Prestretching increases working space at the same insufflation pressure in dogs undergoing laparoscopic procedures

Area of Science:

• Veterinary Surgery
• Minimally Invasive Procedures
• Surgical Technology

Background:

• Laparoscopic surgery requires adequate intra-abdominal working space.
• Achieving sufficient working space often involves high insufflation pressures.
• The effects of abdominal wall prestretching on working space are not fully understood.

Purpose of the Study:

• To evaluate the impact of abdominal wall prestretching on working space during laparoscopic procedures in dogs.
• To determine if prestretching improves intra-abdominal working length (IWL) and intra-abdominal working space (IWS).

Main Methods:

• Prospective cohort study involving 50 dogs undergoing elective laparoscopic procedures.
• Prestretching involved insufflating the abdomen to 10 mmHg for 3 minutes, then desufflating to 6 mmHg.
• Intra-abdominal working length (IWL) and intra-abdominal working space (IWS) were measured using skin markings and port-to-gallbladder distance.

Main Results:

• Increasing intra-abdominal pressure (IAP) from 6 to 10 mmHg increased IWL by 7% and IWS by 10.4%.
• After prestretching and returning to 6 mmHg, IWL increased by 4.4% and IWS by 6.9% compared to baseline.
• These improvements in IWL and IWS persisted throughout the procedures.

Conclusions:

• Prestretching the abdominal wall effectively improves intra-abdominal working length and space.
• This technique provides benefits at a lower intra-abdominal pressure compared to higher insufflation alone.
• Prestretching is a viable method to enhance working space in canine laparoscopic surgery.