Our Summary

This study looked at the outcomes when a specific type of less-invasive surgical procedure, called a single port access system (SPAS), was used to remove the gallbladders of dogs with gallbladder disease. The researchers reviewed the medical records of 15 dogs that had this surgery.

The SPAS was inserted just below the belly button in each case. In two of the operations, the SPAS was the only tool used. In 12 cases, an additional tool called a cannula was also used. In the last 10 operations, the cannula was put in place right at the beginning.

The study found that in 20% of the cases, the surgeons decided to switch to a more traditional operation called a laparotomy. Whether or not this switch happened was influenced by how experienced the surgeon was and whether a cannula was used from the start of the operation.

Out of the 15 dogs, 14 were able to leave the hospital after their operations. However, one dog died after leaving the hospital due to severe inflammation and infection in the liver and bile ducts, and another dog died due to a leak in a feeding tube that had been placed in its stomach.

The researchers concluded that using a SPAS to perform gallbladder surgery in dogs has acceptable outcomes. The surgeon’s experience and the use of a cannula from the beginning of the operation can reduce the need to switch to a more traditional operation.

FAQs

  1. What is the success rate of laparoscopic cholecystectomy performed with a single port access system (SPAS) in dogs?
  2. Does the experience of the surgeon affect the success of the SPAS procedure in laparoscopic cholecystectomy?
  3. What is the significance of adding an additional cannula at the beginning of the SPAS procedure in laparoscopic cholecystectomy?

Doctor’s Tip

A helpful tip a doctor might give a patient about laparoscopic cholecystectomy is to follow post-operative care instructions carefully, including taking prescribed medications, watching for signs of infection, and gradually returning to normal activities as advised by the surgeon. Additionally, maintaining a healthy diet and staying hydrated can aid in the recovery process.

Suitable For

Patients who are typically recommended for laparoscopic cholecystectomy include those with symptomatic gallstones, cholecystitis (inflammation of the gallbladder), biliary dyskinesia (abnormal gallbladder function), and other nonobstructive gallbladder diseases. These patients may experience symptoms such as abdominal pain, nausea, vomiting, and jaundice. Additionally, patients who are at higher risk for complications from traditional open cholecystectomy, such as obese patients or those with multiple comorbidities, may also be good candidates for laparoscopic cholecystectomy.

Timeline

Before laparoscopic cholecystectomy:

  • Patient presents with symptoms such as abdominal pain, nausea, and vomiting
  • Diagnostic tests such as ultrasound or CT scan are performed to confirm gallbladder disease
  • Patient undergoes pre-operative assessment and consultation with a surgeon
  • Patient is scheduled for laparoscopic cholecystectomy

After laparoscopic cholecystectomy:

  • Patient undergoes surgery with SPAS placement 1 cm caudal to the umbilicus
  • Procedure is completed with SPAS alone in some cases, while an additional cannula is added in others
  • Dissection begins at the cystic duct in most cases
  • Some cases may require conversion to laparotomy, either elective or emergent
  • Patient is discharged from the hospital post-surgery
  • Patient may experience complications such as cholangiohepatitis or gastrostomy tube leakage, leading to further treatment or potentially death
  • Overall, laparoscopic cholecystectomy with SPAS has an acceptable outcome, with the risk of conversion reduced by surgeon experience and the addition of a cannula at the beginning of the procedure.

What to Ask Your Doctor

Some questions a patient should ask their doctor about laparoscopic cholecystectomy include:

  1. What are the potential risks and complications associated with this procedure?
  2. How experienced are you in performing laparoscopic cholecystectomy with a single port access system?
  3. What is the success rate of this procedure in dogs with nonobstructive gallbladder disease?
  4. How long is the recovery period expected to be after the surgery?
  5. Will I need any additional procedures or treatments following the cholecystectomy?
  6. What are the alternatives to laparoscopic cholecystectomy, and why is this the recommended option for me?
  7. How will my pain be managed during and after the surgery?
  8. Will I need to make any changes to my diet or lifestyle following the cholecystectomy?
  9. How soon can I expect to return to normal activities after the surgery?
  10. Are there any long-term effects or complications I should be aware of after undergoing this procedure?

Reference

Authors: Simon A, Monnet E. Journal: Vet Surg. 2020 Jun;49 Suppl 1:O156-O162. doi: 10.1111/vsu.13289. Epub 2019 Aug 6. PMID: 31389068