Figure 4.33 (A). Application of a wound retractor. With the flexible ring positioned inside the body cavity, ventral tension is applied, and the stiffer ring is “rolled” in a dorsal direction, thus rolling the softer material and shortening the length of the retractor. (B). With shortening of the retractor, 360° outward retraction force is applied to the edges of the incision.
Figure 4.34 A laparoscopic cap makes a wound retractor to a laparoscopic system enabling maintenance of the capnoperitoneum between laparoscopic‐assisted procedures.
Source: Photo courtesy Dr. Boel Fransson, Washington State University.
Figure 4.35 A morcellator.
Source: © 2014 Photo courtesy of KARL STORZ SE & CO, KG.
References
1 1 Sasmal, P.K., Mishra, T.S., Rath, S. et al. (2015). Port site infection in laparoscopic surgery: a review of its management. World J. Clin. Cases 3 (10): 864.
2 2 Reymond, M.A., Bonjer, H. J., Köckerling. F. Port‐Site and Wound Recurrences in Cancer Surgery: Incidence, Pathogenesis, Prevention. Springer, Berlin Germany, 2000.
3 3 Mishra, R.K. (2013). Textbook of Practical Laparoscopic Surgery, 3e. New Delhi: Jaypee Brothers Medical Publishers.
4 4 Palanivelu, C. (2007). Instrumentation and imaging system in laparoscopy. In: Art of Laparoscopic Surgery Textbook and Atlas, 1e (ed. R. Parthasarathi), 11–34. New Delhi: Jaypee Brothers Medical Publishers.
5 5 Mencaglia, L., Minelli, L., and Wattiez, A. (2013). Manual of Gynecological Laparoscopic Surgery, 11e. Tuttlingen, Germany: Endo Press.
6 6 Amer, N., Amer, M., and Mishra, R.K. (2013). Different techniques of tissue retrieval from abdominal cavity during minimal access surgery. World J. Lap. Surg. 6 (2): 63–68.
7 7 Pitt, K.A., Mayhew, P.D., Steffey, M.A. et al. (2016). Laparoscopic adrenalectomy for removal of unilateral noninvasive pheochromocytomas in 10 dogs. Vet. Surg. 45 (S1): O70–O76.
8 8 Milovancev, M. and Townsend, K.L. (2015). Current concepts in minimally invasive surgery of the abdomen. Vet. Clin.: Small Anim. Pract. 45 (3): 507–522.
9 9 Mayhew, P.D., Mehler, S.J., and Radhakrishnan, A. (2008). Laparoscopic cholecystectomy for management of uncomplicated gall bladder mucocele in six dogs. Vet. Surg. 37 (7): 625–630.
10 10 Otomo, A., Singh, A., Valverde, A. et al. (2019). Comparison of outcome in dogs undergoing single‐incision laparoscopic‐assisted intestinal surgery and open laparotomy for simple small intestinal foreign body removal. Vet. Surg. 48 (S1): O83–O90.
11 11 Mayhew, P.D. (2009). Techniques for laparoscopic and laparoscopic‐assisted biopsy of abdominal organs. Compend. Contin. Educ. Pract. Vet. 31 (4): 170–176.
12 12 Horiuchi, T., Tanishima, H., Tamagawa, K. et al. (2007). Randomized, controlled investigation of the anti‐infective properties of the Alexis retractor/protector of incision sites. J. Trauma 62 (2): 212–215.
13 13 Cheng, K.P., Roslani, A.C., Sehha, N. et al. (2012). Alexis O‐Ring wound retractor vs conventional wound protection for the prevention of surgical site infections in colorectal resections. Color. Dis. 14 (6): 346–351.
14 14 Baron, J.K., Giuffrida, M.A., Mayhew, P.D., et al. (2014). Initial experience and clinical outcome of thoracoscopic assisted pulmonary surgery (TAPS) for complete and partial lung lobectomy in dogs and cats: 11 cases (2008–2013). Proceedings of the Veterinary Endoscopy Society Symposium, Florence, Italy (15–17 May 2014).
15 15 Gibson, E., Culp, W., Mayhew, P.D. et al. (2020). Laparoscopic‐assisted gastrotomy for foreign body retrieval in four dogs. Vet. Rec. 8 (2): e000966.
16 16 Gower, S.B. and Mayhew, P.D. (2011). A wound retraction device for laparoscopic‐assisted intestinal surgery in dogs and cats. Vet. Surg. 40 (4): 485–488.
17 17 Wright, T., Singh, A., Mayhew, P.D. et al. (2016). Laparoscopic‐assisted splenectomy in dogs: 18 cases (2012–2014). J. Am. Vet. Med. Assoc. 248 (8): 916–922.
18 18 Morris, K.P., Singh, A., Holt, D.E. et al. (2019). Hybrid single‐port laparoscopic cisterna chyli ablation for the adjunct treatment of chylothorax disease in dogs. Vet. Surg. 48 (S1): O121–O129.
19 19 Singh, A., Scott, J., Case, J.B. et al. (2019). Optimization of surgical approach for thoracoscopic‐assisted pulmonary surgery in dogs. Vet. Surg. 48 (S1): O99–O104.
20 20 U.S. Food and Drug Administration. Safety Communications. https://www.fda.gov/medical‐devices/safety‐communications/update‐fda‐recommends‐performing‐contained‐morcellation‐women‐when‐laparoscopic‐power‐morcellation (accessed 11 June 2021).
21 21 Milad, M.P. and Milad, E.A. (2014). Laparoscopic morcellator‐related complications. J. Minim. Invasive Gynecol. 21 (3): 486–491.
22 22 Lund, C.M., Ragle, C.A., Lutter, J.D., et al. (2014). Use of a motorized morcellator for elective bilateral laparoscopic ovariectomy in standing equids: 30 cases (2007–2013). J. Am. Vet. Med. Assoc. 244 (10): 1191–1197.
23 23 Sassot, L.N., Ragle, C.A., Farnsworth, K.D. et al. (2017). Morcellation for testes extraction in horses undergoing standing laparoscopic cryptorchidectomy. Can. Vet. J. 58 (11): 1215.
24 24 De Pompeo, C.M., Giassetti, M.I., Elnaggar, M.M. et al. (2020). Isolation of canine adipose‐derived mesenchymal stem cells from falciform tissue obtained via laparoscopic morcellation: a pilot study. Vet. Surg. 40: O28–O37.
25 25 Seidman, M.A., Oduyebo, T., Muto, M.G. et al. (2012). Peritoneal dissemination complicating morcellation of uterine mesenchymal neoplasms. PLoS One 7: e50058.
5 Energy Devices and Stapling Equipment
Sarah Marvel and Eric Monnet
Key Points
A basic understanding of electrosurgical devices is required to allow for appropriate use and prevention of morbidity relating to their use.
Three different types of coupling injuries can occur with monopolar devices: direct, indirect, and capacitive coupling.
Indirect coupling results from defects in the insulating coating of the electrode (instrument), often leads to large current densities concentrated in small areas, and can result in high‐morbidity injuries.
Tissue fusion technology or vessel sealant devices measure tissue impedance and deliver the appropriate amount of energy to achieve a safe seal. They are approved for sealing vessels up to 7 mm in diameter.