| Compared with tranditonal surgery, laparoscopic surgery had many advantages of the minimal invasion on the operative animals, sufficient exposure of abdominal organ structure during the operation, the less bleeding, the minimal incision, postoperative mild pain, the less tissue adhesions and more postoperative rapid recovery. It had been widely used in the domains of diagnosis and treatment of animal clinical diseases, livestock production, embryo transfer abroad.Traumatic diaphragmatic hernias were common in dogs, whereas congenital hernias were infrequently seen. Although reports about repair of diaphragm rupture in dogs had been published in domestic and abroad, which mainly concentrated in the traditional laparotomy, experimental studys of laparoscopic repair of diaphragmatic rupture had not been reported.Orthoptic diagnosis function and certain damage treatment ability by laparoscopy through thoracic path, may reduce blindness by opening investigating the belly. This experiment draws up laparoscopic repair of diaphragmatic rupture through thoracic path, and discusses the feasibility and the security of the technology.The healthy dogs were performed by filling CO2 into thoracic cavity(maintained intra-pressure of 0.53-0.80kPa)to creat operating space, entering into cannulas and instruments, making the diaphragm crack , sewing the diaphragm, douching the thoracic cavity, closing the thoracic cavity under the laparoscopy. Dogs were monitored with respirator and intensive care monitor during the operation and were recorded at the time of before operation, intraoperative 10min,30min and 60min, immediately after operation. The venous blood of the forelimb at the before operation and postoperative was collected in order to detect the white blood cell counting, the neutrocyte ratio, the aspartate aminotransferase, the alanine aminotransferase, the alkaline phosphatase, the blood urea nitraogen, the creatinine, the malondialdehyde, the glutathione peroxidase, the superoxide dismutase, the troponin-I and the myohemoglobin.Experiment results: Laparoscopic repair of diaphragmatic rupture through thoracic path had been successfully completed in eight dogs in this experiment. The time of surgery was 62~95minutes, the length of diaphragmatic incision was 5~8cm, the total length of incision was 4~5cm. It was not obvious larger bleeding during the operation. Abdomen exploration and thorax exploration were carried out in dogs. The blood pressure, heart rate and body temperature decreased during the operation. After the operation, the blood pressure and heart rate rised; the body temperature did not rised. The white blood cell counting, the neutrocyte ratio, the aspartate aminotransferase, the alanine aminotransferase, the alkaline phosphatase, the blood urea nitraogen, the creatinine, the troponin-I and the myohemoglobin were the highest after the operation, then decreased to the level before the operation. The malondialdehyde, the glutathione peroxidase and the superoxide dismutase were the lowest after the operation, then rised to the level before the operation.Through the experiment results, the following conclusions were drawn:1. Laparoscopic repair of diaphragmatic rupture through thoracic path in dogs could be successfully completed in dogs using 3 cannulas portal in the experiment for the first time, which demonstrated the feasibility of the technique.2. The detection results of those items of stress reaction, hepatic and renal function, oxidative stress, myocardial damage drew a conclusion that laparoscopic repair of diaphragmatic rupture through thoracic path merely had the influence on the hepatic and renal function in the short term, but could not create the serious clinical consequence. Doctors should strengthen the guardianship during the operation and take certain protective measures. |
