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Background : Advancements in artificial intelligence (AI) and machine learning (ML) are set to revolutionize healthcare, particularly in fields like endoscopic surgery that heavily rely on digital imaging. However, to effectively integrate these technologies and drive future innovations, pediatric surgeons need specialized AI/ML skills. This survey evaluated the current level of readiness and educational needs regarding AI/ML among members of the European Society of Pediatric Endoscopic Surgeons (ESPES). Methods : A structured survey was distributed via LimeSurvey to ESPES members via email before and during the 2024 Annual Conference. Responses were collected over four weeks with voluntary, anonymous participation. Quantitative data were analyzed using descriptive statistics. Results : A total of 125 responses were received. Two-thirds (65%) of respondents rated their AI/ML understanding as basic, with only 6% reporting advanced knowledge. Most respondents (86%) had no formal AI/ML training. Some respondents (31%) used AI/ML tools in their practice, mainly for diagnostic imaging, surgical planning, and predictive analytics; 42% of the respondents used these tools weekly. The majority (95%) expressed interest in further AI/ML training, preferring online courses, workshops, and hands-on sessions. Concerns about AI/ML in pediatric surgery were high (85%), especially regarding data bias (98%). Half of respondents (51%) expect AI/ML to play a significant role in advancing robotic surgery, oncology, and minimally invasive techniques. A strong majority (84%) felt that the ESPES should lead AI education in pediatric surgery. Conclusions : This survey presents the ESPES with a unique opportunity to develop a competency map of its membership's AI/ML skills and develop targeted educational programs, thus positioning the society to take the lead in AI education and the advancement of AI solutions in pediatric endosurgery.

Background: Endosurgery provides several advantages over open surgery in the context of global surgery; however, there are several barriers to its introduction. The preliminary assessment of needs and barriers is essential for carrying out effective support as Global Surgery. However, no report has described the initiation of support for endosurgery based on a preliminary survey of the needs and barriers. The present survey study aimed at determining the needs and barriers of pediatric endosurgery in Nepal. Materials and Methods: A needs assessment survey was conducted among all pediatric surgeons in Nepal via an online platform. This was followed by workshop on pediatric endosurgical skills in Nepal. To assess the skills of participants and effectiveness of the workshop, the skill evaluation tests and the questionnaire survey were conducted. Results: Fourteen pediatric surgeons (response rate: 60.9%) responded to the needs assessment survey. More than 70% of the participants did not have any experience with advanced endosurgical procedures. However, advanced endosurgical procedures were strongly needed. A lack of training was indicated as a major barrier for the introduction of pediatric endosurgery. Fifteen participants completed the workshop. Participants' confidence in their endosurgical skills improved significantly after the workshop. The skill evaluation tests revealed that participants' endosurgical skills also improved significantly after the workshop, although even after the workshop, participants still took an average of 415.6 seconds to place and knot one suture. Conclusions: The needs assessment survey and workshop for Nepalese pediatric surgeons helped clarify their needs for endosurgery and the barriers to its introduction. [ABSTRACT FROM AUTHOR]

This study aimed to describe the anatomical topography of the abdominal cavity of buffaloes in the quadruped position to establish the best endosurgical access and vantage points and identify possible limitations. Laparoscopies were performed on 10 healthy female buffaloes obtained from the Universidade Federal Rural da Amazônia to explore possible access points to the abdomen. Techniques for assessing and possibly observing certain organs and structures through the left and right flanks of 10 animals have been described. In five animals, access was created through the right side of the last intercostal space to allow more cranial access to the abdominal cavity. Despite the presence of the rumen, access through the left flank allowed the visualization of the structures of the gastrointestinal tract and the genitourinary system. With access through the right flank, however, imaging was hampered by the presence of the greater omentum and its deep and superficial walls, which prevented the progression of the endoscope. Access through the last right intercostal space allowed the visualization of the cranial structures of the abdominal cavity, such as the caudate process, right lobe of the liver, right kidney, and pancreas. Laparoscopic access through the left flank and the last intercostal space in healthy buffaloes in the quadruped position is feasible, and it is promising for the exploration, diagnosis, and treatment of various disorders in buffaloes. [ABSTRACT FROM AUTHOR]

Echinococcosis also remains a serious problem today. Highly informative diagnostic methods allow hepatic echinococcosis to be diagnosed at its early stage. This brings mini-invasive, saving operations under ultrasound, X-ray, TV, and endoscopic guidance up to a new level. The accumulated experience suggests that the current high-tech operations that are an alternative to traditional access surgery can be extensively used. However, only strict observance of a protocol for saving operations, their performance in specialized hospitals, and compulsory antiparasitic therapy with albendazole will be of benefit to mini-invasive surgery for hepatic echinococcosis.

Purpose: This study investigates whether pharmacotherapy with liraglutide is similarly effective in reversing weight regain more than 6 years after Roux-en-Y gastric bypass (RYGB) as revisional surgery aimed at restoring restriction. Methods: Ninety-five consecutive patients (11 male, 84 female; mean BMI 45 ± 6 kg/m2) undergoing RYGB 9 ± 4 years ago were treated for 24 months as follows: Patients, who gained less than 10% from weight NADIR, served as controls and were provided lifestyle counseling (DC, n = 30). The others were allowed to choose between three different treatment groups: daily s.c. administration of liraglutide (LG, n = 34); endosurgery using Apollo's Overstitch System™ (ES, n = 15), or implantation of a Fobi-ring with pouch resizing (FP, n = 16). Results: Controls kept their weight stable during 24 months of study (− 0.1 ± 1.7 kg/m2). Weight loss was 4.8 ± 2.9 kg/m2 for LG and 5.5 ± 2.9 kg/m2 for FP, both losing more than 85% of regained weight from weight NADIR (p < 0.001). In contrast, weight loss in ES was 1.0 ± 0.9 kg/m2 (i.e., 20% of regained weight). Thirty-seven percent of FP experienced serious complications (p < 0.05) in contrast to the other groups. An improved prevalence of hypertension and dyslipidemia was observed in LG and FP (p < 0.02) 24 months after intervention. Conclusions: Weight regain during more than 6 years after RYGB can be safely and effectively reversed with liraglutide. Compared with revisional surgery, pharmacotherapy with liraglutide was low risk and resulted in an important improvement in hypertension and dyslipidemia. Therefore, daily subcutaneous injections of liraglutide are a valid option to treat weight regain after RYGB. [ABSTRACT FROM AUTHOR]

The introduction of endosurgery into medical practice has significantly reduced the severity of surgery for patients, and increased it significantly for endosurgeons. Until now, passive exoskeletons of the upper extremities have not been used to facilitate the work of medical workers. The publication summarizes the first experience of using the endosurgeon's exoskeleton - REXS. It was found that for the optimal work of endosurgeons, unloading of the arms and back is required, which can be done by using the developed original exoskeleton of the upper extremities. The first experience of using the passive exoskeleton of the endosurgeon REX-S is completely positive and indicates the prospects of its wider application. [ABSTRACT FROM AUTHOR]

Background: Dumping syndrome is a known long-term complication of Roux-en-Y gastric bypass (RYGB). Most cases can be avoided with dietary and lifestyle changes. Severe dumping is characterized by multiple daily episodes with significant impact on quality-of-life. As dumping correlates with rapid pouch emptying through a dilated gastro-jejunal anastomosis (GJA), the aim was to assess endoscopic gastro-jejunal revisions (EGR) regarding feasibility, safety, and outcome.Methods: From January 2016 to August 2018, we reviewed the electronic records of all patients with dumping syndrome undergoing EGR with the Apollo OverStitch suturing device (Apollo Endosurgery, Austin, Texas, USA). Demographics, procedure details, and outcome variables were recorded. Sigstad questionnaire was administered before and after surgery to assess symptomatic response.Results: There were 40 patients (M:F = 13:27) treated with EGR for dumping. Mean procedure time was 18.5 min (12-41) with a median number of 1 suture (range 1-3) used. Mean anastomotic diameter was 22.6 mm (R 18-35) at the beginning and 6.2 mm (R 4-13) at the end of the procedure, with 100% technical success in narrowing the GJA. There were no intra-operative or 30-day complications. Repeat EGR was required in 9 patients (22.5%) for persistent/recurrent dumping. Two patients (5%) required a laparoscopic pouch revision. For patients with minimum 1-month follow-up who were treated only endoscopically, 33/37 (89.2%) had improved or resolved symptoms during the follow-up period. Mean follow-up time was 12.5 months (R1-33.8). Survey responses were available for 25/34 (73.5%) patients. Mean Sigstad score decreased from 13.9 (R 0-28) pre-operatively to 8.6 (R 0-28) after EGR.Conclusion: EGR of the dilated GJA is a highly effective treatment option for dumping syndrome after RYGB. Due to its endoluminal approach, it is a feasible and safe procedure, and effective for immediate symptom resolution in most patients. In some patients, repeat narrowing of the anastomosis is necessary for the maintenance of symptom resolution. [ABSTRACT FROM AUTHOR]

Background: Morbidity of traditional open surgery for the treatment of gynecomastia includes asymmetry, retraction of the nipple, and poor scarring. Other approaches were described to improve the results. Endoscopic subcutaneous mastectomy (ESCM) was reported in adult series, including a few adolescents. This technique was considered as safe with good aesthetic results. The aim of this study was to evaluate the results of ESCM in an adolescent series. Patient and Methods: We treated 19 adolescents with Simon's grade IIB and III gynecomastia between June 2014 and July 2018. They could choose open surgery through the nipple or endoscopic surgery by axillary approach. To perform ESCM, three trocars were placed on the midaxillary line to dissect the gland. The resection was performed leaving 1 cm thickness of gland behind the nipple. The gland was extracted after morcellation through the 10 mm trocar. A drainage tube was placed in the cavity. The patients wore a thoracic belt smoothly compressing the operative areas for 15 days. The result was considered as good when there was no remaining gland, good symmetry, and no nipple retraction or nipple lateral displacement. Results: During the study period, 12 adolescents were treated by ESCM and 7 preferred open surgery. Among the 12 ESCM patients, 7 had bilateral and 5 unilateral gynecomastia. A subcutaneous injection of serum was done in the last 6 patients to facilitate the creation of the work space. A 2- or 3-mm second-degree burn occurred in 4 cases, 2 on the nipple and 2 just above the nipple, with a 2 mm remaining scar above the nipple in 1 case. The postoperative course was uneventful in 11 adolescents. One subcutaneous seroma expanded at 15 days postoperative and resolved after 3 weeks of prolonged compression by thoracic belt. The adolescents had 11 good results and 1 persistent asymmetry; 2 other asymmetries had a spontaneous improvement after 1 or 2 years. Conclusion: ESCM is feasible and safe for the treatment of gynecomastia in adolescents. This technique is challenging but permits to reach good aesthetic results and avoids scars on the anterior wall of the thorax. [ABSTRACT FROM AUTHOR]

The article is devoted to the substantiation of strategy changes in acute cholecystitis and the bilirubinemia of obscure etiology. At the first stage the treatment was started from RCG in 120 patients and RCG with EPG in 232 patients. The results obtained were not very good, there being many organizational problems. At the second stage the laparoscopic cholecystectomy with drainage of the common bile duct (228 patients) were performed in 248 patients with acute cholecystitis and increased bilirubin from 29,54 till 167,16 millimole/l. Futhermore, the postoperative transdrainage cholangiography was made in 184 (74,2%) patients, the stones or the obstruction of bile secretion weren’t found. The classical intervention on common bile duct was required only to 4 patients, for the rest EPG was performed according to the indications. EPG was the most effective and the results were the best.

Adhesion formation involving the genitourinary tract is common following laparoscopic procedures. To evaluate the effectiveness of intraperitoneal lidocaine hydrochloride 1% solution for the prevention of abdominal adhesions, twenty four Santa Ines ewes submitted to laparoscopic ovum pick-up, uterine puncture and local rinsing, were randomly distributed into two groups of 12 animals, according to rinsing solution: normal saline (SG) or 1% lidocaine hydrochloride solution (LG). Laparoscopy for manipulation of the reproductive tract (uterine puncture trauma model and ovum pick-up) was applied. A standard laparoscopic approach using three ports in triangulation was employed. The uterus and ovaries were rinsed at the end of the procedure (using either saline or lidocaine hydrochloride) for removal of blood clots from the ovaries and uterine horn surfaces. Inflammation was assessed postoperatively by plasma fibrinogen, and all animals underwent a second laparoscopic procedure 21days after surgery for macroscopic assessment of adhesion formation. Four cases of adhesion were observed in each group. The plasma fibrinogen did not differ between groups and among different time points, indicating an absence of systemic inflammation following laparoscopic procedures. There were no significant differences between treatments. Both normal saline and 1% lidocaine hydrochloride were similarly effective in the prevention of adhesion formation.

Background: Gastro-gastric fistulas (GGF) are reported to be as high as 12% after gastric bypass for treatment of morbid obesity. While different endoscopic methods are described, the management traditionally consists of surgical revision with high associated morbidity. The aim of the study was to assess feasibility, safety and success rate of endoscopic closure using an endoscopic suturing device.Methods: From January 2016 to March 2018, we reviewed the electronic records of all patients undergoing endoscopic closure of a GGF with the Apollo Overstitch system (Apollo Endosurgery, Austin, Texas, USA). Demographic details, procedure details, and outcome variables were recorded.Results: A total of six patients (M:F = 5:1) underwent endoscopic fistula closure. Five patients (83.3%) had a prior banded gastric bypass (with subsequent band removal). The median number of prior abdominal surgeries was 3, the mean time from bypass to endoscopic fistula closure was 5 years (range 1.1-10.4). While immediate complete endoscopic fistula closure was possible in 10 of 12 attempts in those six patients (83%), all patients had recurrent (persistent) fistulas at follow-up. After a mean follow-up time of 12 months, 83.3% had further laparoscopic converted to open (n = 2) or laparoscopic (n = 3) revisions with complete fistula closure. One patient is refusing further intervention.Conclusion: Endoscopic gastro-gastric fistula closure with an endoscopic suturing device is feasible and safe. Unfortunately, due to the nature of gastro-gastric fistulas, permanent successful closure is rare. Therefore, the approach should be reserved for patients in whom a laparoscopic or open surgical attempt is impossible due to prior abdominal revisions. [ABSTRACT FROM AUTHOR]

Background: Dioctophyme renale, also known as "giant kidney worm", is a cosmopolitan parasite, which usually affects domestic and wildlife canids in wetlands. Nephrotomy and nephrectomy are the only treatment options. Laparoscopic nephrectomy for dioctophymosis was first performed in veterinary patients in the late 90's. Canine pyometra is one of the most frequent surgical disorder in the small animal setting. The purpose of this study was to report a case of successful one-stage laparoscopic approach for nephrectomy and ovariohysterectomy in a bitch. Case: A female stray dog, rescued from a riverside community, was presenting hematuria. Abdominal echography revealed presence of Dioctophyme renale worms within the right renal parenchyma. Moreover, the uterus was moderately filled by anechoic content. The patient was clinically stable and undergone laparoscopy. A 10-mm trocar was established at the middle third of the right flank, followed by 12-mmHg CO2 insufflation. The telescope was inserted and a giant worm was seen free within the abdominal cavity. A second 10-mm port was inserted cranial and dorsally to the first one. The parasite was retrieved using a laparoscopic Kelly forceps. A third 5-mm trocar was inserted in a classic laparoscopic triangulation port positioning. Renal artery and vein were individually triple ligated using titanium clips and then transected. The right ovarian pedicle was sequentially coagulated and transected using laparoscopic bipolar forceps. The right kidney was then dissected and detached from the abdominal wall, followed by cauterization and transection of the left ovarian pedicle. The uterus was exposed out of the abdominal cavity through the 5-mm port access. Uterine body and vessels were double ligated using polyglactin 910, with transfixating ligatures, and then transected. The opening of the retrieval bag was exposed through the cranial port site incision. Eight dioctophyme worms and the kidney sections were withdrawn through the sac using a Kelly hemostat. Abdominal wounds were closed in two layers using cross-mattress polyglactin 910 sutures. Skin was closed using interrupted horizontal mattress nylon sutures. Patient was discharged on the early post-op, receiving tramadol chloride and sodium dipyrone for three days and enrofloxacin for seven days. The patient recovered uneventfully. Owner was contacted by phone eight months following surgery, which informed the bitch was clinically stable. Discussion: Riverside stray dogs present high incidence of dioctophymosis worldwide, due to irregular feeding and consequent intake of intermediate hosts. The reported patient met those features, without previous background regarding infestation episode. It presented hematuria, which usually results from renal parenchyma consumption by the worms. The patient was retrieved nine dioctophyme worms. Laparoscopic approach for nephrectomy has already been reported in veterinary patients, as well as three-port lap-assisted OVH have been performed. Innovative aspect of this case report concerns the one-stage laparoscopic approach for both nephrectomy and OVH. Moreover, the procedures required only three-port access, which was considered a suitable and safe minimally invasive approach in dogs affected by Dioctophyme renale and concurrent indication for OVH. The three-port access shown is adequate to perform one-stage nephrectomy and ovariohysterectomy in bitches, for reaching benefits of laparoscopic surgery in comparison to conventional approaches. [ABSTRACT FROM AUTHOR]

The purpose of this study was to develop a laparoscopic-assisted prepubic urethorstomy (PPU) technique using rabbits as an experimental model. Six male New Zealand rabbits (Oryctolagus cuniculus) over six months old and weighing between 3 and 4kg (3.5kg ± 0.4) were used in this study. The animals underwent laparoscopic dissection of the pelvic urethra, which was then exposed for the laparoscopicassisted urethrostomy procedure. The proposed model for training of laparoscopic-assisted PPU in rabbits was considered effective and feasible. It proved to be a simple technique even for surgeons under basic endosurgery skills training, with possibilities of employing the technique for the treatment of cats with loss of function of the distal urethra. [ABSTRACT FROM AUTHOR]

The purpose of this study was to assess the use of a homemade multiport for LESS (laparoendoscopic single-site surgery) ovariohysterectomy (OVH) in cats. Intra and postoperative variables of the surgery steps, technical challenges, complications and evolution of surgical time by a surgeon in training were evaluated. Twenty queens were selected for LESS OVH. The multiport device was manufactured of a conical-shaped ethylene polytereftalate (PET) bottle, urethral catheter no. 8, latex balloon no. 11, a 3.5mm and a 6mm laparoscopic trocars. Hemostasis was carried out using bipolar diathermy. Mean total surgical time was 14.54±5.12 minutes. Approach to right and left ovarian pedicles and abdominal access for insertion of the multiport device were the most time consuming surgical steps. LESS ovariohysterectomy using a new homemade multiport device is feasible and safe. Thus, the proposed technique may be considered as a minimally invasive alternative to ovariohysterectomy in the feline specie. [ABSTRACT FROM AUTHOR]

The purpose of this study was to investigate the feasibility of minilaparoscopic (MINI) ovariohysterectomy (OHE) in healthy cats using three portals, one of 5 millimeters (mm) in diameter and two of 3mm diameter, along with bipolar diathermy. Technical difficulty, feasibility of MINI access, use of bipolar diathermy, surgery time, need for enlargement of incisions, trans- and post-operative complications and rate of conversion to open surgery were assessed. One out of 15 animals required incision enlargement, and one animal required conversion to celiotomy. The main postoperative complication observed was subcutaneous emphysema (46.7%). In conclusion, MINI OHE is feasible in healthy cats. [ABSTRACT FROM AUTHOR]

Study aim: analysis of surgical treatment of congenital diaphragmatocele on the basis of еру multi-profile republican hospital #1 of the National center of medicine. Study participants and methods. The article gives analysis of treatment results for 8 newborns (6 girls and 2 boys) with false diaphragmatoceles. The average age at the moment of operation was 3 days. In 6 cases the malformation was revealed antenatally during ultrasound investigation within a prescribed period, in 3 cases – within the first antenatal hours. Results. All patients were operated thoratoscopically, average operation time – 60 minutes. No intraoperative complications, hemorrhage or conversion. Average time of post-operative artificial pulmonary ventilation – 5.6 days, of pleural draining – 4.7 days. Results were being evaluated from 6 months to 2 years after operation. An excellent direct and long-term functional and cosmetic result was achieved with all patients. Conclusions. Thoracoscopic plastic surgery of defects at false congenital diaphragmatocele introduced in clinical practice is a sufficiently safe procedure for newborns. Excellent visualization of all stages of intervention, lack of technical difficulties with bringing organs down and plastic surgery of the diaphragm itself and quick recovery in the nearest post-operative period are indubitable advantages of endosurgical intervention.

O presente relato descreve a realização de criptorquectomia, ressecção de cisto prostático e herniorrafia perineal vídeolaparoscópicas em um cão da raça Collie que apresentou recidiva dos sinais clínicos após redução cirúrgica convencional. Pela cirurgia laparoscópica, com três portais retroumbilicais, localizou-se um testículo intrabdominal, que foi removido após a aplicação de clipes de titânio no mesórquio e nos vasos testiculares. Verificou-se também a presença de um cisto prostático que foi drenado por punção transparietal com agulha e, em seguida, realizaram-se a ressecção da parede e omentopexia na cavidade cística. Na avaliação da cavidade pélvica, verificou-se que o tamanho do defeito herniário permitia ser manejado por laparoscopia. Aplicou-se uma sutura intracorpórea no padrão colchoeiro abrangendo músculo coccígeo e elevador do ânus. O procedimento total durou aproximadamente 140 minutos, não havendo complicações. Conclui-se que a cirurgia laparoscópica pode ser empregada no tratamento de cisto prostático e na herniorrafia perineal de cães.This research describes the cyst resection of the prostate, perineal hernia and laparoscopic criptorquidectomia of a Collie dog, which showed clinical signs of recurrence after conventional hernia surgery. By mean three retroumbilical portals,an intraabdominal testicle was located through laparoscopic surgery. It was removed after the application of titanium clips in mesorquio and pots testicules. A prostate cyst was noticed that was drained by puncture with a transparietal needle. An incision was made in the wall and omentopexia of the cystic cavity was performed. In the evaluation of the pelvic cavity, it was found that the hernial defect was small and could be managed by laparoscopy. An intracorporeal suturing pattern was applied which covered the coccygeal muscle and lifted the anus. The entire procedure took about 140 minutes, with no complications. It was concluded that laparoscopic surgery can be used to treat prostate cysts and the perineal hernia of dogs.

The use of laparoscopic surgery for the removal of cystic calculi in three dogs was reported. Three trocars were used, one in the ventral midline (10mm) and the others in the right (10mm) and left (5mm) flanks. The calculi were removed and the bladder was sutured with intracorporeal technique in two layers, a simple continuous pattern and interrupted or continuous Lembert pattern. No postoperative complications were observed. One patient had a recurrence of urolithiasis, attributed to inadequate conservative treatment and to the lack of an appropriate diet. It was submitted to another similar videolaparoscopic cystotomy without complication. The proposed technique is appropriate and an alternative to conventional cystotomy for treatment of canine vesical urolithiasis.Descreve-se a remoção de cálculos vesicais por cirurgia laparoscópica em três cães utilizando-se três portais (dois de 10mm e um de 5mm) dispostos na linha média ventral e nas paredes abdominais direita e esquerda. Após a remoção das litíases, realizou-se sutura intracorpórea da parede vesical, em padrão contínuo simples, abrangendo as quatro camadas do órgão e em Lembert contínuo ou interrompido, incorporando a serosa e a muscular. Não houve complicações pós-operatórias. Um dos pacientes apresentou recidiva da doença, condição atribuída ao manejo dietético deficiente no pós-operatório. Esse paciente foi novamente submetido à cistotomia laparoscópica similar sem a ocorrência de complicações. A técnica proposta foi adequada e pode ser utilizada como alternativa para cistotomia por celiotomia no tratamento de litíases vesicais em cães.

Avaliou-se uma nova técnica de colopexia laparoscópica, sem necessidade de suturas intracorpóreas em cães, utilizando a implantação de segmento de tela de polipropileno em 11 animais. As superfícies serosas do cólon descendente e parede muscular foram mantidas em contato com o implante posicionado por meio de lesão produzida no mesocólon e sob o retalho bipediculado de músculo transverso abdominal. As extremidades da tela foram unidas com a aplicação de clipe de titânio. Os procedimentos duraram 36,00±13,15min, sem a ocorrência de complicações. No período pós-operatório, foi verificada a manutenção da colopexia em sete animais, a formação de fixação parcial entre o intestino e a parede em três cães, e a não formação de aderências do cólon em um paciente. Conclui-se que o procedimento proposto é viável para cães, porém necessita de ajustes técnicos.A new laparoscopic colopexy technique was tested in dogs without intracorporeal sutures. The use of polypropylene mesh in eleven mongrel dogs was evaluated. The serosal surface of the descendent colon and transverse abdominal muscle were put in contact with the mesh application, taking into consideration that the polypropylene implant was positioned through the mesocolon and under the muscle flap. Finally, the extremities of the mesh were clipped. The procedures lasted 36:00±13:15min, without any kind of complications. In the post-operative period, adequate colopexy in seven dogs was observed. In three dogs the colopexy was partial and in one the bowel did not adhere to the muscles or mesh. The proposed procedure is viable for dogs, however, it is necessary to make some adjustments.

The results of treatment of 35 patients with acute pancreatitis of alcoholic etiology were studied. It was shown that application of thioctic acid in a dose of 600 mg/day in with minimally invasive surgeries in complex treatment allows to localize the process and. to treat it in an aseptic way.

O acidente botrópico em equinos refere-se à ocorrência de picadas de serpentes do gênero Bothrops, representando um desafio significativo, pois o seu veneno possui ação proteolítica, vasculotóxica, coagulante e nefrotóxica. Estas situações demandam intervenções rápidas e especializadas para minimizar danos e otimizar a recuperação dos animais. Em paralelo, a eletrocoagulação bipolar e um procedimento que utiliza corrente elétrica para coagular tecidos, funciona com a utilização de dois elétrodos para aplicar a corrente elétrica, ajudando na redução de lesões em tecidos circundantes. O objetivo deste trabalho é relatar o caso de um equino da raça quarto de milha, macho de quatro anos, pesando 455 kg vítima de picada de cobra, na propriedade o animal apresentava inquietude, taquicardia (acima de 80 Bpm), e taquipneico (Acima de 40 Mpm), temperatura 38.1°C e motilidade intestinal normal, a partir da evolução dos sinais clínicos, o animal apresentou bastante edema facial, causando obstrução das vias aéreas superiores, vindo a apresentar dispneia e insuficiência respiratória consequente do edema de glote, sendo necessária a realização da traqueotomia de emergência. O animal apresentou sangramento massivo, devido aos fatores de incoagulabilidade sanguínea do veneno botrópico e foi encaminhado ao Hospital Veterinário da Universidade Federal do Pará, onde optou-se pelo uso do equipamento de eletrocoagulação (Deltronix Equipamentos LTDA, São Paulo, SP) associado a traqueoscopia utilizando endoscópio flexível (Endovision 9.8mm, GDI do brasil, Ribeirão Preto, Brasil) para identificação do local exato do sangramento, o qual foi identificado na borda da traqueia, região ventral. Realizou-se a coagulação bipolar na potência de 70watts, controlando por completo a hemorragia. Conclui-se que as ferramentas especiais empregadas na resolução do sangramento são de importância fundamental, já que as associações dessas ferramentas agem de forma eficaz e minimamente invasiva visto que a eletrocoagulação bipolar com precisão na hemostasia e a traqueoscopia possibilita visualização direta, permitindo intervenções focalizadas. [ABSTRACT FROM AUTHOR]

Adhesion formation involving the genitourinary tract is common following laparoscopic procedures. To evaluate the effectiveness of intraperitoneal lidocaine hydrochloride 1% solution for the prevention of abdominal adhesions, twenty four Santa Ines ewes submitted to laparoscopic ovum pick-up, uterine puncture and local rinsing, were randomly distributed into two groups of 12 animals, according to rinsing solution: normal saline (SG) or 1% lidocaine hydrochloride solution (LG). Laparoscopy for manipulation of the reproductive tract (uterine puncture trauma model and ovum pick-up) was applied. A standard laparoscopic approach using three ports in triangulation was employed. The uterus and ovaries were rinsed at the end of the procedure (using either saline or lidocaine hydrochloride) for removal of blood clots from the ovaries and uterine horn surfaces. Inflammation was assessed postoperatively by plasma fibrinogen, and all animals underwent a second laparoscopic procedure 21 days after surgery for macroscopic assessment of adhesion formation. Four cases of adhesion were observed in each group. The plasma fibrinogen did not differ between groups and among different time points, indicating an absence of systemic inflammation following laparoscopic procedures. There were no significant differences between treatments. Both normal saline and 1% lidocaine hydrochloride were similarly effective in the prevention of adhesion formation. [ABSTRACT FROM AUTHOR]

To evaluate whether single-entry endoscopic vasectomy of male feral pigeons ( Columba livia) significantly reduced fertility and would potentially be valuable for control of feral pigeon populations, 252 male feral pigeons were caught in the city of Berne and endoscopically vasectomized. In this procedure, approximately 1 cm of the deferent duct was removed bilaterally. Rapid, uneventful recoveries occurred in 94% (237/252) of the pigeons, whereas 6% (15/252) died because of complications associated with the procedure, consisting of perforation of the ureter (9/15), major hemorrhage (5/15), and respiratory arrest (1/15). Mean anesthesia time was 23 ± 6 minutes. The vasectomized males were habituated to 2 pigeon houses together with fertile females. Another pigeon house with fertile pairs acted as control. All eggs laid were candled weekly to assess fertility. In the 2 pigeon houses with vasectomized males, the mean fertilization rate was 0.9% (5/563), while in the control pigeon house, the rate was 100% (39/39). The results indicate that endoscopic vasectomy of male feral pigeons may be a promising tool for field control of feral pigeon populations, especially in combination with other methods such as pigeon houses. [ABSTRACT FROM AUTHOR]

Background: Laparoscopy provides good visualization of horse's abdominal cavity, besides providing minimal invasiveness and meticulous manipulation intra-abdominal organs. Laparoscopy is suitable for both diagnosing and treating acute abdomen in horses. The purpose of this study was to report a successful case of laparoscopic-assisted surgery for treating sand impaction in a horse. Case: A 3-year-old horse, weighing 460 kg, was admitted following chronic intermittent episodes of diarrhea and colic. Physical exam revealed mild abdominal pain and liquid/pasty diarrhea. There was negative survey of gastrointestinal helminthes and microbiological analyses. Fecal sedimentation test revealed sand impaction. Surgical approach was opted for both accomplishment of the abdominal exploration and resolution of the impactation. The patient was anesthetized and positioned in dorsal recumbency. Laparoscopy was performed through an 11-mm trocar placed right cranially to the umbilicus. There were no apparent adhesions, bowel inflammation nor visceral displacement. A 15-cm celiotomy was carried out caudally to the umbilicus, under laparoscopic guidance, for initial inspection of the gastrointestinal tract. Incision enlargement was required for exteriorizing the pelvic flexure. Afterwards, enterotomy was carried out for drainage of the impactating content, followed by enterorraphy. The pelvic flexure was rinsed with heparin diluted in normal saline (5 IU/ ml) for prophylaxis of postoperative intraperitoneal adhesions. The pelvic flexure was repositioned within the abdominal cavity, followed by withdrawn of the trocar, synthesis of the muscle layer, approximation of the subcutaneous tissue and usual skin suture. Overall surgical time was 64 min and the patient recovered uneventfully from anesthesia. Convalescence was excellent and the patient presented a short-term mild abdominal pain in the early postoperative period, using the visual analogue scale (VAS). The wound healed uneventfully following two weeks and no postoperative complication was noted. Discussion: Sand impaction a gastrointestinal disorder common in horses bred in sandy soil or subjected to poor quality water source, usually from streams or ponds. The aspect of the feces is an important parameter for the diagnosis, which is accomplished using the fecal sedimentation test. Intraperitoneal adhesions may affect the equine gastrointestinal tract following abdominal surgery or inflammatory disorders, with a predilection not only for anastomosis or enterotomy sites, but also in cases of acute enteritis and impactations. Laparoscopy provided optimal observation of the abdominal cavity and close examination of the intestines for discharging the presence of inflammation-related intraperitoneal adhesions in this case. The laparoscopic-assisted approach to the pelvic flexure reduced the length of the surgical wound, while minimizing the likelihood of adhesion formation and preventing incision complications which are common complications following abdominal surgery in horses. The reduced celiotomy minimized postoperative pain, which has been one of the main efforts of surgeons for enhancing convalescence of patients undergoing exploratory celiotomy. The patient showed no relapsed or painful discomfort and had great recovery and healing, demonstrating that the technique can be applied in equine surgical clinic routine. [ABSTRACT FROM AUTHOR]

Background: Intraperitoneal adhesions are common in equines, especially following exploratory celiotomy. Adhesiolysis is the treatment of choice for patients presenting postsurgical adhesions. Laparoscopic approach for adhesiolysis presents several advantageous aspects in human patients. The aim of the current study was to report a case of successful laparoscopic adhesiolysis in a mini pony horse. Case: A male Shetland Pony, weighing 140 kg, was admitted under complaint of right hind limb trauma and treated surgically for metatarsal fracture reduction. The patient has also had intermittent episodes of colic and was always treated clinically without major complications. The pony had no history of previous abdominal surgery and no episodes of acute abdomen were seen during hospital stay. Three months following ostheosynthesis, an exploratory laparoscopic approach was carried out to assess the possible cause or consequences of the episodes of acute abdomen. The patient was submitted to general anesthesia, positioned in dorsal recumbency and the abdomen was clipped and aseptically prepared for surgery. During the laparoscopic inspection, there were adhesions involving the ventral abdominal wall and a ventral mesogastric segment of duodenum. Laparoscopic adhesiolysis was performed using a two-port approach, by gently breaking the adhesion bands using meticulous traction with a 10-mm laparoscopic atraumatic Babcock forceps. Afterwards, the intestinal loop was rinsed with heparin sodium solution diluted in normal saline. The pneumoperitoneum was completely drained and the trocars sequentially withdrawn from the abdominal wall. The synthesis of the muscular layer was carried out using an interrupted cross mattress pattern, followed by synthesis of the skin with an interrupted cushion pattern. Total surgical time was 58 min. the patient was able to recover without complications. In the early postoperative period, the surgical recovery was considered excellent. No apparent adhesion involving the previously affected intestinal loop was found during the ultrasound exam following 15 days of surgery. Furthermore, the surgical wounds had healed completely, with no complications. Discussion: In the current case report, the primary cause of the acute abdomen episodes was not determined since the patient had never undergone abdominal surgery. It was hypothesized that an acute inflammation of the duodenal loop that was involved by the adhesion bands may have triggered the adhesiogenesis. Laparoscopy was efficient and presented a short operative time, due to magnification of image and adequate observation of structures surrounded by adhesion bands. Although the use of Babcock forceps is not usually recommended for adhesiolysis in the current literature, it was both effective in manipulating the bowel and performing the adhesiolysis. The heparin solution diluted in normal saline was effective in preventing the recurrence of new adhesions, which was evidenced by ultrasonography following 15 days. The laparoscopic approach usually minimizes the new formation of adhesions as trauma to the peritoneal surfaces is minimized by the use of delicate instruments, as observed in the current study. In addition, laparoscopy reduces the possibility of contact among the peritoneal surfaces and foreign bodies, such as gauze, glove powder and room air particles. Moreover, it maintains the abdominal surfaces in adequate humidity environment. [ABSTRACT FROM AUTHOR]

Abstract: The term minimally invasive surgery refers to procedures performed using endoscopic guidance to enter a part of the body (e.g., laparoscopy, thoracoscopy, arthroscopy, rhinoscopy, gastroscopy). Endoscope-assisted procedures generally use a rigid endoscope to improve visualization and/or access or permit completion of the procedure extracorporeally to access internal body structures through small openings compared with traditional “open” incision techniques. Endoscope-assisted procedures currently performed in exotics include, but are not limited to, exploratory laparoscopy/coelioscopy/thoracoscopy, procurement of thoracic and abdominal organ biopsies, intestinal foreign body removal, cystotomy, and reproductive sterilization. [Copyright &y& Elsevier]

This research describes the cyst resection of the prostate, perineal hernia and laparoscopic criptorquidectomia of a Collie dog, which showed clinical signs of recurrence after conventional hernia surgery. By mean three retroumbilical portals,an intraabdominal testicle was located through laparoscopic surgery. It was removed after the application of titanium clips in mesorquio and pots testicules. A prostate cyst was noticed that was drained by puncture with a transparietal needle. An incision was made in the wall and omentopexia of the cystic cavity was performed. In the evaluation of the pelvic cavity, it was found that the hernial defect was small and could be managed by laparoscopy. An intracorporeal suturing pattern was applied which covered the coccygeal muscle and lifted the anus. The entire procedure took about 140 minutes, with no complications. It was concluded that laparoscopic surgery can be used to treat prostate cysts and the perineal hernia of dogs. [ABSTRACT FROM AUTHOR]

Abstract: Background: Laparoendoscopic single-site surgery (LESS) is a laparoscopic surgery in which a single small incision is made, associated with the use of a special device (single-port), or several small incisions grouped in one location (single-incision) are made, through which the laparoscopic trocars are inserted. The incision is made in the abdomen, preferably in the umbilicus. Certain peculiarities are noted in this approach, such as the difficulty, and sometimes the impossibility, of centering the image, the need to move both the camera and instruments together, requiring even more delicate and precise movements than in laparoscopy. Since information on training for LESS is scarce in the current literature, the authors report their experience with five different cases of this nature, performed in two porcine models, and then discuss a training plan for LESS. Methods: Five LESS procedures were performed in two pigs using different training techniques: two (one single-port and one single-incision) transumbilical laparoscopic cholecystectomies; one right-sided single-incision laparoscopic radical nephrectomy; one single-incision transumbilical laparoscopic radical nephrectomy; and one single-port transumbilical laparoscopic nephrectomy. Discussion: Different from what was observed in the transition from open surgery to laparoscopy, the Halstedian model should not be used in the teaching of LESS since this procedure requires that professionals partner together, thus requiring not only the training of surgeons, but of the whole team. Conclusion: LESS procedures are feasible and considered as further refinements in laparoscopic techniques. However, the peculiarities and difficulties inherent in these procedures require a specific training program combining theory and practice. The authors believe that this training is essential to achieve proficiency levels before the technique can be tried on human subjects. [Copyright &y& Elsevier]

Port-site recurrence (PSR) following laparoscopic procedures has been an unpredictable complication in adult cancer patients; however, no data exist about this phenomenon in the pediatric field. The aim of this study was to determine whether PSR, following endosurgical procedure for malignancies, is a typical complication or a rare event in the pediatric population. Eighty-one questionnaires were mailed to members of The Japanese Society of Pediatric Endosurgeons. They were asked to provide a list of their institutions that had experience with PSR after endosurgical procedures for pediatric malignancies. Among 29 institutions, a total of 129 endosurgical procedures for pediatric malignancies were reported; these included 85 laparoscopic and 44 thoracoscopic procedures, performed on 104 neuroblastomas, 8 hepatoblastomas, 7 nephroblastomas, and 10 other tumors. Of the 104 neuroblastomas, 83 were found by mass screening using high levels of urinary vanillylmandelic acid and homovanillic acid. Sixty-five of the 83 patients had their tumor excised, and 18 had their tumor biopsied by endosurgical procedures. Additionally, 47 of these patients did not require any postoperative chemotherapy. No incidence of PSR was reported in any of the patients that underwent endosurgical procedures. The PSR following endosurgical procedure is a rare phenomenon in the pediatric population. Both, laparoscopic and thoracoscopic procedures, are safe and recommended for treating pediatric malignancies, especially mass-screened neuroblastomas. [ABSTRACT FROM AUTHOR]

Laparoscopic surgery burst into the surgical scene in the late 20th century and completely changed the art, craft and scene of surgery in a most dramatic fashion. With the dawn of a new century, much of the pioneering literature is now invaluable surgical relics. A comprehensive review of publications from Fellows of the College of Surgeons of Hong Kong prior to the year 2000 reveals many significant innovations in major fields of surgery: a rich legacy worthy of a permanent, orderly record in the Annals of the College. Some of the novel techniques proposed therein have stood the test of time and have now become a standard of care worldwide. [ABSTRACT FROM AUTHOR]

ObjectiveTo assess the results of operative laparoscopy in terms of operation time, postoperative care, histological diagnosis and complications. DesignRetrospective evaluation of women who had undergone laparoscopic management of cystic ovarian masses. SettingTwo Swedish university hospitals. Subjects275 women with clinically and sonographically benign cystic ovarian masses. InterventionsOperative laparoscopy under general anaesthesia was carried out in all the women. Bipolar coagulation, suture loops, suction/irrigation and various cutting instruments were used. Main outcome measures and ResultsNo major intraoperative complications occurred in this series. Minor complications included injury of the inferior epigastric artery, postoperative nausea, shoulder pain and temporary urine retention. Three patients underwent a second surgical procedure because of postoperative intra-abdominal bleeding. The adnexal cystic masses varied in size from 2 to 12 cm (mean 5.5 cm). The mean total operation time was 54 min (range 15–200 min). The postoperative stay at the clinic ranged from 6 to 144 h (mean 23 h). Histopathological examination showed malignancy in 1.8% of the cases. ConclusionsIn this setting operative laparoscopy appears to be a safe and effective method for treating clinically and ultrasonographically benign ovarian cysts. Day surgery is possible in the majority of cases. [ABSTRACT FROM AUTHOR]

This paper describes a case of laparoscopic-assisted ovariohysterectomy in a female cat presenting pyometra and mammary fi broadenomatous hyperplasia. Using four portals, mesovarium were ligated by titanium ligature clips whereas the uterine vessels were occluded by video-assisted conventional ligatures. There were no postoperative complications. Videoassisted technique can be an alternative method for treatment of pyometra and cystic endometrial hyperplasia in female cats. [ABSTRACT FROM AUTHOR]

The aim of this article is to review some of the technological advances in endoscopy and endosurgery. The article focuses on a few key areas relevant to exotic pets, including advances in urolith management, visualization, and laparoscopic surgery., (Copyright © 2019 Elsevier Inc. All rights reserved.)