Thesis
Laparoscopic suture ligation techniques
Washington State University
Master of Science (MS), Washington State University
05/2021
DOI:
https://doi.org/10.7273/000000050
Handle:
https://hdl.handle.net/2376/112848
Abstract
Minimally invasive surgery (MIS) offers the benefits of minimized pain and faster recovery
when compared with traditional open surgery. However, MIS can be technically challenging to
perform, particularly with respect to laparoscopic suturing and knot tying. Laparoscopic suturing
can be used for both tissue approximation and ligation of vascular tissues. Surgeons have largely
been able to circumvent the need for laparoscopic suturing through the advent of automated
suturing devices for tissue approximation and vessel sealing technology for ligation. However,
the considerable cost of this technology limits its availability and vessel sealing devices have
been found to be inconsistent or even inadequate in some non-vascular tissues, leaving suture
ligation as a reasonable alternative. As such, laparoscopic suturing may be a key skill for
veterinary surgeons who perform laparoscopic surgery. The efficacy of laparoscopic suturing
techniques used in live animals has not been extensively investigated in the veterinary literature.
There are two general techniques of suture ligation described in veterinary surgery:
intracorporeal knot-tying and extracorporeal slipknots. The purpose of this work was to compare
the surgical time of intracorporeal knot-tying and extracorporeal slipknots using ligation of the
canine ovarian pedicle during laparoscopic ovariectomies as a model. The left and right ovarian pedicles of dogs undergoing laparoscopic ovariectomy were randomly assigned to intracorporeal
(n = 18) or extracorporeal (n = 18) ligation groups. Surgeries were performed by two American
College of Veterinary Surgery (ACVS) diplomates and two ACVS residents. The time required
to place extracorporeal and intracorporeal ligations, duration of surgery, and intraoperative
complications were compared between ligation techniques. Post-operative complications were
recorded. The time required for intracorporeal ligation (17.3 ± 8.7 minutes) did not differ from
that required for extracorporeal ligation (15.1 ± 6.1 minutes; p = 0.38). The total duration of
surgery was 102.7 ± 28.7 minutes, including portal placement and veterinary student closure of
incisions. Ligation of the ovarian pedicle was successful in 16/17 of dogs. Intraoperative
hemorrhage occurred in 3 dogs and postoperative complications were noted in 3 dogs, without
apparent difference between ligation techniques.
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Details
- Title
- Laparoscopic suture ligation techniques
- Creators
- Kyle Martin
- Contributors
- BOEL ANITA FRANSSON (Degree Supervisor) - Washington State University, Veterinary Clinical Sciences, Department ofTINA JO OWEN (Committee Member) - Washington State University, Veterinary Clinical Sciences, Department ofBONNIE G CAMPBELL (Committee Member) - Washington State University, Veterinary Clinical Sciences, Department ofSTEVEN A MARTINEZ (Committee Member) - Washington State University, Veterinary Clinical Sciences, Department of
- Awarding Institution
- Washington State University
- Academic Unit
- Veterinary Medicine, College of
- Theses and Dissertations
- Master of Science (MS), Washington State University
- Publisher
- Washington State University
- Format
- pdf
- Number of pages
- 35
- Identifiers
- 99900587063701842
- Language
- English
- Resource Type
- Thesis