Basic Studies And Clinical Application Of Laparoscopic Technology To Dogs

Minimally invasive surgery is the development direction of surgical in 21^st.And as an important component part of the minimally invasive surgery,laparoscopic technology has clear surgery eyesight,less bleeding,minimally invasive,small impact on the body,slight pain response,rapid postoperative recovery and other characteristics.The technology has been widely used in human medicine.There were many reports in veterinary field abroad about laparoscopic technology applying on animals and related to animal species has widespread applications. However,domestic laparoscopic technology applying on aninal field is very limited and most of which were used for breeding areas.There is no conrelated and basic reseach or surgery on dogs in China so far.So the objectives of the study were to choose the optimum pneumoperitoneum on dog's surgery;to complete the sliver and suture of stomach,cholecystectomy and the sliver and suture of bladder with the best pneumoperitoneum;to understand the advantages and disadvantages of laparoscopic cholecystectomy(LC) and open cholecystectomy(OC) according to comparative analysis of laparoscopic versus open splecectomy.Thirty dogs(male or female) weighing about 18kg were selected and cultivated 7 days in the same constitution,then began to experimentize after the dogs were confirmed healthy in clinical and laboratory examination,randomly selected for five groups,named group A,B,C,D and E.Group A was anesthesia and group B,C,D,E were subjected to CO₂ pneumoperitoneum(PP) at pressure 0.80, 1.06,1.33 and1.60kPa.Body temperature(BT),blood pressure(SBP and SDP),SpO₂,respiratory rate(RR),PetCO₂ were recorded at seven time point after anesthesia.At the same time,each group were collected the blood for measurement of immunity function(WBC,Lym,IL-6,IL-8,CRP, TNF-α);liver function(AST,ALT,ALP,TBIL);renal function(Crea,BUN).Otherwise,we insufflated with different airpressure(0.80,1.06,1.33,1.60kPa) in order to compare which one could reveal the surgery eyesight thoroughly.We determined an optimum pneumoperitoneum according to test the above index and inflation condition.Then with the optimum pneumoperitoneum,laparoscopic surgery was performed such as laparoscopic repair of experimentally ruptured urinary bladder,laparoscopic splenectomy,laparoscopic cholecystectomy, laparoscopic silver and repair of stomach.At last,we did the contrast between laparoscopic cholecystectomy(LC) and open cholecystectomy(OC).The item of operating time and length of incision and index of immunity-stress were compared in order to test the advantages of laparoscope technique.The results showed that:Firstly,the influence of different CO₂ pneumoperitomeum on physical function.In the study,during the pneumoperitoneum process,along with increased abdominal pressure gas,all index have changed accordingly.The pneumoperitoneum pressure was more bigger and the change is more bigger.We found that the surgery eyesight can be exposed thoroughly at 1.33kPa and the surgery can be carried out with different insufflation in the test selecting the optimum surgery eyesight.Secondly,the clinical application of laparoscope technique on dogs.30 surgery were successfully completed with 1.33kPa pneumoperitoneum,and no postoperative infections,and only one incision and repair of the bladder appeared adhesions,after the second day its appetite,mental state recovered to normal.The fact that Laparoscopic techniques could be applied in veterinary clinical surgery was verified.Thirdly,the contrast between laparoscopic cholecystectomy(LC) and open cholecystectomy(OC).According to the test,complishing the LC needed 30min,but OC needed 50min.The total operative incision was about 3.3cm in LC and only one scobination could suture puncture hole of 11mm after surgery but the puncture hole of 5.5mm needn't suture;but operative incision was about 15cm and needed routine scobination suturation about 8-10.The results show that,body tempture and WBC were increased;immunity index such as IL-6,CRP,TNF-α,immunoglobulin were changed accordingly.On the whole,the laparoscopic surgery on dogs was firstly studied in China.The optimum PP of the dog was 1.33kPa,the effects of laparoscopic and traditional surgery was compared.All these revealed that the advantages of laparoscopy was feasible and practical,these will be the basis for applying of LS in domestic veterinary clinic.