| Minimally invasive surgery is one of the development directions in the 21st century. Laparoscopic surgery is an important component of minimally invasive surgery. The advantages of the laparoscopic surgery is minimally invasive, excellent visualization, less bleeding, less pain, faster recovery and less tissue adhesion. Laparoscopic surgery has been a rapid development in urinary surgery in human medicine, but a slow development in urinary surgery in small animal. Now, Laparoscopic assisted cystopexy, resection of inflammatory polyps using laparoscopic-assisted cystoscopy, Laparoscopic cystotomy for urolith removal and laparoscopic unilateral adrenalectomy. Therefore, the purpose of this study to design and perform laparoscopic cystostomy, laparoscopic assisted ureterotomy, laparoscopic nephrectomy, and improve laparoscopic adrenalectomy. The surgical effects were evaluated comprehensively and objectively by the influence of operation on physiological function of dogs. And further study of the influence of laparoscopic and open surgery on oxidative stress and immune systems in dogs.30 healthy mixed dogs were used as experimental animals. These dogs were divided into two groups randomly, 6 in each group. Laparoscopic cystostomy, laparoscopic assisted ureterotomy, laparoscopic nephrectomy, and laparoscopic adrenalectomy were performed by the procedures of pneumoperitoneum, establishment of surgical approaches, dissecting of organ under laparoscope, vascular closure, suture fixation, irrigation of the abdominal cavity, retrieval of the hepatic specimen and closure of the abdominal cavity. Clinical signs, heart rate, body temperature, systolic blood pressure, diastolic blood pressure, mean arterial pressure, respiratory rate and end-tidal partial pressure of carbon dioxide were monitored during operation. Intraoperative and postoperative complications and recovery were recorded. Peripheral blood samples were obtained before surgery and after surgery for white blood cell and neutrocyte, aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase, creatinine, blood urea nitraogen.Laparoscopic and open nephrectomy was performed in dogs. Peripheral blood samples were obtained before surgery and after surgery for maleic dialdehyde, superoxide dismutase and glutathione peroxidase, CD4+, and CD8+ lymphocyte subsetsLaparoscopic cystostomy, laparoscopic assisted ureterotomy, laparoscopic adrenalectomy and laparoscopic nephrectomy were accomplished successfully in dogs without major intraoperative and postoperative complications. All dogs were alive. The spleen injury during pneumoperitoneum with a Veress in a dog, subcutaneous emphysema in two dogs and abdominal vascular injury during puncture with trocar/cannula in a dog were observed. Pain was mild after operation. Appetite was recovered within 1-2 day. Stitch removal was at day 7 after the operation. Infection of incision of cannula was observed in a dog. Others had primary healing. They showed: only from the aspects of laparoscopic surgical technique, the laparoscopic surgical technique could be applied to urinary surgery of dogs.Laparoscopic cystostomy, laparoscopic assisted ureterotomy, laparoscopic nephrectomy, and laparoscopic adrenalectomy on clinical signs, respiratory and circulatory system have different degrees of inhibition. The eyelid reflex disappeared in certain dog. But there had been corneal reflex all time. Pain reflex was significant or dull during certain procedure. Pain reflex disappeared during most of procedures. Heart rate, body temperature, blood pressure and respiratory rate decreased, and end-tidal partial pressure of carbon dioxide increased. Especially, the change of the body temperature was higher. Body temperature was decreased immediately after surgery more than 3℃. It did not return to normal levels at 4 hours postoperatively, and return to preoperative levels on 1 day postoperatively. The four laparoscopic surgeries had a little effect on inflammatory stress and renal function. The dogs were rapid recovery. But there was a certain impact on liver function. The aspartate aminotransferase and alanine aminotransferase had a significant change. Compared with before surgery, there were statistically significant differences on 3 days postoperatively. They were recovery on 5 day postoperatively. They showed: Laparoscopic surgery had a slight effect on physiological functions. All dogs could be normal tolerance, and soon returned to normal levels.Laparoscopic and open nephrectomy made maleic dialdehyde decrease, and superoxide dismutase and glutathione peroxidase increase. But laparoscopic group was more rapidly. Compared with before surgery, there were statistically significant differences at 4 hour postoperatively (P<0.01). It was recovery on 1 day postoperatively. Compared with before surgery, there were statistically significant differences on 2 day postoperatively (0.010.05). CD4+ Lymphocyte subsets and CD4+/CD8+ decreased significantly (0.01 < P < 0.05). There were statistically significant differences between laparoscopic nephrectomy and open nephrectomy group at 1 day postoperatively (0.01 |
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