Minimally invasive small intestinal exploration and targeted abdominal organ biopsy with a wound retraction device in 42 cats (2005‐2015)

• Published in: Veterinary surgery 2017-10, Vol.46 (7), p.925-932
• Main Authors: Baron, Jessica, Giuffrida, Michelle, Mayhew, Philipp D., Singh, Ameet, Case, J. Brad, Culp, William T. N., Holt, David E., Mayhew, Kelli N., Runge, Jeffrey J.
• Format: Article
• Language: English
• Subjects: Abdomen; Animals; Biopsy; Biopsy - methods; Biopsy - veterinary; Cat Diseases - diagnosis; Cat Diseases - pathology; Cat Diseases - surgery; Cats; Complications; Diagnostic systems; Digestive System Surgical Procedures - instrumentation; Digestive System Surgical Procedures - methods; Digestive System Surgical Procedures - veterinary; Enteritis; Exploration; Female; Humans; Inflammatory bowel diseases; Intestinal Diseases - diagnosis; Intestinal Diseases - pathology; Intestinal Diseases - veterinary; Intestine, Small - pathology; Laparoscopy; Laparotomy - instrumentation; Laparotomy - methods; Laparotomy - veterinary; Leukocytes (eosinophilic); Lymphoma; Organs; Postoperative Complications - veterinary; Retrospective Studies; Small intestine; Splenectomy; Surgery; Surgical Instruments - veterinary; Umbilicus; Wounds
• ISSN: 0161-3499; 1532-950X
• DOI: 10.1111/vsu.12693

Objective To describe the surgical technique and evaluate short‐term outcome after minimally invasive small intestinal exploration and targeted organ biopsy with a wound retractor device (WRD) in cats. Study design Multi‐institutional retrospective study. Animals Forty‐two cats. Methods A wound retractor was inserted into the abdomen on the ventral midline through a 2‐4 cm incision at the level of the umbilicus. Short segments (6‐10 cm long) of intestinal tract were sequentially exteriorized and explored through the WRD. Full thickness, small intestinal biopsies were obtained extracorporeally via the WRD. A commercially available single‐port device was inserted through the WRD for laparoscopic exploration of the abdomen. Results The majority of the small intestine could be exteriorized and explored through the WRD. In all cases, full thickness biopsies of the small intestine of diagnostic quality were obtained. The most common histological findings were inflammatory bowel disease (n = 16), intestinal lymphoma (n = 14), and eosinophilic enteritis (n = 7). Two cases required conversion to a traditional open laparotomy due to abdominal pathology diagnosed after placement of the WRD (abdominal adhesions and need for a splenectomy). Postoperative complications occurred in 4 of 39 cats (10.3%), leading to 2 deaths after discharge from the hospital. Conclusions and clinical relevance MISIETB with a WRD alone or combined with laparoscopy is a safe technique for small intestinal exploration and targeted abdominal organ biopsy in cats. Single‐port laparoscopy can effectively be performed through the WRD for complete abdominal exploration and biopsy of abdominal organs.