Laparoscopy Offers Diagnostic and Treatment Options for Dogs and Cats
By Dr. Alvaro Larin, DVM ACVS (original link https://vetmedicine.about.com/od/veterinaryqa/a/Laparoscopy-In-Veterinary-Medicine.htm)
Many of the diagnostic and treatment options available to humans are also available for animals. Guest Author Dr. Alvaro Larin, DVM ACVS, a veterinary surgeon in Miami, Florida, discusses the use of laparoscopy in veterinary medicine, for diagnosing and treating a variety of conditions.
What is Laparoscopy?
Laparoscopy is a minimally invasive way to view the organs in the abdomen. It is a safe technique that minimizes soft tissue trauma to the patient allowing for faster and less painful recovery. Anesthesia time can also be reduced which is important in geriatric and debilitated patients.
This technique was originally used as a diagnostic tool for viewing the internal contents of the abdomen and obtaining tissue samples but has progressed to allow for surgical procedures such as ovariectomy (removal of the ovaries), adrenalectomy (removal of the adrenal gland), cholecystectomy (removal of the gall bladder), cryptorchid surgery etc. Advanced laparoscopy procedures are opening the door to new treatment options for pets.
The laparoscopic procedure involves passing a small needle into the abdomen and inflating the abdomen with gas (carbon dioxide) in order to distend it and allow for visualization and working space. Approximately 34 portals are usually made which involves a skin incision that is 5-10mm. Specific surgical instruments are inserted into the abdomen through the portals. A scope is placed to view the abdomen and several other instruments such as electrocautery, laparoscopic surgical instruments and lasers can be placed via the other portals to perform the procedure.
The images from the scope are magnified on a monitor in the operating room which gives an excellent view of the internal organs. Once the procedure is performed the site can be closely monitored for complications such as excess bleeding. This can be dealt with immediately if needed.
Ideal candidates for laparoscopy are dogs that are lean and weigh at least 30 pounds. Obese dogs or dogs that are very small (<15 lbs) can make the procedure more difficult.
Laparoscopic diagnostic techniques that are most commonly performed are biopsies of organs or masses to rule out disease or cancer. The most commonly biopsied organs are the liver, pancreas, spleen and less frequently the kidney. Other organs such as the intestines and bladder can also be biopsied via laparoscopic assisted technique.
Laparoscopic surgical techniques such as ovariectomy and prophylactic gastropexy are gaining popularity.
Ovariectomy (spay) is a fast and simple technique. Unlike the “typical” spay (Ovariohysterectomy) where the ovaries and uterus are removed, in this procedure, only the ovaries are removed. The uterus remains inactive and poses no problem for the patient. This method of spaying has been performed in Europe for many years without problem. Ovariohysterectomy can also be performed via laparoscopy or laparoscopic-assisted method where the uterus can be exteriorized from the abdomen through a small incision and removed.
Gastric-Dilatation/Volvulus or “Bloat” is a life-threatening problem that occurs in large, deep-chested dogs such as the Great Dane. A prophylactic gastropexy is a procedure that can be performed via laparoscopy to prevent this disease from occurring.
A prophylactic (preventative) gastropexy is a technique in which the stomach is tacked to the abdominal wall permanently, therefore, preventing the stomach from rotating abnormally (GDV). This procedure can be performed in dogs that are predisposed to GDV in order to prevent the disease from occurring.
Prophylactic gastropexy refers to performing the procedure before the dog has the problem. In a laparoscopic procedure, scopes and instruments are inserted into the abdomen. The stomach is grasped with forceps and pulled to the right side of the abdomen just behind the 13th rib where it is fixed to the abdominal wall using sutures .
Laparoscopy offers another way to diagnose and treat certain diseases. Its minimal invasiveness as compared to an exploratory laparotomy has many advantages which include less pain, shorter recovery time and decreased infection rate.