Novas abordagens videolaparoscópicas para cirurgias renais em cães
Autor(a) principal: | |
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Data de Publicação: | 2022 |
Tipo de documento: | Tese |
Idioma: | por |
Título da fonte: | Manancial - Repositório Digital da UFSM |
Texto Completo: | http://repositorio.ufsm.br/handle/1/24427 |
Resumo: | The aim of this study was to evaluate the feasibility of renal biopsy and gasless laparoscopic radical nephrectomy techniques using a multidirectional abdominal traction platform in canine cadavers. Also, to report the first laparoscopic nephrotomies described in patients with dioctophymatosis. In article 1, two surgical cases are presented, one patient had a history of hematuria and the other an incidental finding of the parasite D. renale in the abdominal cavity. Both dogs underwent abdominal ultrasound, which indicated the presence of the parasite in the right kidney, still with partial preservation of the parenchyma, and therefore underwent laparoscopic nephrotomy to remove the parasites. In articles 2 and 3, 20 canine cadavers were randomly divided into two groups, with the GCG (n=10) undergoing renal biopsy and laparoscopic gasless nephrectomy using the multidirectional traction platform, and the GCP (n=10) submitted to renal biopsy and laparoscopic nephrectomy with pneumoperitoneum. The total operative time and the times of each step of the procedure were recorded. The degree of difficulty of surgical approaches to renal biopsy was evaluated by the surgeon and assistant, and by external surgeons who analyzed the video recordings, using a Likert scale. To assess the difficulty of surgical approaches in nephrectomy, the surgeon and assistant used a visual analogue scale (VAS) and the Likert scale. Renal samples were evaluated for quality, number of glomeruli and proportion of renal cortex. The total operative time for biopsy (p<0.01) and for nephrectomy (p<0.01) was higher in the GCG. For the biopsy, we observed a difference in the steps of positioning portal 2 and establishing the platform, being higher in the GCG (p<0.01). For nephrectomy, we observed a difference in the steps of positioning portal 2 (T2), establishment of the abdominal lifting equipment (T4), dissection of the renal hilum vessels (T5) and dissection of the kidney from the renal fascia (T8), being higher also in the GCG (p<0.05). The surgical groups differed from each other with respect to almost all parameters of the degree of difficulty of the surgical approaches for biopsy and nephrectomy, on the Likert scale (p<0.05), receiving a higher score on the GCG. For the VAS scale, we also observed a higher response in the GCG (p<0.01). In evaluating the video recordings for the renal biopsy, the surgical groups differed from each other with respect to almost all aspects of the degree of difficulty of the surgical approaches (p<0.05), receiving a higher score on the GCP. Renal histological parameters were similar between groups and sides of surgery. We conclude that laparoscopic nephrotomy proved effective in the cases of dioctophimosis described, with satisfactory recovery of patients and preservation of the kidneys affected by the parasite D. renale. Additionally, the feasibility of renal biopsy and laparoscopic radical nephrectomy procedures with an abdominal wall elevation device was demonstrated in canine cadavers. Although gasless procedures required longer surgical time and were more difficult to perform, they proved to be viable in the ex-vivo model. |
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Novas abordagens videolaparoscópicas para cirurgias renais em cãesNew videolaparoscopic approaches for kidney surgery in dogsCirurgia urológicaPneumoperitônioLaparoscopia gaslessElevação da parede abdominalUrological surgeryPneumoperitoneumGasless laparoscopyAbdominal wall liftCNPQ::CIENCIAS AGRARIAS::MEDICINA VETERINARIAThe aim of this study was to evaluate the feasibility of renal biopsy and gasless laparoscopic radical nephrectomy techniques using a multidirectional abdominal traction platform in canine cadavers. Also, to report the first laparoscopic nephrotomies described in patients with dioctophymatosis. In article 1, two surgical cases are presented, one patient had a history of hematuria and the other an incidental finding of the parasite D. renale in the abdominal cavity. Both dogs underwent abdominal ultrasound, which indicated the presence of the parasite in the right kidney, still with partial preservation of the parenchyma, and therefore underwent laparoscopic nephrotomy to remove the parasites. In articles 2 and 3, 20 canine cadavers were randomly divided into two groups, with the GCG (n=10) undergoing renal biopsy and laparoscopic gasless nephrectomy using the multidirectional traction platform, and the GCP (n=10) submitted to renal biopsy and laparoscopic nephrectomy with pneumoperitoneum. The total operative time and the times of each step of the procedure were recorded. The degree of difficulty of surgical approaches to renal biopsy was evaluated by the surgeon and assistant, and by external surgeons who analyzed the video recordings, using a Likert scale. To assess the difficulty of surgical approaches in nephrectomy, the surgeon and assistant used a visual analogue scale (VAS) and the Likert scale. Renal samples were evaluated for quality, number of glomeruli and proportion of renal cortex. The total operative time for biopsy (p<0.01) and for nephrectomy (p<0.01) was higher in the GCG. For the biopsy, we observed a difference in the steps of positioning portal 2 and establishing the platform, being higher in the GCG (p<0.01). For nephrectomy, we observed a difference in the steps of positioning portal 2 (T2), establishment of the abdominal lifting equipment (T4), dissection of the renal hilum vessels (T5) and dissection of the kidney from the renal fascia (T8), being higher also in the GCG (p<0.05). The surgical groups differed from each other with respect to almost all parameters of the degree of difficulty of the surgical approaches for biopsy and nephrectomy, on the Likert scale (p<0.05), receiving a higher score on the GCG. For the VAS scale, we also observed a higher response in the GCG (p<0.01). In evaluating the video recordings for the renal biopsy, the surgical groups differed from each other with respect to almost all aspects of the degree of difficulty of the surgical approaches (p<0.05), receiving a higher score on the GCP. Renal histological parameters were similar between groups and sides of surgery. We conclude that laparoscopic nephrotomy proved effective in the cases of dioctophimosis described, with satisfactory recovery of patients and preservation of the kidneys affected by the parasite D. renale. Additionally, the feasibility of renal biopsy and laparoscopic radical nephrectomy procedures with an abdominal wall elevation device was demonstrated in canine cadavers. Although gasless procedures required longer surgical time and were more difficult to perform, they proved to be viable in the ex-vivo model.O objetivo deste estudo foi avaliar a viabilidade das técnicas de biopsia renal e nefrectomia radical laparoscópica gasless utilizando uma plataforma de tração abdominal multidirecional em cadáveres caninos. E ainda, relatar as primeiras nefrotomias laparoscópicas descritas em pacientes com dioctofimatose. No artigo 1 são apresentados dois casos cirúrgicos, uma paciente apresentava histórico de hematúria e outra um achado incidental do parasito D. renale na cavidade abdominal. Ambos os cães foram submetidos à ultrassonografia abdominal, que indicou a presença do parasita no rim direito, ainda com preservação parcial do parênquima, e por isso foram submetidos à nefrotomia laparoscópica para remoção dos parasitas. Nos artigos 2 e 3, 20 cadáveres caninos foram distribuídos aleatoriamente em dois grupos, sendo os do GCG (n=10) submetidos à biopsia renal e nefrectomia laparoscópica gasless com o uso da plataforma de tração multidirecional, e os GCP (n=10) submetidos à biopsia renal e nefrectomia laparoscópica com pneumoperitônio. O tempo operatório total, e os tempos de cada etapa do procedimento foram registrados. O grau de dificuldade das abordagens cirúrgicas para a biopsia renal foi avaliado pelo cirurgião e auxiliar, e por cirurgiões externos que analisaram as gravações em vídeo, a partir de uma escala Likert. Para a avaliação da dificuldade das abordagens cirúrgicas na nefrectomia, cirurgião e auxiliar utilizaram uma escala visual analógica (EVA) e a escala Likert. As amostras renais foram avaliadas quanto a sua qualidade, número de glomérulos e proporção de córtex renal. O tempo cirúrgico total para a biopsia (p<0,01) e para a nefrectomia (p<0,01) foi mais alto no GCG. Para a biopsia, observamos diferença nas etapas de posicionamento do portal 2 e estabelecimento da plataforma, sendo mais alto no GCG (p<0,01). Para a nefrectomia, observamos diferença nas etapas do posicionamento do portal 2 (T2), estabelecimento do equipamento de elevação abdominal (T4), dissecação dos vasos do hilo renal (T5) e dissecação do rim da fáscia renal (T8), sendo mais alto também no GCG (p<0,05). Os grupos cirúrgicos diferiram entre si com relação a quase todos os parâmetros do grau de dificuldade das abordagens cirúrgicas para a biopsia e nefrectomia, na escala Likert (p<0,05), recebendo uma pontuação mais alta no GCG. Para a escala EVA, também observamos uma resposta mais alta no GCG (p<0,01). Na avaliação das gravações em vídeo para a biopsia renal, os grupos cirúrgicos diferiram entre si com relação a quase todos os aspectos do grau de dificuldade das abordagens cirúrgicas (p<0,05), recebendo uma pontuação mais alta no GCP. Os parâmetros histológicos renais foram semelhantes entre os grupos e os lados da cirurgia. Concluímos que, a nefrotomia laparoscópica mostrou-se eficaz nos casos de dioctofimose descritos, com recuperação satisfatória dos pacientes e preservação dos rins acometidos pelo parasita D. renale. Adicionalmente, foi demonstrada a exequibilidade dos procedimentos de biopsia renal e nefrectomia radical laparoscópica, com um dispositivo de elevação da parede abdominal em cadáveres caninos. Ainda que, os procedimentos gasless tenham exigido maior tempo cirúrgico e maior dificuldade em sua execução, demonstraram ser viáveis no modelo exvivo.Universidade Federal de Santa MariaBrasilMedicina VeterináriaUFSMPrograma de Pós-Graduação em Medicina VeterináriaCentro de Ciências RuraisBrun, Maurício Velosohttp://lattes.cnpq.br/3913050752928325Rappeti, Josaine Cristina da SilvaMüller, Daniel Curvello de MendonçaDalmolin, FabíolaSilva, Marco Augusto MachadoMilech, Vanessa2022-05-23T20:00:53Z2022-05-23T20:00:53Z2022-02-23info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/doctoralThesisapplication/pdfhttp://repositorio.ufsm.br/handle/1/24427porAttribution-NonCommercial-NoDerivatives 4.0 Internationalhttp://creativecommons.org/licenses/by-nc-nd/4.0/info:eu-repo/semantics/openAccessreponame:Manancial - Repositório Digital da UFSMinstname:Universidade Federal de Santa Maria (UFSM)instacron:UFSM2022-05-23T20:00:53Zoai:repositorio.ufsm.br:1/24427Biblioteca Digital de Teses e Dissertaçõeshttps://repositorio.ufsm.br/ONGhttps://repositorio.ufsm.br/oai/requestatendimento.sib@ufsm.br||tedebc@gmail.comopendoar:2022-05-23T20:00:53Manancial - Repositório Digital da UFSM - Universidade Federal de Santa Maria (UFSM)false |
dc.title.none.fl_str_mv |
Novas abordagens videolaparoscópicas para cirurgias renais em cães New videolaparoscopic approaches for kidney surgery in dogs |
title |
Novas abordagens videolaparoscópicas para cirurgias renais em cães |
spellingShingle |
Novas abordagens videolaparoscópicas para cirurgias renais em cães Milech, Vanessa Cirurgia urológica Pneumoperitônio Laparoscopia gasless Elevação da parede abdominal Urological surgery Pneumoperitoneum Gasless laparoscopy Abdominal wall lift CNPQ::CIENCIAS AGRARIAS::MEDICINA VETERINARIA |
title_short |
Novas abordagens videolaparoscópicas para cirurgias renais em cães |
title_full |
Novas abordagens videolaparoscópicas para cirurgias renais em cães |
title_fullStr |
Novas abordagens videolaparoscópicas para cirurgias renais em cães |
title_full_unstemmed |
Novas abordagens videolaparoscópicas para cirurgias renais em cães |
title_sort |
Novas abordagens videolaparoscópicas para cirurgias renais em cães |
author |
Milech, Vanessa |
author_facet |
Milech, Vanessa |
author_role |
author |
dc.contributor.none.fl_str_mv |
Brun, Maurício Veloso http://lattes.cnpq.br/3913050752928325 Rappeti, Josaine Cristina da Silva Müller, Daniel Curvello de Mendonça Dalmolin, Fabíola Silva, Marco Augusto Machado |
dc.contributor.author.fl_str_mv |
Milech, Vanessa |
dc.subject.por.fl_str_mv |
Cirurgia urológica Pneumoperitônio Laparoscopia gasless Elevação da parede abdominal Urological surgery Pneumoperitoneum Gasless laparoscopy Abdominal wall lift CNPQ::CIENCIAS AGRARIAS::MEDICINA VETERINARIA |
topic |
Cirurgia urológica Pneumoperitônio Laparoscopia gasless Elevação da parede abdominal Urological surgery Pneumoperitoneum Gasless laparoscopy Abdominal wall lift CNPQ::CIENCIAS AGRARIAS::MEDICINA VETERINARIA |
description |
The aim of this study was to evaluate the feasibility of renal biopsy and gasless laparoscopic radical nephrectomy techniques using a multidirectional abdominal traction platform in canine cadavers. Also, to report the first laparoscopic nephrotomies described in patients with dioctophymatosis. In article 1, two surgical cases are presented, one patient had a history of hematuria and the other an incidental finding of the parasite D. renale in the abdominal cavity. Both dogs underwent abdominal ultrasound, which indicated the presence of the parasite in the right kidney, still with partial preservation of the parenchyma, and therefore underwent laparoscopic nephrotomy to remove the parasites. In articles 2 and 3, 20 canine cadavers were randomly divided into two groups, with the GCG (n=10) undergoing renal biopsy and laparoscopic gasless nephrectomy using the multidirectional traction platform, and the GCP (n=10) submitted to renal biopsy and laparoscopic nephrectomy with pneumoperitoneum. The total operative time and the times of each step of the procedure were recorded. The degree of difficulty of surgical approaches to renal biopsy was evaluated by the surgeon and assistant, and by external surgeons who analyzed the video recordings, using a Likert scale. To assess the difficulty of surgical approaches in nephrectomy, the surgeon and assistant used a visual analogue scale (VAS) and the Likert scale. Renal samples were evaluated for quality, number of glomeruli and proportion of renal cortex. The total operative time for biopsy (p<0.01) and for nephrectomy (p<0.01) was higher in the GCG. For the biopsy, we observed a difference in the steps of positioning portal 2 and establishing the platform, being higher in the GCG (p<0.01). For nephrectomy, we observed a difference in the steps of positioning portal 2 (T2), establishment of the abdominal lifting equipment (T4), dissection of the renal hilum vessels (T5) and dissection of the kidney from the renal fascia (T8), being higher also in the GCG (p<0.05). The surgical groups differed from each other with respect to almost all parameters of the degree of difficulty of the surgical approaches for biopsy and nephrectomy, on the Likert scale (p<0.05), receiving a higher score on the GCG. For the VAS scale, we also observed a higher response in the GCG (p<0.01). In evaluating the video recordings for the renal biopsy, the surgical groups differed from each other with respect to almost all aspects of the degree of difficulty of the surgical approaches (p<0.05), receiving a higher score on the GCP. Renal histological parameters were similar between groups and sides of surgery. We conclude that laparoscopic nephrotomy proved effective in the cases of dioctophimosis described, with satisfactory recovery of patients and preservation of the kidneys affected by the parasite D. renale. Additionally, the feasibility of renal biopsy and laparoscopic radical nephrectomy procedures with an abdominal wall elevation device was demonstrated in canine cadavers. Although gasless procedures required longer surgical time and were more difficult to perform, they proved to be viable in the ex-vivo model. |
publishDate |
2022 |
dc.date.none.fl_str_mv |
2022-05-23T20:00:53Z 2022-05-23T20:00:53Z 2022-02-23 |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/doctoralThesis |
format |
doctoralThesis |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://repositorio.ufsm.br/handle/1/24427 |
url |
http://repositorio.ufsm.br/handle/1/24427 |
dc.language.iso.fl_str_mv |
por |
language |
por |
dc.rights.driver.fl_str_mv |
Attribution-NonCommercial-NoDerivatives 4.0 International http://creativecommons.org/licenses/by-nc-nd/4.0/ info:eu-repo/semantics/openAccess |
rights_invalid_str_mv |
Attribution-NonCommercial-NoDerivatives 4.0 International http://creativecommons.org/licenses/by-nc-nd/4.0/ |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
Universidade Federal de Santa Maria Brasil Medicina Veterinária UFSM Programa de Pós-Graduação em Medicina Veterinária Centro de Ciências Rurais |
publisher.none.fl_str_mv |
Universidade Federal de Santa Maria Brasil Medicina Veterinária UFSM Programa de Pós-Graduação em Medicina Veterinária Centro de Ciências Rurais |
dc.source.none.fl_str_mv |
reponame:Manancial - Repositório Digital da UFSM instname:Universidade Federal de Santa Maria (UFSM) instacron:UFSM |
instname_str |
Universidade Federal de Santa Maria (UFSM) |
instacron_str |
UFSM |
institution |
UFSM |
reponame_str |
Manancial - Repositório Digital da UFSM |
collection |
Manancial - Repositório Digital da UFSM |
repository.name.fl_str_mv |
Manancial - Repositório Digital da UFSM - Universidade Federal de Santa Maria (UFSM) |
repository.mail.fl_str_mv |
atendimento.sib@ufsm.br||tedebc@gmail.com |
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1805922079966494720 |