Today's Veterinary Practice provides comprehensive information to keep every small animal practitioner up to date on companion animal medicine and surgery as well as practice building and management.
| THE CUTTING EDGE: INTRODUCING REDUCED PORT LAPAROSCOPIC SURGERY
Jeffrey J. Runge, DVM, Diplomate ACVS, is a lecturer in small animal surgery at University of Pennsylvania School of Veterinary Medicine. He specializes in companion animal and exotic species surgery and focuses
on laparoscopic and thoracoscopic minimally invasive surgery. Through ongoing collaboration with leading human laparoscopic surgeons, Dr. Runge and the University of Pennsylvania School of Veterinary Medicine have become leaders in veterinary reduced port surgery. Dr. Runge's group applies newer human laparoscopic single-site techniques, such as single port access (SPA), single incision laparoscopic surgery (SILS), and laparo-endoscopic single- site surgery (LESS), to minimally invasive surgery for companion animals. Dr. Runge lectures internationally on both single port and multiport laparoscopic surgery.
Ongoing advancements in human laparoscopy
have inspired our group to improve existing mini- mally invasive surgical techniques and evaluate the reduced port platform's use in veterinary laparoscopy (Tables 1 and 2, page 19). Our initial experience is promising. The combination of successful use of SPA techniques in canine patients and multitrocar devices in cats and dogs for specific laparoscopic procedures have provided evidence that, with appropriate patient selection, the reduced port platforms have a role in companion animal veterinary medicine. ■
LESS = laparo-endoscopic single-site surgery; NOTES = natural orifice transluminal endoscopic surgery; SILS = single incision laparoscopic surgery; SPA = single port access
PHOTO CREDITS
Figure 2: Courtesy of Covidien (covidien.com) Figures 3, 7, and 8: Courtesy of Olympus America, Inc (olympusamerica.com)
Figure 4: Courtesy of Applied Medical (appliedmedical.com)
References 1. Darzi A, Munz Y. The impact of minimally invasive surgical techniques. Annu Rev Med 2004; 55(1):223-237.
2. Davidson EB, Moll HD, Payton ME. Comparison of laparoscopic ovariohysterectomy and ovariohysterectomy in dogs. Vet Surg 2004; 33:62-69.
3. Culp WTN, Mayhew PD, Brown DC. The effect of laparoscopic versus open ovariectomy on postsurgical activity in small dogs. Vet Surg 2009; 38(7):811-817.
4. Kalloo AN, Singh VK, Jaggannath SB, et al. Flexible 20 Today's Veterinary Practice January/February 2012
transgastric peritoneoscopy: A novel approach to diagnostic and therapeutic interventions in the peritoneal cavity. Gastrointest Endosc 2004; 60(1):114-117.
5. Podolsky ER, Rottman SJ, Poblete H, et al. Single port access (SPA) cholecystectomy: A completely transumbilical approach. J Laparoendosc Adv Surg Tech A, 2009; 19(2):219-222.
6. Runge JJ, Curcillo PG, King SA, et al. Reduced port surgery: Single port access (SPA) technique for laparoscopic canine ovariectomy. Vet Endosc Soc Proc, 2011.
7. Curcillo PG, Wu A, Podolsky E, et al. Single port access (SPA) cholecystectomy—initial validation of a single incision approach. Soc Am Gastrointest Endosc Surg Proc, 2008.
8. Gill IS, Advincula AP, Aron M, et al. Consensus statement of the consortium for laparoendoscopic single-site surgery. Surg Endosc 2010; 24(4):762-768.
9. King SA, Atogho A, Podolsky E, Curcillo PG. Single port access (SPA) bilateral oophorectomy and hysterectomy. Laparosc Today 2008; 7:2.
10. Podolsky ER, Rottman SJ, Curcillo PG. Single port access (SPA) cholecystectomy: Two year follow-up. J Soc Laparosc Surg 2009; 13(4):528-535.
11. Curcillo PG, Wu AS, Podolsky ER, et al. Single port access (SPA) cholecystectomy: A multi-institutional report of the first 297 cases. Surg Endosc 2010; 24(8):1854-1860.
12. Romanelli JR, Roshek TB, Lynn DC, Earle DB. Single port laparoscopic cholecystectomy: Initial experience. Surg Endosc 2010; 24(6):1374-1379.
13. Stolzenburg JU, Kallidonis P, Hellawell G, et al. Technique of laparoscopic-endoscopic single-site surgery radical nephrectomy. Eur Urol 2009; 56(4):644-650.
14. Horiuchi T, Tanishima H, Tamagawa K, et al. Randomized controlled investigation of the anti-infective properties of the Alexis retractor/protector of incision sites. J Trauma 2007; 62(1):212-215.
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