysis, additionally confirming the preferential hydrolysis of trimethylene carbonate units and the enrichment of glycolide units in the remaining solid matrix. The mechanical performance of the perforated band was followed for the first week of hydrolysis and the results suggest that sufficient strength is retained during the healing time of the blood vessels.
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| 8. |
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| 9. |
- Badman, Märit, et al.
(författare)
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Veterinary Student Confidence after Practicing with a New Surgical Training Model for Feline Ovariohysterectomy
- 2016
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Ingår i: Journal of Veterinary Medical Education. - 0748-321X .- 1943-7218. ; 43, s. 427-433
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Tidskriftsartikel (refereegranskat)abstract
- Lack of confidence and self-efficacy are the main causes of negative emotions experienced by veterinary students when performing surgery. A surgical training model (STM) was developed to test the hypothesis that practical training on an STM before performing live surgery would enhance the students' confidence. In addition, low-cost and easily accessible materials were used for the construction. In the STM, neodymium magnets that were detached if too much traction was applied were used to ensure careful tissue handling during ligation of the ovarian pedicles and cervix. A pilot study was performed to evaluate veterinary undergraduate students' confidence when using the STM before performing their first live feline ovariohysterectomy (OHE) as lead surgeon. The results showed that the students rated their confidence level higher after performing feline OHE if they had practiced with the STM before surgery. Voluntary written comments revealed that live surgery as a learning situation could have a very negative emotional impact on some students.
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| 10. |
- Enlund, Karolina Brunius, et al.
(författare)
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Development and validation of two questionnaires: Dental home care and dental health in Swedish dogs
- 2019
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Ingår i: PLoS ONE. - : Public Library of Science (PLoS). - 1932-6203 .- 1932-6203. ; 14:1
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Tidskriftsartikel (refereegranskat)abstract
- This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Background: Dental disease is one of the most common health problems in dogs. However, no studies have investigated the attitudes, opinions and practices of dog owners, veterinarians and veterinary nurses regarding dental health and preventative dental home care in dogs. The objective of this study was therefore to develop and validate questionnaires for this purpose, in accordance with survey methodology guidelines. Methods: Questionnaire items were determined based on the authors' academic knowledge and clinical experience, and modified throughout the validation process. Several measures were taken to reduce sampling, coverage, measurement and non-response errors. Content validity was assessed by Subject-Matter Experts (SME) and cognitive interviews were conducted in accordance with the “think-aloud protocol”. Non-response analysis was performed using several methods. Results: Constructs were identified using exploratory factor analysis and two predefined constructs from the dog owner questionnaire were confirmed “Dog owners' attitudes towards brushing their dog's teeth” (Cronbach's α = 0.86) and “Dog owners' assessment of their dog's dental health” (α = 0.76). Additionally, exploratory factor analysis identified three potential constructs. In the veterinary health practitioner questionnaire, two constructs were identified: “Veterinary health practitioners' attitudes towards dental chews and dental feed” (α = 0.78) and “Veterinary health practitioners' attitudes and opinions on dental problems and dental cleaning” (α = 0.73). Non-response analysis showed a higher proportion of women in the sample of dog owners and veterinarians compared to the target populations. Veterinarians in the sample were also younger. In contrast, gender and age distributions in veterinary nurses did not differ between sample and target. Conclusion: The validation presented in this work showed that the developed questionnaires could be used as accurate and reliable tools for measuring attitudes and practices regarding dental home care in dogs among Swedish dog owners, veterinarians and veterinary nurses.
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| 11. |
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| 12. |
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| 13. |
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| 14. |
- Hansson, Kerstin, et al.
(författare)
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Comparison of macroscopic resorption time for a self-locking device and suture material in ovarian pedicle ligation in dogs
- 2019
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Ingår i: Veterinary Record. - : Wiley. - 0042-4900 .- 2042-7670. ; 184
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Tidskriftsartikel (refereegranskat)abstract
- A resorbable self-locking device (LigaTie) was developed to enable safe and easy surgical ligation of blood vessels. The aim of this study was to compare the long-term in vivo resorption of the device to a commercially available suture of equivalent material (Maxon) following ovarian pedicle ligation. After ovariohysterectomy follow-up ultrasound examinations were performed monthly on 21 dogs ligated with the device and 22 dogs ligated with the suture material until no hyperechoic remnants, acoustic shadowing or local tissue reactions were detected. In both groups, the ovarian pedicles gradually decreased in size. Ligation material was considered macroscopically resorbed when ultrasound showed no signs of the device or suture, ovarian pedicle or tissue reaction. Macroscopic resorption had occurred without signs of complications and was complete by four months for sutures and 5.5 months for the device. The results show that resorption time in vivo for the resorbable self-locking device is mildly longer than suture of the same material and that no complications of device resorption were detected, supporting that the resorbable self-locking device is safe for in vivo use.
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| 15. |
- Höglund, Odd, et al.
(författare)
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A new resorbable device for ligation of blood vessels - A pilot study
- 2011
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Ingår i: Acta Veterinaria Scandinavica. - : Springer Science and Business Media LLC. - 0044-605X .- 1751-0147. ; 53, s. 47-
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Tidskriftsartikel (refereegranskat)abstract
- Background: During surgery, controlled haemostasis to prevent blood loss is vital for a successful outcome. It can be difficult to ligate vessels located deep in the abdomen. A device that is easy to use and enables secure ligatures could be beneficial. Cable ties made of nylon have been used for ligation but the non-resorbable material caused tissue reactions. The objective of this study was to use a resorbable material to construct a device with a self-locking mechanism and to test its mechanical strength and ligation efficiency. Methods: The device was manufactured by injection moulding of polydioxanone, a resorbable polymer used for suture materials. Polydioxanone with inherent viscosities of 1.9 dL/g and 1.3 dL/g were tested. The device consisted of a perforated flexible band which could be pulled through a case with a locking mechanism. After a first version of the device had been tested, some improvements were made. The locking case was downsized, corners were rounded off, the band was made thicker and the mould was redesigned to produce longer devices. Tensile tests were performed with the second version. The first version of the device was used to ligate the ovarian pedicle in a euthanized dog and to test echogenicity of the device with ultrasound. Compression of vessels of the ovarian pedicle was examined by histology. Both versions of the device were tested for haemostasis of and tissue grip on renal arteries in six anaesthetised pigs. Results: The tensile strength of the flexible band of the devices with inherent viscosity of 1.9 dL/g was 50.1 +/- 5.5 N (range 35.2-62.9 N, n = 11) and the devices with inherent viscosity of 1.3 dL/g had a tensile strength of 39.8 +/- 8.1 N (range 18.6-54.2 N, n = 11). Injection moulding of the polymer with lower inherent viscosity resulted in a longer flow distance. Both versions of the device had an effective tissue grip and complete haemostasis of renal arteries was verified. The device attached to the ovarian pedicle could be seen with ultrasound, and vessel compression and occlusion were verified by histology. Conclusions: Tests of functionality of the device showed complete haemostasis and good tissue grip. Devices with a band of sufficient length were easily applied and tightened in tissue.
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| 16. |
- Höglund, Odd
(författare)
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A resorbable device for ligation of blood vessels : development, assessment of surgical procedures and clinical evaluation
- 2012
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Maintaining haemostasis during surgery is vital for a successful outcome. The objectives of this thesis were to develop a resorbable device, which would enable safe ligation and less surgical stress than the conventional method. For manufacturing of the device, the resorbable polymer polydioxanone was injection moulded. The device was constructed as a flexible band attached to a self-locking mechanism. The band formed a loop around the tissue, the end of the band was inserted into the locking mechanism and was pulled through until the loop was closed. The design allowed complete closure of the loop and the device resisted ligature slip-off from renal arteries at 10 N. Tissue reactions and surgical stress responses to ligation with the device were studied in healthy dogs subjective to elective neutering. For evaluation of haemostatic efficiency the ovarian pedicles of 14 dogs were ligated bilaterally (9) or unilaterally (5). All pedicles were successfully ligated, but one device first after being further tightened. The dogs were examined by ultrasound for up to twelve months with no adverse observations recorded. In two dogs histological examinations revealed local and transient tissue reactions around the devices. Systolic blood pressure and heart rate were registered during ligation of ovarian pedicles bilaterally in nine dogs and unilaterally in five dogs using the device and in 26 dogs using conventional techniques. In 16 of the 26 dogs laparoscopic and open abdomen techniques were compared and in the remaining 10 dogs ligation of the two ovaries was compared. Plasma vasopressin was analysed in the latter study. The increase in systolic blood pressure was greater in the open abdomen group compared to the laparoscopic group and the device-group. Ligation of the first ovarian pedicle caused a greater cardiovascular response than ligation of the second pedicle. However, plasma vasopressin concentration changed in synchrony with systolic blood pressure and the combination may be useful for evaluation of surgical stress. In conclusion, a resorbable device which efficiently ligated both single vessels and ovarian pedicles was successfully constructed. Whether use of the device enables less surgical stress than a conventional ligation technique remains to be clarified.
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| 17. |
- Höglund, Odd, et al.
(författare)
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A Self-locking Implant for Short-Term Use as an Alternative to Purse-String Suture in Colon Anastomosis
- 2015
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Ingår i: Veterinary Surgery. - 0161-3499 .- 1532-950X. ; 44, s. E55-E55
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Colorectal cancer is common in humans where treatment involves surgical removal of the cancerous part of the intestines. A new short term implant, based on the principle of a self-locking loop, was developed to replace the purse string suture for temporary sealing of the lumen in colon anastomosis. The aim of this in vivo study was to test the self-locking implant, in conjunction with a new suture-free method (Adaptive Anaerobic Anastomosis) and the traditional circular staplers, to perform colonic anastomosis. A flexible band with a locking mechanism was constructed. Small protrusions, designed for increased friction between implant and tissue, were added to one side of the flexible band in order to enhance the grip at closure of the loop around tissue. The in vivo test was performed on six female pigs of approximately 50 kg, where the self-locking implant was used for closure of the lumen around anvils and trocars. Adaptive Anaerobic Anastomosis (n=3) and traditional circular stapler anastomosis (n=3). The self-locking implant could close the lumen of colon around the anvil and trocar of both tested techniques. Subjectively, the device achieved a tight closure of the colon. The technology was perceived as potentially timesaving and easy to use. We conclude the device may be an alternative to the traditional purse-string suture for temporary closure of the colon lumen in colon anastomosis.
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| 18. |
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| 19. |
- Höglund, Odd, et al.
(författare)
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A surgical selflocking loop tested for colon anastomosis.
- 2015
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Ingår i: Veterinary Surgery. - 0161-3499 .- 1532-950X. ; 44, s. E34-E34
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Introduction Colorectal cancer is common in humans. After removal of the pathologic part of the colon, leakage at the site of anastomosis is a frequently reported complication. A new suture-free method for anastomosis of the colon has been developed, CARP (Compression Anastomotic Ring-locking Procedure). The use of staplers, the traditional method to seal the lumen of colon, may interfere with the CARP method. A new technology, based on the principle of a self-locking loop, was therefore developed for temporary sealing of the lumen i conjunction with the CARP method. The aim of this in vitro and in vivo study was to test the self-locking loop with the CARP implant for closure of the colon. Materials and methods A flexible band with a case containing a locking mechanism was constructed. Studs were added to one side of the flexible band in order to enhance the tissue grip at closure of the loop around tissue. Fresh intestines (lukewarm) from a pig were used in this cadaver test. The colon was transected approximately 15 cm from the anus. The CARP implant (anvil) was inserted into the lumen. The self-locking loop was placed around the transected colon and the loop was tightened around the CARP implant inside the lumen. The closure was visually inspected and the locked loop was removed for inspection of the compressed colonic tissue. The procedure was repeated ten times. The test was repeated in vivo in four pigs of approximately 50 kg, where the self-locking loop was used for closure of the lumen in conjunction with both CARP and circular stapler anastomosis. Results The self-locking implant could close the colonic lumen around the anvil in both the in vitro (n=10) and in vivo (n=8) model. Subjectively, the device achieved a tight closure of the colon and no damage to the intestines was seen on visual inspection at removal of the self-locking implant. Discussion/conclusion Subjectively, the technology was perceived as potentially timesaving and easy to use. The self-locking loop may be an alternative to staplers or purse-string closure for temporary closure of the colon lumen in conjunction with the CARP method. Further development, such as designing a tool for tightening the loop in a laparoscopic procedure, should be addressed.
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| 20. |
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| 21. |
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| 22. |
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| 23. |
- Höglund, Odd, et al.
(författare)
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Chromogranin A and cortisol at intraoperative repeated noxious stimuli : surgical stress in a dog model
- 2015
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Ingår i: SAGE Open Medicine. - : SAGE Publications. - 2050-3121. ; 3
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: Biomarkers representing sympathetic tone and the surgical stress response are measured to objectively evaluate surgical techniques and anaesthetic protocols. If a part of the intraoperative procedure is repeated on the contralateral organ, one animal may potentially serve as its own control and, if so, may minimize the problem of individual differences of the stress response to anaesthesia and surgery. This study aimed to investigate the use of chromogranin A for measurement of the intraoperative sympathetic tone. Additional aims were to investigate chromogranin A and cortisol as indicators of the intraoperative surgical stress response caused by repeated noxious stimuli in dogs subjected to ovariohysterectomy and thereby to investigate the possibility of one dog serving as its own control. Methods: Experiments were carried out on 10 dogs subjected to ovariohysterectomy. Perioperative blood samples (0-6) were collected after premedication, immediately before induction of anaesthesia (0), after induction of anaesthesia and before incision (1), before (2) and after (3) removal of the first ovary, after a 15-min pause before removal of the second ovary (4), after removal of the second ovary (5) and after closing the abdomen (6). Plasma chromogranin A and cortisol were analysed. Results: Plasma chromogranin A did not change. Plasma cortisol concentration did not change between before anaesthesia and opening of the abdomen. Plasma cortisol increased at removal of the first ovary. Cortisol did not change at removal of the second ovary but remained increased compared to initial sample. Conclusion: The results suggest chromogranin A is a poor indicator of intraoperative sympathetic tone during elective surgery in dogs. Cortisol measurement was useful for assessment of intraoperative noxious stimuli. However, at these test conditions, neither plasma chromogranin A nor plasma cortisol was useful for assessment of repeated intraoperative noxious stimuli where one dog served as its own control..
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| 24. |
- Höglund, Odd, et al.
(författare)
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Comparison of haemodynamic changes during two surgical methods for neutering female dogs
- 2011
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Ingår i: Research in Veterinary Science. - : Elsevier BV. - 0034-5288 .- 1532-2661. ; 91, s. 159-163
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Tidskriftsartikel (refereegranskat)abstract
- The aim was to investigate if intraoperative registrations of blood pressure and heart rate could be used to estimate surgical trauma. In a prospective clinical trial, registrations in eight dogs neutered by laparoscopic ovariectomy (LOE) were compared with eight dogs subjected to open ovariohysterectomy (OHE). For comparisons phases were used: phase zero = steady state after induction of anaesthesia; phase one = opening of abdomen; phase two severing of ovarian pedicles; and, phase three = abdominal closure. During LOE, mean systolic blood pressure increased by 7 mm Hg (p = 0.05) and 15 mm Hg (p = 0.01) from phase zero to phase one and two, respectively, and during OHE by 3 mm Hg (ns) and 29 mm Hg (p < 0.0001), respectively. The increase from phase one to phase two differed between groups (p = 0.03). Heart rate did not change. Frequent intraoperative measurements of blood pressure appear a promising method for evaluating surgical trauma. (C) 2010 Elsevier Ltd. All rights reserved.
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| 25. |
- Höglund, Odd, et al.
(författare)
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Cystic duct pressures after ligation with a novel absorbable device in an ex vivo caprine cholecystectomy model
- 2017
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Ingår i: Canadian Journal of Veterinary Research. - 0830-9000. ; 81, s. 223-227
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Tidskriftsartikel (refereegranskat)abstract
- Laparoscopic cholecystectomy is the standard of care in human medicine for gall bladder disease. Although infrequently reported in veterinary literature, laparoscopic cholecystectomy is an option for uncomplicated gall bladder disease in canine patients. Due to the risk of cystic duct ligature slippage or clip dislodgement, we wanted to explore the use of a LigaTie; a novel absorbable medical device modeled after a cable tie. Our object was to describe the use of the LigaTie in a caprine cadaveric study of cholecystectomies as a model for canine patients and demonstrate the leak pressure of the cystic duct compared with cholecystectomies performed with 2 large endoscopic hemoclips. Samples of caprine gall bladder, liver, and cystic duct were collected. The cystic duct was ligated with either 2 large endoscopic hemoclips or a LigaTie. Maximum cystic duct pressure was recorded. Results showed that there was no statistically significant difference in the maximum cystic duct pressure achieved for cystic ducts ligated with 2 large endoscopic hemoclips or the LigaTie (P = 0.865). No leakage was observed from the cystic duct, hemoclip, or LigaTie site in either group. Supraphysiologic pressures were achieved in both groups and high pressure occlusion of the infusion pump determined the maximum intraluminal pressure achieved. Based on these results, the LigaTie may provide advantages in minimally invasive surgery, especially when considering ligation of a friable or thickened cystic duct during laparoscopic cholecystectomy. Future in vivo studies are warranted to determine minimally invasive maneuverability, tissue interaction, complications, and outcomes.
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