Applying and Cutting Device for Tie-Wraps During Laparoscopic Ovariectomy in Standing Mares
Keywords:laparoscopic ovariectomy, hemostasis, tie-wrap, horse.
Background: Laparoscopic ovariectomy it is used more than 20 years in veterinary medicine, however, information of this technique in Brazil are rare. Also, the cost for his execution are high, specially the ovarian hemostasis procedure, that depends on highly specialized surgical instruments. The goal of this study is show the results achieved during laparoscopic ovariectomy in mares using a device to apply and cut tie-wraps, developed by the authors and that is in a patent process.
Materials, Methods & Results: Four mares with ovarian pathologies were selected for a standing unilateral ovariectomy procedure and access to cavity occurred through three laparoscopic portals. The vessels and ligament were dissected to allow positioning of a polyamide tie-wrap by the device for cutting and applying those seals. Occlusion was made by pushing, and cutting through a rotation on the tie latch. Then, the mesovarium was cut with laparoscopic scissors and ovary removed by a communication between two accesses. Total surgical time and the equipment handling were noted. The average duration of surgical procedures was 80 ± 12.35 min and device handling time since its external preparation, application and cutting the polyamide tie-wraps was 3.4 ± 2.63 min. Only in one of four animals it was necessary to apply more than one tie, since the first promoted incomplete vessels occlusion. Within 10 postoperative days none of the animals showed clinical signs consistent with bleeding and / or infection and the wound’s healing were complete.
Discussion: Surgical time for dissection and hemostasis during laparoscopic ovariectomy in mares shows great variation in the literature and depend on hemostasis technique. The average time of 80 min for a one-sided procedure using the device for application and cutting tie-wraps was considered appropriate, with the possibility of significantly reduction, since this is an instrumental in testing and yet there is not a definition of the learning curve from its use. The main reason related to the tie-wraps use, even controversial, is due a significant reduction in cost, since the devices for hemostasis available are very expensive to brazilian veterinarians. Although considered a simple application and advantages over other hemostatic methods the authors of this study do not indicate the use of non-surgical polyamide ties when other materials are available, also, it is important to clarify that the main purpose of this study was to report the effectiveness of the device for application and cut these ties while performing these surgical procedure steps. The device for applying and cutting tie-wraps allows closing and resection of polyamide tie-wraps, producing safe hemostasis to ovarian vessels during laparoscopic ovariectomy in mares, with appropriate surgical time and without trans or postoperative complications.
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