Laparoscopic-assisted splenectomy in dogs: 18 cases (2012-2014).

OBJECTIVE To describe the operative technique and perioperative outcome for laparoscopic-assisted splenectomy (LAS) in dogs. DESIGN Retrospective case series. ANIMALS 18 client-owned dogs. PROCEDURES Medical records of dogs with naturally occurring disease of the spleen treated by means of LAS between 2012 and 2014 were reviewed. History, signalment, results of physical examination, results of preoperative diagnostic testing, details of surgical technique, intraoperative findings including results of abdominal exploration and staging, concurrent surgical procedures, complications, histopathologic diagnoses, duration of postoperative hospitalization, and perioperative outcome were recorded. The perioperative period was defined as the time from hospital admission for LAS until discharge or death (within the same visit). RESULTS All dogs underwent initial abdominal exploration and staging via multiple 5-mm laparoscopic ports (n = 2) or a single commercially available multichannel port (16), followed by minilaparotomy with insertion of a wound retraction device, progressive exteriorization of the spleen, sealing of hilar vessels, and splenectomy. Splenectomy was performed for treatment of a splenic mass (n = 15), suspected neoplasia (2), or refractory immune-mediated disease (1). Median size (width × length) of splenic masses was 5 × 5 cm (range, 1.6 to 11.0 cm × 1.5 to 14.5 cm). Complications were limited to minor intraoperative hemorrhage in 1 dog; no patient required conversion to open laparotomy. CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that LAS was technically feasible in dogs and not associated with major complications. Further evaluation is required; however, in appropriately selected patients, LAS may offer the benefits of a minimally invasive technique, including a smaller incision and improved illumination and magnification during exploration and staging.

[1]  Ameet Singh,et al.  Single incision laparoscopic-assisted ovariohysterectomy for an ovarian tumor in a dog. , 2017, The Canadian veterinary journal = La revue veterinaire canadienne.

[2]  S. Tosun,et al.  Single-site multiport combined splenectomy and cholecystectomy with conventional laparoscopic instruments: Case series and review of literature , 2015, International journal of surgery case reports.

[3]  P. Mayhew,et al.  Short-Term Outcome of Multiple Port Laparoscopic Splenectomy in 10 Dogs. , 2015, Veterinary surgery : VS.

[4]  Shengping Lin,et al.  Hand‐assisted versus conventional laparoscopic splenectomy: a systematic review and meta‐analysis , 2014, ANZ journal of surgery.

[5]  R. Boston,et al.  Evaluation of the learning curve for a board-certified veterinary surgeon performing laparoendoscopic single-site ovariectomy in dogs. , 2014, Journal of the American Veterinary Medical Association.

[6]  P. Kass,et al.  Decreased surgical time with a vessel sealing device versus a surgical stapler in performance of canine splenectomy. , 2014, Journal of the American Animal Hospital Association.

[7]  J. B. Case,et al.  Evaluation of costs and time required for laparoscopic-assisted versus open cystotomy for urinary cystolith removal in dogs: 43 cases (2009-2012). , 2013, Journal of the American Veterinary Medical Association.

[8]  Jennifer Dykema,et al.  Minimally invasive surgery in veterinary practice: a 2010 survey of diplomates and residents of the American College of Veterinary Surgeons. , 2013, Veterinary surgery : VS.

[9]  S. Karmali,et al.  Minimally invasive splenectomy: an update and review. , 2013, Canadian journal of surgery. Journal canadien de chirurgie.

[10]  J. B. Case,et al.  Single incision laparoscopic-assisted intestinal surgery (SILAIS) in 7 dogs and 1 cat. , 2013, Veterinary surgery : VS.

[11]  P. Mayhew,et al.  Evaluation of laparoscopic-assisted ovariohysterectomy for treatment of canine pyometra. , 2013, Veterinary surgery : VS.

[12]  P. Mayhew,et al.  Laparoscopic splenectomy: operative technique and outcome in three cats , 2013, Journal of feline medicine and surgery.

[13]  A. Khalaj,et al.  Comparison between single and three portal laparoscopic splenectomy in dogs , 2012, BMC Veterinary Research.

[14]  C. Law,et al.  ALEXIS O‐Ring wound retractor vs conventional wound protection for the prevention of surgical site infections in colorectal resections 1 , 2012, Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland.

[15]  P. Mayhew,et al.  Comparison of surgical site infection rates in clean and clean-contaminated wounds in dogs and cats after minimally invasive versus open surgery: 179 cases (2007-2008). , 2012, Journal of the American Veterinary Medical Association.

[16]  S. Johnston,et al.  Veterinary Surgery: Small Animal , 2012 .

[17]  T. Fahey,et al.  Three-Dimensional CT Volumetry Predicts Outcome of Laparoscopic Splenectomy for Splenomegaly: Retrospective Clinical Study , 2012, World Journal of Surgery.

[18]  P. Mayhew,et al.  A wound retraction device for laparoscopic-assisted intestinal surgery in dogs and cats. , 2011, Veterinary surgery : VS.

[19]  J. Connors,et al.  Hand-assisted laparoscopic splenectomy versus open splenectomy for massive splenomegaly: 20-year experience at a Canadian centre. , 2011, Canadian journal of surgery. Journal canadien de chirurgie.

[20]  E. Monnet,et al.  Use of a vessel sealant device for splenectomy in dogs. , 2011, Veterinary surgery : VS.

[21]  É. Carmel,et al.  Laparoscopic splenectomy for treatment of splenic hemangiosarcoma in a dog. , 2010, Veterinary surgery.

[22]  P. Mayhew,et al.  The effect of laparoscopic versus open ovariectomy on postsurgical activity in small dogs. , 2009, Veterinary surgery : VS.

[23]  R. Stedile,et al.  Laparoscopic versus open splenectomy in dogs , 2009 .

[24]  F. Greene,et al.  Initial results with an electrothermal bipolar vessel sealer , 2001, Surgical Endoscopy.

[25]  G. Silecchia,et al.  Laparoscopic splenectomy: the clinical practice guidelines of the European Association for Endoscopic Surgery (EAES) , 2008, Surgical Endoscopy.

[26]  M. Inoue,et al.  Randomized, controlled investigation of the anti-infective properties of the Alexis retractor/protector of incision sites. , 2007, The Journal of trauma.

[27]  N. Quaranta,et al.  Sutureless and stapleless laparoscopic splenectomy using radiofrequency , 2006, Surgical Endoscopy And Other Interventional Techniques.

[28]  C. Devitt,et al.  Duration, complications, stress, and pain of open ovariohysterectomy versus a simple method of laparoscopic-assisted ovariohysterectomy in dogs. , 2005, Journal of the American Veterinary Medical Association.

[29]  E. Targarona,et al.  Is the Laparoscopic Approach Reasonable in Cases of Splenomegaly? , 2004, Seminars in laparoscopic surgery.

[30]  Y. Novitsky,et al.  Hand-assisted laparoscopic splenectomy in the setting of splenomegaly , 2004 .

[31]  L. Brunt,et al.  Perioperative outcomes of laparoscopic versus open splenectomy: a meta-analysis with an emphasis on complications. , 2003, Surgery.

[32]  N. O'Rourke,et al.  Massive Splenomegaly Is Associated With Significant Morbidity After Laparoscopic Splenectomy , 2003, Annals of surgery.

[33]  M. Rosen,et al.  Hand-assisted laparoscopic splenectomy vs conventional laparoscopic splenectomy in cases of splenomegaly. , 2002, Archives of surgery.

[34]  B. Heniford,et al.  Laparoscopic splenectomy for massive splenomegaly. , 2002, American journal of surgery.

[35]  C. Rawlings Laparoscopic-assisted gastropexy. , 2002, Journal of the American Animal Hospital Association.

[36]  A. Lacy,et al.  Hand-assisted laparoscopic splenectomy (HALS) in cases of splenomegaly , 2001, Surgical Endoscopy And Other Interventional Techniques.

[37]  R. Hodin,et al.  Laparoscopic splenectomy for massive splenomegaly using a Lahey bag. , 2001, American journal of surgery.

[38]  A Park,et al.  Laparoscopic vs open splenectomy. , 1999, Archives of surgery.

[39]  E. Targarona,et al.  Effect of spleen size on splenectomy outcome , 1999, Surgical Endoscopy.

[40]  J. S. Kennedy,et al.  High-burst-strength, feedback-controlled bipolar vessel sealing , 1998, Surgical Endoscopy.

[41]  J. Langer,et al.  Comparative analysis of laparoscopic versus open splenectomy. , 1996, American journal of surgery.

[42]  R. Kusminsky,et al.  Hand-assisted laparoscopic splenectomy. , 1995 .

[43]  M. Culbertson,et al.  Prevalence, type, and importance of splenic diseases in dogs: 1,480 cases (1985-1989). , 1992, Journal of the American Veterinary Medical Association.

[44]  B. Mazières,et al.  [Association of T lymphoma localized at the sacrum and pulmonary sarcoidosis]. , 1991, Presse medicale.