Small Animal Laparoscopy and Thoracoscopy. Группа авторов

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Название Small Animal Laparoscopy and Thoracoscopy
Автор произведения Группа авторов
Жанр Биология
Серия
Издательство Биология
Год выпуска 0
isbn 9781119666929



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function of many port closure devices (PCD) include a needlescopic grasper, which does not require a cannula. (A). From left to right: PCD in neutral position‐grasper contained within the needle lumen, PCD with top button engaged which exposes the grasper, PCD grasps suture material, PCD with suture ready to be introduced. (B) PCD and suture is introduced under visual guidance next to the cannula. (C). With suture released within the body cavity the PCD is now introduced on the opposite side of the cannula to grasp the suture end. (D). Both suture ends are now exteriorized and can be tied to close the port site.

      Formation of a postoperative trochar site herniation is considered a serious complication in human laparoscopic patients. Therefore, it has been recommended that 10 mm or larger cannula sites should be closed in adults and 5 mm or larger in children [20]. However, herniation has been reported in port sites as small as 3 mm [21]. In veterinary patients, the true incidence of such herniations has not been elucidated, and port closure recommendations are currently lacking. It seems generally accepted that all laparoscopic port sites in small animals should be closed by sutures engaging the rectus fascia whenever possible. However, like in people [22], port sites in small animals can be difficult to close in obese animals, or with obliquely oriented port sites.

Photo depicts many port closure systems utilize a suture guide to facilitate placing the suture through the small cannula skin incision.

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       Penny J. Regier and W. Alex Fox‐Alvarez

      Key Points

       Specimen retrieval bags allow for extraction of tissue with reduced risk of bacterial or neoplastic contamination.

       Single‐use integrated suction and irrigation devices are commercially available, but separate options for resterilization are also available.

       Wound protector and retractor devices are very useful for increased surgical exposure and port protection.

      Prior to the development of specimen retrieval bags, minimally invasive surgeons removed intracorporeally resected tissue through unprotected port sites and small