Milan Milovancev1, Valery F Scharf2, Katy L Townsend1, Ameet Singh3, Giovanni Tremolada4, Deanna Worley4, Chad W Schmiedt5. 1. Department of Clinical Sciences, Carlson College of Veterinary Medicine, Oregon State University, Corvallis, Oregon. 2. Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina. 3. Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada. 4. Flint Animal Cancer Center and Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado. 5. Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, Georgia.
Abstract
OBJECTIVE: To describe the use of a bipolar sealing device (BSD) for partial cystectomy in dogs undergoing excision of bladder tumors. STUDY DESIGN: Multicenter, prospective, clinical pilot study. SAMPLE POPULATION: Seven client-owned dogs with nontrigonal urinary bladder lesions. METHODS: Dogs underwent a sealed partial cystectomy with a BSD, with or without cystoscopic guidance of the resection. The sealed cystectomy site was oversewn with a single-layer simple continuous pattern with monofilament absorbable suture. RESULTS: Sealed partial cystectomy was successfully performed in all dogs, with a median surgical duration of 69 minutes (range, 50-120). Lesions were located at the apex in six dogs and on the ventral midbody of the bladder in one dog. No urine leakage from the BSD luminal seal was visible prior to suture closure in three dogs, while varying amounts of urine leaked from the sealed site in four dogs. Suture was placed over the seal in grossly normal bladder tissue in six dogs and in the BSD peripheral thermal effect zone in one dog; in this latter dog, revision cystorrhaphy was required 3 days later because of uroabdomen. The other six dogs had no clinical evidence of urinary bladder healing complications. CONCLUSION: The integrity of the seal generated by the BSD tested here on partial cystectomies varied between dogs and was unpredictable. CLINICAL SIGNIFICANCE: Sealed partial cystectomy with a BSD may reduce exposure of urinary bladder luminal contents to the surgical site. However, the placement of sutures over the seal and through grossly normal bladder tissue is recommended to prevent postoperative uroabdomen.
OBJECTIVE: To describe the use of a bipolar sealing device (BSD) for partial cystectomy in dogs undergoing excision of bladder tumors. STUDY DESIGN: Multicenter, prospective, clinical pilot study. SAMPLE POPULATION: Seven client-owned dogs with nontrigonal urinary bladder lesions. METHODS:Dogs underwent a sealed partial cystectomy with a BSD, with or without cystoscopic guidance of the resection. The sealed cystectomy site was oversewn with a single-layer simple continuous pattern with monofilament absorbable suture. RESULTS: Sealed partial cystectomy was successfully performed in all dogs, with a median surgical duration of 69 minutes (range, 50-120). Lesions were located at the apex in six dogs and on the ventral midbody of the bladder in one dog. No urine leakage from the BSD luminal seal was visible prior to suture closure in three dogs, while varying amounts of urine leaked from the sealed site in four dogs. Suture was placed over the seal in grossly normal bladder tissue in six dogs and in the BSD peripheral thermal effect zone in one dog; in this latter dog, revision cystorrhaphy was required 3 days later because of uroabdomen. The other six dogs had no clinical evidence of urinary bladder healing complications. CONCLUSION: The integrity of the seal generated by the BSD tested here on partial cystectomies varied between dogs and was unpredictable. CLINICAL SIGNIFICANCE: Sealed partial cystectomy with a BSD may reduce exposure of urinary bladder luminal contents to the surgical site. However, the placement of sutures over the seal and through grossly normal bladder tissue is recommended to prevent postoperative uroabdomen.
Authors: Mahmoud F Ahmed; Elsayed Metwally; Yasmina K Mahmoud; Saber M Abuzeid; Mohamed H El-Daharawy; Mohamed A Hashem Journal: Vet Anim Sci Date: 2022-03-18