Laparoscopic and hand-assisted cystorrhaphy strengthened with omental pedicle in dogs: Radiographic and ultrasonographic study

This study was designed to evaluate the using of two laparoscopic techniques for repairing an experimental cystotomy of urinary bladder reinforced with omental pedicle in dogs. Eighteen local breed male dogs were randomly allocated into two equal groups: first group an experimental cystotomy (about 2 cm) was induced laparoscopically at the ventral surface of the urinary bladder, repaired with titanium clips and reinforced with the omental pedicle. In the second group: similar technique was followed; however, the induced was repaired with hand-assisted extracorporeal laparoscopic method. In both groups, several diagnostic parameters were followed including clinical / laparoscopic exploration, radiology, and ultrasonography. Results obtained in the first group shown the titanium clips 4-6 clips freely applicated and whole time consuming for performing operation was 45±2.1 minutes. Clinically, the experimental animals didn't show any abnormal changes in their behavioral activities. Radiographic examination revealed distention of the urinary bladder accompanied by the presence of distances between the titanium clips; however, ultrasonography didn't show any leakage or thickness at the site of operation. Laparoscopic examination demonstrated mild adhesion between urinary bladder and adjacent organ. In the second group, the operation required 36±1.1 minutes to be completed. Postoperatively, no signs of pain were observed, however, animals demonstrated post-operative transient hematuria, lasts for 24 hours, accompanied with severe adhesion between the bladder and abdominal wall. Radiographically, regular distention of the bladder was revealed, while ultrasonographic examination showed hyperechoic dots and thickening of the bladder wall. We concluded that the hand-assisted laparoscopic cystorrhaphy strengthened by omentum is a practical, time saving and mini-invasive surgical technique.