Wound Retractor Laparoscopic Port System for Standing Laparoscopic Cryptorchidectomy in the Horse: A Case Report.
Abstract: Cryptorchidectomy is the most commonly performed laparoscopic procedure in horses. However, its use for the extraction of an abdominal testis has disadvantages such as loss of a resected testis from grasp and fragmentation of the specimen because of the excessive tension required for extraction through a thick body wall. The ring wound retractor laparoscopic port system was recently used in human and small animal surgery to perform laparoscopic-assisted procedures and retrieve large specimens from the abdomen. In the present case, the wound retractor was placed as the ventral port in the right flank through a minilaparotomy. Thereafter, the cap with the gas inlet and instrument port was connected. The other two ports were placed dorsally using 10-mm stainless steel cannulas. Grasping forcep was introduced through the ventral port, and the laparoscope and vessel-sealing devices were introduced through the dorsal ports. After the testis was resected, it was retrieved from the abdomen through the retractor without the grasping forceps jaw being released. This is the first case report describing the use of the wound retractor laparoscopic port system for standing cryptorchidectomy in a horse. This system can be a feasible and safe option for flank laparoscopy in horses, and it facilitates specimen retrieval from the abdominal cavity, but further studies should confirm this preliminary report.
Copyright © 2020 Elsevier Inc. All rights reserved.
Publication Date: 2020-06-23 PubMed ID: 32797790DOI: 10.1016/j.jevs.2020.103168Google Scholar: Lookup
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Summary
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This research presents a case study on the use of the wound retractor laparoscopic port system for performing cryptorchidectomy (removal of undescended testis) in a standing horse. This method potentially overcomes earlier drawbacks such as the loss of a resected testis and fragmentation due to tension during extraction.
Methodology
- The wound retractor device was placed in the right flank of the horse via a small incision, which served as the ventral port.
- To this, a cap with a gas inlet and instrument port was attached. In addition to the ventral port, two other ports were placed dorsally using 10-mm stainless steel cannulas.
- A grasping forcep was then introduced through the ventral port, and the laparoscope and vessel-sealing tools were introduced via the two dorsal ports.
Retraction and Retrieval Process
- Once the testis was delicately separated from the surrounding tissue, it could be retrieved from the abdomen through the retractor without having to release the jaw of the grasping forcep.
- This technique addressed the primary issues that traditional methods of removing the abdominal testis faced, such as the loss of the resected testis from grasp and its fragmentation due to excessive tension required for extraction.
Conclusion
- This case report is the first documentation of the use of this wound retractor laparoscopic port system for standing laparoscopic cryptorchidectomy in a horse.
- It indicates that the system could be a feasible and safe alternative for flank laparoscopy in equine patients, making the retrieval of the specimen from the abdominal cavity easier.
- However, the authors suggest further investigations should be conducted to confirm the findings of this preliminary report.
Cite This Article
APA
Lacitignola L, Imperante A, De Siena R, Acquafredda C, Trisciuzzi R, Stabile M, Confalonieri E, Crovace AM, Staffieri F.
(2020).
Wound Retractor Laparoscopic Port System for Standing Laparoscopic Cryptorchidectomy in the Horse: A Case Report.
J Equine Vet Sci, 92, 103168.
https://doi.org/10.1016/j.jevs.2020.103168 Publication
Researcher Affiliations
- Dipartimento dell'Emergenza e dei Trapianti di Organi (DETO), Sezione di Cliniche Veterinarie e P.A, Università degli Studi di Bari "Aldo Moro", Bari, Italy. Electronic address: luca.lacitignola@uniba.it.
- Dipartimento dell'Emergenza e dei Trapianti di Organi (DETO), Sezione di Cliniche Veterinarie e P.A, Università degli Studi di Bari "Aldo Moro", Bari, Italy; Dottorato di ricerca in "Trapianti di Tessuti ed Organi e Terapie Cellulari", Dipartimento dell'Emergenza e dei Trapianti di Organi (DETO), Università degli Studi di Bari "Aldo Moro", Bari, Italy.
- Field Veterinary Surgeon, Bari, Italy.
- Dipartimento dell'Emergenza e dei Trapianti di Organi (DETO), Sezione di Cliniche Veterinarie e P.A, Università degli Studi di Bari "Aldo Moro", Bari, Italy; Dottorato di ricerca in "Trapianti di Tessuti ed Organi e Terapie Cellulari", Dipartimento dell'Emergenza e dei Trapianti di Organi (DETO), Università degli Studi di Bari "Aldo Moro", Bari, Italy.
- Dipartimento dell'Emergenza e dei Trapianti di Organi (DETO), Sezione di Cliniche Veterinarie e P.A, Università degli Studi di Bari "Aldo Moro", Bari, Italy; Dottorato di ricerca in "Trapianti di Tessuti ed Organi e Terapie Cellulari", Dipartimento dell'Emergenza e dei Trapianti di Organi (DETO), Università degli Studi di Bari "Aldo Moro", Bari, Italy.
- Dipartimento dell'Emergenza e dei Trapianti di Organi (DETO), Sezione di Cliniche Veterinarie e P.A, Università degli Studi di Bari "Aldo Moro", Bari, Italy; Dottorato di ricerca in "Trapianti di Tessuti ed Organi e Terapie Cellulari", Dipartimento dell'Emergenza e dei Trapianti di Organi (DETO), Università degli Studi di Bari "Aldo Moro", Bari, Italy.
- Dipartimento dell'Emergenza e dei Trapianti di Organi (DETO), Sezione di Cliniche Veterinarie e P.A, Università degli Studi di Bari "Aldo Moro", Bari, Italy.
- Scuola di Bioscienze e Medicina Veterinaria, Università di Camerino, Matelica, Italy.
- Dipartimento dell'Emergenza e dei Trapianti di Organi (DETO), Sezione di Cliniche Veterinarie e P.A, Università degli Studi di Bari "Aldo Moro", Bari, Italy.
MeSH Terms
- Animals
- Cryptorchidism / surgery
- Cryptorchidism / veterinary
- Horse Diseases / surgery
- Horses
- Humans
- Laparoscopes
- Laparoscopy / veterinary
- Male
- Orchiectomy / veterinary
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