ISSN 2398-2969      

Laparoscopy

Clapis

Introduction

  • Laparoscopy has been used in rabbits mainly for female reproductive procedures (ovariectomy and ovariohysterectomy), with the suggested benefits of reducing time of surgery, enhancing recovery, and reducing post-operative complications.
  • It may also be used for exploratory purposes and for biopsy, eg renal biopsy.

Uses

Advantages

  • It may reduce the formation of intra-operative adhesions, but operator experience is necessary to achieve this advantage. 
  • It may reduce intra-operative time, but operator experience is necessary to achieve this advantage. 
  • Facilitates rapid recovery (minimal incision, reduced post-operative pain, reduced potential for gastrointestinal tract).

Disadvantages

  • Pneumoperitoneum, even at normal intra-abdominal pressure levels, leads to significant oxidative stress-induced biochemical and histologic damage to some organs, such as ovaries. In other organs, such as kidneys, causes reversible renal dysfunction.
  • Bowel injury is more likely when previous surgery has been performed and there are abdominal wall adhesions. This risk may be reduced by initial insufflation before direct trocar insertion.
  • The technique needs a significant investment in training, equipment and personnel:
    • Learning laparoscopic technique requires more financial and time investment than learning laparotomy techniques. Significant experience is also needed in order to achieve and maximize the advantages of the technique.
    • The cost of the equipment is significant and far higher than when laparotomy techniques are used. Operating rooms should also be larger to accommodate all equipment, extra personnel and more space for the surgeon to move around the operating table.
    • More personnel are needed to perform laparoscopic procedures, as one operator is usually not enough to hold all the equipment. Additional personnel also need more specialization than when laparotomy techniques are used.
  • Higher financial investment for the owner:
    • Due to equipment expense and the need for more personnel during the procedure, this extra cost needs to be reflected in the fees the owner is paying.
    • The cost of laparoscopic sterilization is 50-100% (if not more) greater compared to traditional sterilization.
  • Some of the advantages of this technique have not been clearly demonstrated in rabbits. 
  • Results from studies or reviews comparing laparoscopic ovariectomy with laparotomy ovariohysterectomy Ovariohysterectomy should be viewed with caution, as laparoscopic ovariectomy should be compared directly with laparotomy ovariectomy.
  • While the technique has been properly described for years in experimental (and university) settings, implementation in private clinical practice has been low so far.

Requirements

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Preparation

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Procedure

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Aftercare

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Outcomes

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Prognosis

  • Good.

Further Reading

Publications

Refereed Papers

  • Recent references from PubMed and VetMedResource.
  • McLean E J, Woodwards A P & Ryan S D (2020) Comparison of the use of a vessel-sealing device versus ligatures for occlusion of uterine tissues during ovariohysterectomy or ovariectomy in rabbits (Oryctolagus cuniculus). Am J Vet Res 81 (9), 755-759 PubMed.
  • McCracken B D, Beths T, Herbert S et al (2019) Comparison of isobaric and insufflated laparoscopy-assisted ovariohysterectomy in the common rabbit (Oryctolagus cuniculus). J Exotic Pet Med 28, 193-204 SciDirect.
  • Divers S J (2011) Clinical technique: endoscopic oophorectomy in the rabbit (Oryctolagus cuniculus): the future of preventative sterilizations. J Exotic Pet Med 20 (1), 72-80 SciDirect.
  • Telles de Sousa I D, Candido dos Reis F J, Brito Garcia S et al (2003) Adhesion formation after uterine horn resection in rabbit model: comparative study of laparoscopic procedure vs. laparotomy. Gynaecol Endoscopy 11 (6), 365-369.
  • Luciano A A, Maier D B & Koch E I (1989) A comparative study of postoperative adhesions following laser surgery by laparoscopy versus laparotomy in the rabbit model. Obstet Gynecol 74 (2), 220-224 PubMed.

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