| This thesis is a clinical evaluation of laparoscopic-assisted placement of jejunostomy feeding tubes in dogs under general anesthesia and under sedation and local anesthesia. Specific objectives were: to determine the ease of laparoscopic-assisted placement; to determine the feasibility of identifying the correct site and aboral direction for placement of a jejunostomy tube; to describe potential complications; and to compare hemodynamic parameters between animals undergoing tube placement under general anesthesia and those receiving sedation, local and epidural.;All tubes were placed aborally and were in a correct location. Only minor tube complications were identified. Intestinal stricture and altered motility were not evident on contrast studies. Statistical comparison of cardiovascular parameters was performed between groups and revealed significant differences in cardiac output, stroke volume, mean arterial pressures, Pa CO2 and Pa O2 between dogs in groups 1 and 2 compared to group 3.;Laparoscopic-assisted jejunostomy tube placement was effective, accurate and was without major complications. Laparoscopic jejunostomy tube placement was successful with tubes inserted in the correct direction and location. Tube placement under sedation and local anesthesia is feasible and represents a promising technique for clinical cases. Furthermore, this study shows that jejunostomy tube placement under local anesthetic may be beneficial in critically ill patients because superior cardiovascular function was maintained in healthy dogs compared to dogs undergoing the procedure under general anesthesia.;Fifteen dogs were equally randomized to receive either surgical tube placement via laparotomy under general anesthesia (group 1); laparoscopic tube placement under general anesthesia (group 2); or laparoscopic tube placement under sedation, local and epidural anesthesia (group 3). Feeding tubes were inserted into the jejunum in an aboral direction. A jejunopexy was performed along the left body wall. Cardiovascular parameters were assessed throughout the procedures and recovery and pain assessment scores were assigned. Radiographic contrast studies were performed on the 1st and 10th postoperative day to document location and direction of the tube as well as any evidence of stricture or altered motility. The dogs were tube-fed for 5 days post-operatively. |
