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The aim of this paper is to report the Salpingopharyngeus fistula technique by means of videosurgery through a natural orifice (NOTES) in order to treat bilateral empyema. A mare was seen at the Large Animal Sector of UFPR, with a history of bilateral purulent nasal discharge associated with dysphagia lasting for ninety days. The animal was submitted to endoscopy, showing a moderate amount of purulent secretion in both guttural pouches. With no improvement on the clinical treatment, we opted for surgical treatment by endoscopy through Salpingopharyngeus fistula made with the aid of a device containing an electrical scalpel developed to perform this technique. It consisted of making an incision in the pharyngeal recess in order to access the guttural pouches and subsequently drain the purulent content. The patient was discharged at the same day and returned to work 30 days after the procedure. Surgical treatment for cases of guttural pouch empyema is indicated when the clinical resolution has not been effective, and the minimally invasive technique is indicated due to the reduction of risks and the easiness of postoperative management. Until this moment, there are no reports of the salpingopharyngeal fistula technique through video surgery for the treatment of guttural pouch empyema, which has proved to be efficient for the treatment of the disease.

Abdominal wall defects (AWDs) include recti diastasis and midline hernias (umbilical, epigastric, and incisional). In the coexistence of such fascia defects, simultaneous repair is recommended. Conventional and hybrid techniques have been reported as an option of approach. This study aims to present the results of a total minimal invasive access to treat AWD with mesh reinforcement (subcutaneous videosurgery for abdominal wall defects [SVAWD] technique).The prospective observational study included patients with small/medium midline incisional hernia and/or multiple AWDs (symptomatic umbilicus and/or an epigastric hernia and/or abdominal rectus diastasis2 cm) operated between August 2016 and February 2018. The exclusion criteria were, namely, fascia defects10 cm, complex hernias, excess of skin and/or subcutaneous abdominal fatty tissue, and body mass index35 kg/mTwenty-one patients were treated by SVAWD technique, with a median follow-up of 14 (range 6-22) months. The mean size of all fascia defects was 7.46 cm (range 4.5-10.5). Surgical site occurrence was identified in three (14.3%) patients and surgical site occurrence requiring procedural intervention in two (9.5%). Diabetes mellitus was the only predictor factor for higher intraoperative bleeding (RDespite the low number of patients operated, the subcutaneous approach presented has proven to be safe, feasible, and effective, as no major complications and relapse occurred. Still, fibrin sealant and TAP block were associated with fewer complications and less oral analgesics intake.

The most appropriate treatment for the infantile Hypertrophic Pyloric Stenosis (HPS) is still debated. The non-surgical conservative treatment with oral or intravenous administration of atropine does not enjoy a widespread appreciation for several factors (...)

Linee guida della Società Italiana di Videochirurgia Infantile Le Linee Guida della Società Italiana di Videochirurgia Infantile (SIVI) sono uno strumento semplice e pratico redatto ed approvato dal Consiglio Direttivo della Società. Esse sono frutto di un lungo lavoro di revisione sistematica della letteratura integrato dal parere di esperti nel campo della Chirurgia Mininvasiva Pediatrica. Queste linee guida sono intese ad aiutare il chirurgo pediatra che si avvicina, o già pratica, la Chirurgia Mininvasiva, ed hanno lo scopo di facilitare la scelta dell’indicazione e del trattamento chirurgico ottimale per le principali patologie chirurgiche pediatriche. Tuttavia, data la complessità delle malformazioni congenite, delle patologie chirurgiche pediatriche e l’estrema varietà dell’ambiente sanitario, è importante sottolineare come l’approccio suggerito potrebbe non essere necessariamente l’unico approccio accettabile e/o percorribile. Le linee guida devono essere considerate uno strumento flessibile in quanto poi è il medico che, con il consenso dei genitori/tutori, avrà il compito di scegliere l’approccio più adatto al singolo paziente. Tale approccio sarà attuato in scienza e coscienza ed in base alla patologia ed alle eventuali variabili esistenti al momento della decisione. La massima accessibilità possibile alle Linee Guida è garantita dalla loro pubblicazione sulla rivista ufficiale della SIVI: La Pediatria Medica e Chirurgica. Il progetto Linee Guida è stato approvato dall’assemblea generale del Congresso SIVI 2016 di Madrid.

Background: Three-dimensional videosurgery is already a reality worldwide. The trainee program for this procedure should be done initially and preferably in simulators. Aim: Assemble low-cost simulator for three-dimensional videosurgery training. Methods: The simulator presented here was mounted in two parts, base and glasses. After, several stations can be inserted into the simulator for skills training in videosurgery. Results: It was possible to set up three dimensional (3D) video simulations with low cost. It has proved to be easy to assemble and allows the training surgeon of various video surgical skills. Conclusion: This equipment may be used in undergraduate programs and advanced courses for residents and surgeons. The acrylic box allows the visualization of the task executed by the tutor and even by other experienced students. RESUMO Racional: A videocirurgia em três dimensões já é realidade no cenário atual. O treinamento dessa habilidade deve ser feito inicialmente e preferencialmente em simuladores. Objetivo: Montar simulador de baixo custo para treinamento de videocirurgia em três dimensões. Métodos: O simulador aqui apresentado foi montado em duas partes, base e óculos. Após montagem, podem ser inseridas estações diversas no simulador para treinamento de habilidades em videocirurgia. Resultados: Foi possível montar simuladores de videocirurgia em 3D com custo baixo. Ele apresentou-se ser de fácil montagem permitindo o treinamento de várias habilidades videocirúrgicas. Conclusão: Este equipamento pode ser utilizado tanto em cursos básicos para a graduação quanto para avançados destinados a residentes e cirurgiões. A caixa de acrílico permite a visualização da tarefa executada pelo orientador/tutor e por outros alunos.

Throughout history, the pediatric laparoscopic nephrectomy was first described at the beginning of the Nineties by Erlich and colleagues in a child and by Koyle and colleagues in an unweaned patient. (...)

BACKGROUND: Few reports have elucidated the role of minimally invasive surgery (MIS) for pediatric malignancies. This study aimed to review the results of a multicenter study on the management of thoracic tumors in children using MIS. METHODS: A 5-year retrospective review of all MIS procedures for the treatment of pediatric malignancies performed in seven centers belonging to the Italian Society of Videosurgey in Infancy is reported. The data from 145 pediatric oncologic patients (80 girls and 65 boys) ages 30 days to 17 years (median, 7.2 years) were analyzed. Of the procedures performed, 87 were laparoscopies (60%), 55 were thoracoscopies (38%), and 3 were lumboscopies (2%). This study focused only on the results of the 55 thoracoscopic procedures performed for diagnostic purposes in 19 cases (34.6%) and for therapeutic purposes in 36 cases (65.4%). RESULTS: The duration of surgery was 15 to 180 min (median, 65 min). Metastasectomies were performed for various etiologies in 31 of the 55 cases. Of the 55 patients, 5 underwent resection of a mediastinal tumor, and 19 underwent a diagnostic thoracoscopy. During a mean follow-up period of 25.6 months, 2 (3.6%) of the 55 patients experienced perioperative complications. CONCLUSIONS: The role of MIS in tumor resection for children is currently limited, but may be used in individual cases when the preoperative workup shows it to be feasible. Its indication is strictly dependent on the thoracoscopic experience of the surgeon and the tumor site for preoperative imaging techniques. When the indication for thoracoscopy is correct, this approach has high therapeutic applicability (65.4% in our series). Our preliminary experience shows that careful patient selection and an appropriate level of technical skill make thoracoscopy a reasonable and safe option for the treatment of pediatric malignancies.

Linee guida della Società Italiana di Videochirurgia Infantile Le linee guida della Società Italiana di Videochirurgia Infantile (SIVI) sono uno strumento semplice e pratico redatto ed approvato da consiglio direttivo della società. Sono frutto di un lungo lavoro di revisione sistematica della letteratura rivisto ed integrato dal parere di esperti nel campo della Chirurgia Mininvasiva Pediatrica. Esse sono intese ad aiutare il chirurgo pediatra che si avvicina o già pratica la chirurgia Mininvasiva; le linee guida della SIVI hanno lo scopo di facilitare la scelta dell’indicazione e del trattamento chirurgico ottimale per le principali patologie chirurgiche pediatriche. Tuttavia, vista la complessità delle malformazioni congenite, delle patologie chirurgiche pediatriche e l’estrema varietà dell’ambiente sanitario, è importante sottolineare come l’approccio suggerito potrebbe non essere necessariamente l’unico approccio accettabile e/o percorribile. Le linee guida devono essere considerate uno strumento flessibile in quanto poi è il medico che, con il consenso dei genitori/tutori, avrà il compito di scegliere l’approccio più adatto al singolo paziente. Tale approccio sarà attuato in scienza e coscienza e in base alla patologia ed alle eventuali variabili esistenti al momento della decisione. La massima accessibilità possibile è garantita dalla pubblicazione sulla rivista ufficiale della SIVI: La Pediatria Medica e Chirurgica. Il progetto linee Guida è stato approvato dall’assemblea generale del Congresso SIVI 2016 di Madrid. La revisione delle Linee Guida pubblicate è stata effettuata dal Consiglio Direttivo della SIVI e della Società Italiana di Urologia Pediatrica (SIUP).

BACKGROUND: The aim of this study was to evaluate the incidence and management of complications of videosurgical procedures that occurred during a 4-year period in eight Italian pediatric surgery centers. METHODS: Between 1996 and 1999, 2305 videosurgical procedures were performed in 11 centers of pediatric surgery. The data from 3 centers, for a total of 616 procedures, were largely incomplete and were thus excluded from the study. We analyzed the data from 8 centers only, for a total of 1689 laparoscopic or thoracoscopic operations on patients aged between 15 days and 16 years. The type of operations performed ranged from basic videosurgical interventions, such as varicocelectomy and cryptorchidism, to advanced laparoscopic procedures, such as splenectomy, total colectomy, and esophageal achalasia. Each patient's file was examined for any complications that may have occurred during the surgical procedure and for a record of how these were managed. RESULTS: We recorded 79 complications (4.6%) in our series. In 57 cases (72.2%) the problem was solved by videosurgery. Twenty-two cases (27.8%) required conversion to open surgery. There was no mortality in our series. At a maximum follow-up of 4 years, all children were alive and had no problems related to the videosurgical complications. CONCLUSIONS: We believe that the routine use of open laparoscopy in pediatric patients is a key factor to avoiding complications related to the Veress needle and blind introduction of the first trocar. Moreover, the surgeon's laparoscopic experience, the correct indications for laparoscopic surgery, and the verification of the laparoscopic equipment before surgery are also important rules to follow to reduce the incidence of complications. In the beginning, it is preferable to have the assistance of an expert laparoscopic surgeon to decrease the complications related to the learning curve period.

Complex procedures for managing congenital abnormalities are reported to be feasible. However, neonatal videosurgery involves very specific physiologic constraints. This study evaluated the safety and complication rate of videosurgery during the first month of life and sought to determine both the risk factors of perioperative complications and the most recent trends in practice.From 1993 to 2005, 218 neonates (mean age, 16 days; weight, 3,386 g) from seven European university hospitals were enrolled in a retrospective study. The surgical indications for laparoscopy (n = 204) and thoracoscopy (n = 14) were congenital abnormalities or exploratory procedures.Of the 16 surgical incidents that occurred (7.5%), mainly before 2001, 11 were minor (parietal hematoma, eventration). Three neonates had repeat surgery for incomplete treatment of pyloric stenosis. In two cases, the incidents were more threatening (duodenal wound, diaphragmatic artery injury), but without further consequences. No mortality is reported. The 26 anesthetic incidents (12%) that occurred during insufflation included desaturation (80% despite 100% oxygen ventilation) (n = 8), transient hypotension requiring vascular expansion (n = 7), hypercapnia (45 mmHg) (n = 5), hypothermia (34.9 degrees C) (n = 4), and metabolic acidosis (n = 2). The insufflation had to be stopped in 7% of the cases (transiently in 9 cases, definitively in 6 cases). The significant risk factors for an incident (p0.05) were young age of the patient, low body temperature, thoracic insufflation, high pressure and flow of insufflation, and length of surgery.Despite advances in miniaturizing of instruments and growth in surgeons' experience, the morbidity of neonatal videosurgery is not negligible. A profile of the patient at risk for an insufflation-related incident emerged from this study and may help in the selection of neonates who will benefit most from these techniques in conditions of maximal safety.

• The distance between ourselves and the pioneers and founders of this field. • After many years trying to perform laparoscopic procedures exactly as we had done by an open approach, we began to distance ourselves from conventional procedures because we felt we could do better surgery using video and laparoscopic techniques. • The distance from our patients and how this may be dangerous. • How both teachers and the taught are able to keep their distance from each other.

As a recent innovation, videosurgery (VS) has enjoyed rapid and widespread development. While colon cancers in adults are quite commonly removed using laparoscopic techniques, children could also benefit from the improved diagnostic and interventional possibilities using VS techniques. From January 1992 to February 1994, we carried out 15 procedures. Eight thoracic operations were performed on 7 patients: diagnostic in 5 cases and metastasis resection in 3. Six patients underwent 7 laparoscopic operations for biopsies (5) or lymph-node harvesting (2). Based on this experience, we discuss the advantages of VS (noninvasive technique for primary or “second-look” exploration, guided biopsies, and removal of tumors) and its risks (spillage of malignant cells, subjective palpation) in the management of pediatric malignancies.

Introduction : Pneumoperitoneum (PP) is known to cause ischemia in kidneys and other intra-abdominal organs because of decreased splanchnic blood flow. Aim : We aimed to determine the degree of renal injury that occurs due to a PP and prolonged PP. We measured renal injury biomarkers and made a histopathological evaluation to estimate the degree of injury and assessed the correlation of biomarkers with histopathological findings. Material and methods : Twenty-one female Sprague Dawley rats were separated randomly into three groups. Group 1 was the control group and was given anesthesia for 3 h. In group 2, a PP was administered under anesthesia for 1 h. A pneumoperitoneum was administered under anesthesia to animals in group 3 for 3 h. Results : Pathological analysis showed a significant statistical difference between the 3 groups. In particular, neutrophil gelatinase-associated lipocalin (NGAL) and cystatin C (Cys C) levels at the 24th h and preoperative mean urea levels showed a significant difference between the groups. The 24th-hour NGAL level in group 3 was significantly higher than that of group 1. The preoperative Cys C level was higher in group 1 than in either group 2 or 3. Cys C was decreased significantly in group 1 and increased significantly in both groups 2 and 3. Conclusions : The increase in NGAL and Cys C levels directly correlated with the duration of PP and intra-abdominal pressure, and they are therefore good biomarkers in diagnosing acute renal injury in the early phase. Serum creatinine level is not a good biomarker in the early phase of renal injury.

Introduction: Esophagogastroduodenoscopy (EGD) is a diagnostic method used in the investigation of upper gastrointestinal system diseases. A high level of anxiety of patients who undergo EGD increases the duration of the procedure and the sedation and analgesic requirements. Sedation is used to increase patient comfort and tolerance by reducing the anxiety and pain associated with endoscopic procedures. Aim: In this study, the effect of anxiety scores on medication doses was investigated in patients who underwent EGD under sedation. Material and methods: A psychiatrist, an endoscopist and an anesthesiologist conducted a prospective observational study blindly to investigate the effect of pre-procedural (before EGD) anxiety level on medication doses for sedation. Patients were divided into two groups, with and without additional medication doses. Results: The study included 210 consecutive patients who underwent EGD under sedation. The average STAI-S score was 40.28 and the average STAI-T score was 40.18. There was no relationship between anxiety scores and gender (p = 0.058, p = 0.869). Statistically significant results were obtained for anxiety scores with additional sedation dosing (p < 0.05). It was observed that an additional dose of medication was affected by age, body mass index and anxiety scores (p < 0.005). Patients who were young, had a low body mass index and had high anxiety scores had significantly higher additional dose requirements. Conclusions: The medications used for sedation during EGD may be inadequate or an additional dose of medication may be needed for patients who have higher anxiety scores, younger age, and lower body mass index.

Mesothelioma is a very aggressive malignant tumor with low survival rates that is often diagnosed belatedly. Pericardial effusion is a common consequence in cases of mesothelioma, with pericardiocentesis and pericardiectomy indicated; therefor thoracocentesis is necessary to drain the contents no longer retained in the pericardium. The present report describes a mesothelioma-carrying dog with a history of cardiac tamponade that underwent thoracoscopic pericardiectomy and, later, thoracoscopic implantation of a fully implantable catheter to function as a thoracic drain. In the consulted literature, there is no use of a fully implantable catheter for this purpose. The authors consider that there was an improvement in the quality of life.

Background: The anorectal anomalies consist in a complex group of birth defects. Laparoscopic-assisted anorectoplasty improved visualization of the rectal fistula and the ability to place the pull-through segment within the elevator muscle complex with minimal dissection. There is no consensus on how the fistula should be managed. Aim: To evaluate the laparoscopic-assisted anorectoplasty and the treatment of the rectal urinary fistula by a bipolar sealing device. Method: It was performed according to the original description by Georgeson1. Was used 10 mm infraumbilical access portal for 30º optics. The pneumoperitoneum was established with pressure 8-10 cm H2O. Two additional trocars of 5 mm were placed on the right and left of the umbilicus. The dissection started on peritoneal reflection using Ligasure(r). With the reduction in the diameter of the distal rectum was identified the fistula to the urinary tract. The location of the new anus was defined by the location of the external anal sphincter muscle complex, using electro muscle stimulator externally. Finally, it was made an anastomosis between the rectum and the new location of the anus. A Foley urethral probe was left for seven days. Results: Seven males were operated, six with rectoprostatic and one with rectovesical fistula. The follow-up period ranged from one to four years. The last two patients operated underwent bipolar sealing of the fistula between the rectum and urethra without sutures or surgical ligation. No evidence of urethral leaks was identified. Conclusion: There are benefits of the laparoscopic-assisted anorectoplasty for the treatment of anorectal anomaly. The use of a bipolar energy source that seals the rectal urinary fistula has provided a significant decrease in the operating time and made the procedure be more elegant. RESUMO Racional: As anomalias anorretais consistem de um grupo complexo de defeitos congênitos. A anorretoplastia laparoscópica permite melhor visualização da fístula retourinária e propicia o posicionamento do reto abaixado dentro do complexo muscular do elevador do ânus com mínima dissecção. Não há consenso na literatura sobre o melhor tratamento dessa fístula. Objetivo: Avaliar a anorretoplastia laparoscópica e o selamento bipolar da fístula retourinária. Método: Ela foi realizada de acordo com a descrição original de Georgeson1. Utilizou-se o acesso infraumbilical com portal de 10 mm para a ótica de 30º. O pneumoperitônio foi estabelecido com pressão de 8-10 cm de H2O. Dois trocárteres adicionais de 5 mm foram colocados à direita e à esquerda da cicatriz umbilical. A dissecção foi iniciada na reflexão peritoneal usando Ligasure(r). Com a redução do calibre do reto distalmente, foi identificada a fístula para a o trato urinário. O local do novo ânus foi definido por meio da localização do complexo muscular do esfíncter anal externo, utilizando-se estimulador eletro muscular externamente. Por fim, foi confeccionada uma anastomose entre o reto e o novo local do ânus. Uma sonda uretral de Foley foi deixada durante sete dias. Resultados: Sete meninos foram operados, seis com fístula retoprostática e um retovesical. O período de seguimento variou de um a quatro anos. Os dois últimos pacientes operados foram submetidos ao selamento bipolar da fístula entre o reto e a uretra, sem suturas ou ligadura cirúrgica com pontos. No seguimento em longo prazo não houve evidências de fístulas urinárias. Conclusão: Há benefícios da anorretoplastia laparoscópica para o tratamento de anomalia anorretal. O uso de uma fonte de energia bipolar que promova o selamento da fístula retourinária propiciou redução significativa do tempo cirúrgico e tornou o procedimento mais elegante.

RESUMO A doença do refluxo gastroesofágico decorre do fluxo de conteúdo gastroduodenal para o esôfago e/ou órgãos adjacentes, o que leva à ampla gama de sinais e implicações clínicas. A incidência de refluxo gastroesofágico transoperatório em caninos é desconhecida. O objetivo deste trabalho foi, por meio da endoscopia flexível, avaliar a presença e quantificar o refluxo gastroesofágico em cadelas submetidas à ovário-histerectomia por duas abordagens cirúrgicas (convencional e videoassistida com dois portais), pré-medicadas com morfina. Cem por cento das cadelas submetidas à ovário-histerectomia videoassistida e 30% das cadelas submetidas à ovário-histerectomia convencional apresentaram algum grau de refluxo. A intensidade dos refluxos foi maior nas cadelas submetidas ao procedimento minimamente invasivo, visto que elas (10 entre 10 animais) apresentaram, no mínimo, um refluxo classificado em R4, enquanto as outras (três entre 10) apresentaram, no máximo, refluxos em grau R3, de acordo com a escala planejada para esta pesquisa. Concluiu-se que os procedimentos laparoscópicos sob o protocolo anestésico utilizado promovem mais refluxo gastroesofágico que os convencionais. ABSTRACT Gastroesophageal reflux disease occurs when gastric or duodenal contents flow back into the esophagus by retroperistalsis, which leads to several signs and clinical implications. The incidence of intraoperative gastroesophageal reflux in canines is unknown. The aim of this study was, using flexible endoscopy, to assess the presence and quantify gastroesophageal reflux in bitches undergoing ovariohysterectomy by two surgical approaches (conventional and video-assisted by two portals-access), pre-medicated with morphine. 100% of dogs submitted to video-assisted and 30% of dogs submitted to conventional ovariohysterectomy presented some reflux degree. Reflux intensity was higher in dogs submitted to the minimally invasive procedure, since they (10 out of 10 animals) had at least one reflux classified in R4 while the others (three out of 10) had a maximum reflux in degree R3 according to the planned scale for this research. The laparoscopic procedures under the used anesthetic protocol promote more gastroesophageal reflux than the conventional ones.

Background: Ovariectomy(OVE) and ovariohysterectomy (OVH) are the most performed surgical procedures in Veterinary Medicine. In videosurgery, both in stray animals at sterilization campaigns and in the increasing demand of tutors to perform the technique. Laparoscopy results in reduced tissue damage, due to minimal organ manipulation and surgical access hemostasis can be performed by several methods, such as electro-coagulation, clips, and intra and extracorporeal ligatures. A pre-tied ligature system, or endoloop, is a haemostatic technique comprised of a slipknot and knot pusher, which is inserted into the abdominal cavity through one of the laparoscopic ports. The aim of this study was to describe a novel OVE technique in cats, in which haemostasis was performed using miniloop, aimed at reducing the number of ports needed for knot tying.Material, Methods & Results: Ten healthy not spayed female cats, aged 6 months to 5 years, were selected for this study. They were submitted to an OVE using miniloop as haemostasis method. Access to the peritoneal cavity was through two 5 mm ports on the midline of the ventral abdomen, 5 cm apart, with one immediately caudal to the umbilical scar and the other in between the last pair of teats. The first trocar was inserted at the caudal incision using the Hasson technique and a 5 mm zero-degree optics attached to a camera was introduced through it. The placement of the second access port was video assisted. For ovary exposure, the patients were positioned in lateral recumbency on the contralateral side to the ovary being removed. The miniloop was composed of a 2 mm diameter minitrocar, a 1.8 mm knot pusher, and a pre-tied slipknot. It was introduced percutaneously at the lateral abdominal wall. It was inserted attached to a pre-tied loop ligature. A Babcock forceps was used to guide the slipknot until it enveloped the ovarian vessels and the proximal part of the uterine horn. Subsequently, the knot was tightened with the aid of the knot pusher. A second miniligature was applied. The forceps was removed and a Metzenbaum scissors inserted to cut between the ligatures, releasing the ovary with the nylon ligature but keeping the PDS knot. It was performed at both ovary. Mean (±SD) surgical time was 44.8 min (± 13.4) and varied significantly (P = 0.0006) between animals, with the shortest time being 29 min and the longest 66 min. Positioning of the patients in lateral decubitus allowed for good ovarian exposure, without the need for excessive manipulation of the intestinal loops or other abdominal organs. Rupture of the suture thread was the only trans-operative complication observed and occurred in two animals. A second ligature (miniloop) was needed to ensure haemostasis. One cat showed eventration at the site of the caudal port on the second day post-operative.Discussion: The mean surgical time in the present study was lower than reported by some authors, but longer than anothers. Furthermore, the surgical time from this study is similar to that of other studies in cats in which haemostasis of the OAVC was achieved using bipolar electrocoagulation. Surgical team expertise is of outmost importance in minimizing complications and overcoming problems during videosurgical procedures in order to reduce surgical time, such as gas leakage, extensive incision, and difficulty in manipulating surgical instruments.

Submitted by EMERSON GONÇALVES MARTINS DE SIQUEIRA null (emerson-rascvet@yahoo.com.br) on 2016-10-03T20:15:09Z No. of bitstreams: 1 Arquivo concluido 1409.pdf: 1339430 bytes, checksum: 0272c4fd40387ca5c64663dc0e149a0c (MD5) Rejected by Ana Paula Grisoto (grisotoana@reitoria.unesp.br), reason: Solicitamos que realize uma nova submissão seguindo as orientações abaixo: Inserir o mês da defesa na capa e folha de rosto do trabalho. Corrija estas informações e realize uma nova submissão com o arquivo correto. Agradecemos a compreensão. on 2016-10-04T19:43:17Z (GMT) Submitted by EMERSON GONÇALVES MARTINS DE SIQUEIRA null (emerson-rascvet@yahoo.com.br) on 2016-10-06T00:31:02Z No. of bitstreams: 1 Arquivo concluido 1409.pdf: 1339430 bytes, checksum: 0272c4fd40387ca5c64663dc0e149a0c (MD5) Approved for entry into archive by Juliano Benedito Ferreira (julianoferreira@reitoria.unesp.br) on 2016-10-06T17:43:28Z (GMT) No. of bitstreams: 1 siqueira_egm_me_bot_par.pdf: 635034 bytes, checksum: 647ec1ee63537d320123f891ce4337d4 (MD5) Made available in DSpace on 2016-10-06T17:43:28Z (GMT). No. of bitstreams: 1 siqueira_egm_me_bot_par.pdf: 635034 bytes, checksum: 647ec1ee63537d320123f891ce4337d4 (MD5) Previous issue date: 2016-06-20 Os tumores malígnos renais compreendem uma casuística significativa na clínica médica, sendo o tipo histológico mais comum o carcinoma de células renais (CCR). Graças aos avanços radiodiagnósticos os tumores vêm sendo diagnosticados cada vez mais precocemente. Com isso, técnicas menos invasivas tornam-se cada vez mais necessárias. Nas cirurgias com mínima invasão os agentes hemostáticos apresentaram importância sobretudo pela diminuição do tempo cirúrgico e biocompatibilidade. Assim o presente trabalho propõe a realização de nefrectomia parcial laparoscópica e a realização de hemostasia com diferentes agentes hemostáticos, visando avaliar sua eficácia no controle de sangramento transoperatório e biocompatibilidade. Um dos grupos não utilizou qualquer agente hemostático, sendo a hemostasia realizada por isquemia por clampeamento. Os outros dois grupos utilizaram como agentes hemostáticos submucosa intestinal suína e uma esponja de gelatina suína purificada. No presente estudo foi observada biocompatibilidade com ambos os materiais analisados, porém foi constatada menor perda sanguínea transoperatória no grupo que utilizou a gelatina suina purificada Malignant tumors represent a high incidence in medical clinic service, being the most frequently histopathologic type the renal cells carcinoma (RCC). Radiodiagnosis progress allows us to discover these tumors earlier. Thereby, less invasive technics became increasingly necessary. In low invasive surgery procedures, hemostatic agents showed importance specially by the oportunity to decrease surgical duration and by their biocompatibility. Therefore, this study proposes the execution of parcial laparoscopic nefrectomy with hemostasis with diferent hemostatic agents, aiming to evaluate their efficacy in controlling transoperatory bleeding and biocompatibility. one of the groups did not used any kind of hemostatic agent, being the hemostasia done by ischemic clamping. The other two groups used hemostatic agents, like suine intestinal submucousa and a sponge made of suine purified skin. The present study was observed biocompatibility with both hemostatic agents used, however it was found less transoperatory bleeding in the group that used suine purified skin.

Pleuroperitoneal hernias are the most uncommon type of diaphragmatic hernias in dogs and cats. The treatment of choice is surgery and may involve the use of prosthetic implant through celiotomy. In the current report, laparoscopic repair of a congenital pleuroperitoneal hernia using polypropylene mesh in a dog is described. The surgery was feasible. Appropriate reduction of the hernia was carried out and no complications were noted.

A afecção congênita mais comum nos animais domésticos é denominada de criptorquidismo, sendo caracterizada pela não migração de um ou ambos os testículos até o escroto. O objetivo deste trabalho é relatar a técnica de criptorquidectomia videoassistida, através de um único acesso (LESS) sem dispositivos específicos, em um gato siamês com dois anos de idade e 3,9kg de massa corporal. Utilizou-se um único portal de 5 mm, inserido na linha média ventral na região pré-púbica. Por esse portal, a cavidade foi insuflada com CO2 medicinal, permitindo a obtenção do pneumoperitônio (8mmHg) a uma velocidade de 1 l/min. Após o inventário da cavidade abdominal, com o auxílio de um endoscópio de 5mm e 25o, identificou-se o testículo ectópico. Com a utilização de uma pinça de apreensão para mini laparoscopia (3mm), introduzida ao lado do trocarte (pelo mesmo acesso), o testículo foi fixado e tracionado para o exterior da cavidade abdominal para realização de hemostasia, não sendo necessária a ampliação da ferida cirúrgica. Após a secção dos vasos testiculares, o testículo foi totalmente liberado e o coto vascular devolvido à cavidade abdominal. O presente relato demonstra que a cirurgia laparoscópica por um único acesso (LESS) pode ser utilizada com sucesso no diagnóstico e tratamento de casos de criptorquidismo em gatos, com as possíveis vantagens que o acesso apresenta em relação à cirurgia convencional. The most common congenital disease in domestic animals is cryptorchidism, which is characterized by the failure of one or both testicles to descend into the scrotum. The objective of this paper is to describe a video-assisted cryptorchidectomy through a single access (LESS), without specific portal multifunctional, in a two-year-old siamese cat weighing 3.9kg. To perform the cryptorchidectomy, it was inserted a single portal (5mm) in the ventral midline in the pre-pubic region. The cavity was insufflated with medicinal CO2 at a rate of 1l/minute in order to obtain a pneumoperitoneum (8mmHg). After the inspection of the abdominal cavity with an endoscope (5mm/25º) the ectopic testicle was identified. With a minilaparoscopy, forceps (3mm) was introduced in the side of the first portal (same access), the testicle was grasped and pulled outside to realize hemostasis, without need to extend surgical wound. After sectioning the testicular vessels, the testicle was fully released and the vascular stump was returned to the abdominal cavity. The present report demonstrates that laparoscopic surgery by a single access (LESS) may be successful in the diagnosis and treatment of cryptorchidism in cats, considering the potential benefits that this procedure brings in relation to conventional surgery.

Descreveu-se a anatomia topográfica, obtida por videolaparoscopia, da cavidade abdominal de 21 equinos hígidos, em estação, distribuídos em três grupos conforme massa corpórea. No grupo A foram incluídos animais com até 250kg; no grupo B, animais entre 251 e 350kg; e no grupo C, animais acima de 351kg. A técnica cirúrgica realizada foi a laparoscopia com acesso pelas fossas paralombares esquerda e direita, utilizando a introdução videoassistida da cânula, iniciando sempre pelo flanco esquerdo. O acesso esquerdo permitiu a observação do diafragma, estômago, lobo hepático esquerdo, baço, área renal, intestino delgado, cólon menor, bexiga, órgãos reprodutivos internos do macho e da fêmea e reto. No acesso paralombar direito, foram observados diafragma, lobo hepático direito, área renal, cólon dorsal, duodeno, ceco, intestino delgado, cólon menor, bexiga, órgãos reprodutivos internos do macho e da fêmea e reto. O procedimento videolaparoscópico para estudo da anatomia abdominal de equinos é viável, não sendo observadas limitações decorrentes do tamanho do animal. The present study aimed to perform an anatomic description of the abdominal cavity of equines in standing position. Twenty-one healthy equines were allotted into three groups according to their corporal mass. Animals weighing up to 250kg were included in group A, 251 to 350kg in group B and over than 351kg in group C. Laparoscopy was the surgical technique performed, with access through the left and right paralumbar fossas using a video-assisted introduction of cannula, starting from the left flank. This first access allowed the observation of the diaphragm, stomach, left hepatic lobe, spleen, renal area, small intestine, descending colon, bladder, rectum and internal reproductive organs of the male and female. During the right access were observed: diaphragm, right hepatic lobe, renal area, dorsal colon, duodenum, cecum, small intestine, descending colon, bladder, rectum and internal reproductive organs of the male and female. The video-laparoscopic for the study of the abdominal anatomy of equines is feasible, and no limitations due to animal size have been observed.