Köpek orşiektomisinde bir bipolar damar kapama cihazının kullanılması

Abstract

Bipolar damar kapama (BDK) cihazları veteriner hekimlikte artarak kullanılmaktadır. Bu çalışmada köpeklerin preskrotal açık orşiektomide bir bipolar damar kapama (BDK) cihazının kullanılmasının cerrahi süre, portoperatif ağrı ve cerrahi bölge komplikasyonlarını azaltıp azaltılamayacağının sütur ligasyonu ile karşılaştırılarak belirlenmesi amaçlanmıştır. Elektif kastrasyon amacıyla başvuran 50 orta ve büyük ırk köpek rastgele ligasyon ve BDK gruplarına ayrılmıştır. Cerrahi süre, 15. dakika, 1, 6 ve 24 saatlerde portoperatif ağrı ve 24. saatte cerrahi bölge şişlik ve morluk skorları karşılaştırılmıştır. Cerrahi süre BDK grubunda (medyan 8.30; aralık 7.03 to 10.17 minutes) ligasyon grubundan (medyan 10.18; aralık 7.47 to 12.33 dakika) daha kısa bulunmuştur. Bipolar damar kapama grubunda köpeklerin yaş (r=0.458, P=0.021) ve vücut ağırlığı (r=0.432, P=0.031) cerrahi süreyi etkilemiştir. Bipolar damar kapama grubunda postoperatif 15. dakika (P=0.001) ve 1. saatte (P=0.045) ligasyon grubundan daha düşük ağrı skorları gözlenmiştir. Cerrahi bölge şişlik skoru BDK grubunda (0.24 ± 0.09) ligasyon grubuna (0.72 ± 0.17) kıyasla düşük (P=0.034) olmuştur. Bipolar damar kapama grubunda (0.44 ± 0.13) ligasyon grubundan (1.16 ± 0.22) daha düşük morluk skoru (P=0.168) gözlenmiştir. Köpeklerin açık orşiektomisinde BDK yönteminin kullanılması geleneksel ligasyon tekniğine kıyasla daha kısa cerrahi süre ve daha düşük postoperatif ağrı ve cerrahi bölge komplikayonları ile sonuçlanmaktadır.

Keywords

• Bipolar damar kapama
• köpek
• orşiektomi
• postoperatif komplikasyon
• postoperatif ağrı

Use of a bipolar vessel sealing device in canine orchiectomy

Abstract

Bipolar vessel sealing (BVS) devices are being used increasingly in veterinary medicine. The objective was to determine whether the use of a BVS device in prescrotal open orchiectomy of dogs reduced surgical time, postoperative pain and surgical site complications compared to ligation with suture. Fifty medium to large breed dogs admitted for elective castration were randomly assigned to either the ligation or BVS groups. Duration of surgery, pain score at postoperative 15 minutes, 1, 2, and 24 hours, and surgical site swelling and bruising scores at 24 hours were compared. Duration of surgery was shorter (P˂0.001) in the BSV group (median 8.30; range 7.03 to 10.17 minutes) than the ligation group (median 10.18; range 7.47 to 12.33 minutes). There was a significant effect of age (r=0.458, P=0.021) and body weight (r=0.432, P=0.031) of the animal on the duration of surgery in the BVS group. Lower pain scores were observed in the BVS group at postoperative 15 minutes (P=0.001) and 1 hour (P=0.045). Pain scores were not different between groups at 2 hours and 24 hours (P˃0.05). The surgical site swelling score was lower (P=0.034) in the BVS group (0.24 ± 0.09) compared to the ligation group (0.72 ± 0.17). A lower bruising score (P=0.015) was observed in the BVS group (0.44 ± 0.13) than in the ligation group (1.16 ± 0.22). The use of BVS method was associated with significantly shorter surgery times and lower postoperative pain and surgical site complications than traditional ligation technique in canine open orchiectomy.

Keywords

• Bipolar vessel sealing
• canine
• orchiectomy
• postoperative complication
• postoperative pain

References

1. Adin CA (2011): Complications of ovariohysterectomy and orchiectomy in companion animals. Vet Clin North Am Small Anim, 41, 1023-1039.
2. Airikkala-Otter I, Gamble L, Mazeri S, et al (2018): Investigation of short-term surgical complications in a low-resource, high-volume dog sterilisation clinic in India. BMC Vet Res, 14, 56.
3. Belanger JM, Bellumori TP, Bannasch DL, et al (2017): Correlation of neuter status and expression of heritable disorders. Canine Genet Epidemiol, 26, 4-6.
4. Boothe HW (2003): Testes and Epididymides. 1521-1530. In: D Slatter (Ed), Textbook of Small Animal Surgery. WB Saunders, Philadelphia.
5. BSAVA (2016): BSAVA Guide to the Use of Veterinary Medicines. British Small Animal Veterinary Association, Gloucester.
6. Chekan E, Davison M, Singleton D, et al (2015): Consistency and sealing of advanced bipolar tissue sealers. Med Devices (Auckl), 8, 193-199.
7. De la Puerta B, Baines S (2012): Surgical diseases of the genital tract in male dogs 1. Scrotum, testes and epididymides. In Pract, 34, 58-65.
8. Devriendt N, Van Goethem B, Van Brantegem L, et al (2017): Comparison of a 5-mm and 10 mm vessel sealing device in an open ovariectomy model in dogs. Vet Rec, 180, 425.

9. Eberli D, Helermehl LJ, Müller A, et al (2011): Thermal spread of vessel-sealing devices evaluated in a clinically relevant in vitro model. Urol Int, 86, 476-482.
10. Freeman LJ, Ferguson N, Fellenstein C, et al (2017): Evaluation of learning curves for ovariohysterectomy of dogs and cats and castration of dogs. J Am Vet Med, 251, 322-332.
11. Gardeweg S, Bockstahler B, Dupre G (2019): Effect of multiple use and sterilization on sealing performance of bipolar vessel sealing devices. Plos One, 14, e0221488.
12. Goldstein SL, Harold KL, Lentzner A (2002): Comparison of thermal spread after ureteral ligation with the ultrasonic shears and LigaSure system. J Laparoendosc Adv Surg Tech, 12, 61-63.
13. Hamilton KH, Henderson ER, Toscano M, et al (2014): Comparison of post-operative complications in healthy dogs undergoing open and closed orchidectomy. J Small Anim Pract, 55, 521-526.
14. Harold KL, Pollinger H, Matthews BD, et al (2003): Comparison of ultrasonic energy, bipolar thermal energy, and vascular clips for the hemostasis of small-, medium-, and large-sized arteries. Surg Endosc, 17, 1228-1230.
15. Hedlund C (2007): Surgery of the Male Reproductive Tract. 714-715. In: TW Fossum (Ed), Small Animal Surgery. Mosby, St. Louis.
16. Heniford BT, Matthews BD, Sing RF, et al (2001): Initial results with an electrothermal bipolar vessel sealer. Surg Endosc, 15, 799-801.
17. Howe LM (1997): Short-term results and complications of prepubertal gonadectomy in cats and dogs. J Am Vet Med, 211, 57-62.
18. Howe LM (2006): Surgical methods of contraception and sterilization. Theriogenology, 66, 500-509.
19. Kennedy JS, Stranahan PL, Taylor KD, et al (1998): High-burst strength, feedback-controlled bipolar vessel sealing. Surg Endosc, 12, 876-878.
20. Kum C, Voyvoda H, Sekkin S, et al (2013): Effects of carprofen and meloxicam on C-reactive protein, ceruloplasmin, and fibrinogen concentrations in dogs undergoing ovariohysterectomy. Am J Vet Res, 74, 1267-1273.
21. Kushnir Y, Toledano N, Cohen L, et al (2017): Intratesticular and incisional line infiltration with ropivacaine for castration in medetomidine-butorphanol-midazolam sedatand dogs. Vet Anaesth Analg, 44, 346-355.
22. Kustritz MV (2007): Determining the optimal age for gonadectomy of dogs and cats. J Am Vet Med, 231, 1665-1675.
23. Leece EA, Brearley JC, Harding EF (2005): Comparison of carprofen and meloxicam for 72 hours following ovariohysterectomy in dogs. Vet Anaesth Analg, 32, 184-192.
24. Lorange M, De Arburn Parent R, Huneault L, et al (2019): Use of a vessel-sealing device versus conventional hemostatic techniques in dogs undergoing thyroidectomy because of suspected thyroid carcinoma. J Am Vet Med, 254, 1186-1191.
25. Mathews KA (2002): Non-steroidal anti-inflammatory analgesics: A review of current practice. J Vet Emerg Crit Care, 12, 89-97.
26. Neilson JC, Eckstein RA, Hart BL, et al (1997): Effects of castration on problem behaviors in male dogs with reference to age and duration of behavior. J Am Vet Med, 211, 180-182.
27. Ohlund M, Höglund O, Olsson U, et al (2011): Laparoscopic ovariectomy in dogs: a comparison of the LigaSureTM and the SonoSurg TM systems. J Small Anim Pract, 52, 290-294.
28. Parkinson TJ (2012): Progress towards less invasive veterinary surgery. Vet Rec, 171, 67-68.
29. Person B, Vivas DA, Ruiz D, et al (2008): Comparison of four energy-based vascular sealing and cutting instruments: A porcine model. Surg Endosc, 22, 534-538.
30. Pollari FL, Bonnett BN (1996): Evaluation of postoperative complications following elective surgeries of dogs and cats at private practices using computer records. Can Vet J, 37, 672-678.
31. Quarterone C, Luna SPL, Crosignani N, et al (2017): Ovariohysterectomy requires more post-operative analgesia than orchiectomy in dogs and cats. Can Vet J, 58, 1191-1194.
32. Schwarzkopf I, Van Goethem B, Vandekerckhove PM, et al (2015): Vessel sealing versus suture ligation for canine ovarian pedicle haemostasis: a randomised clinical trial. Vet Rec, 176, 125.
33. Shaver SL, Larrosa M, Hofmeister EH (2019): Factors affecting the duration of anesthesia and surgery of canine and feline gonadectomies performed by veterinary students in a year-long predinical surgery laboratory. Vet Surg, 48, 352-359.
34. Sindram D, Martin K, Medows JP, et al (2011): Collagen-elastin ratio predicts burst pressure of arterial seals created using a bipolar vessel sealing device in a porcine model. Surg Endosc, 25, 2604-2612.
35. Stevens BJ, Posner LP, Jones CA, et al (2013): Comparison of the effect of intratesticular lidocaine/bupivacaine vs. saline placebo on pain scores and incision site reactions in dogs undergoing routine castration. Vet J, 196, 499-503.
36. Wagner AE, Worland GA, Glawe JC, et al (2008): Multicenter, randomized controlled trial of pain-related behaviors following routine neutering in dogs. J Am Vet Med, 233, 109-115.
37. Watts J (2018): The use of bipolar electrosurgical forceps for haemostasis in open surgical ovariectomy of bitches and queens and castration of dogs. J Small Anim Pract, 59, 465-473.
38. White RN (1998): Surgery of the Genital Tract. 171-196. In: GM Simpson, GCW England, M Havery (Eds), BSAVA Manual of Small Animal Reproduction and Neonatology. British Small Animal Veterinary Association, Cheltenham.
39. Wouters EG, Buishand FO, Kirpensteijn J (2011): Use of a bipolar vessel-sealing device in resection of canine insulinoma. J Small Anim Pract, 52, 139-145.
40. Wright T, Singh A, Mayhew PD, et al (2016): Laparoscopic-assisted splenectomy in dogs: 18 cases (2012-2014). J Am Vet Med, 248, 916-922.