Laparoscopic cholecystectomy using vessel sealant device and modification of technique using hand tied loop in rabbits: experimental study

Abstract

Laparoscopic surgeries have known advantages being widely used in human medicine and there is a great tendency to reduce open surgical procedures. However, in veterinary medicine, this advancement in video-surgeries does not occur in the same way. Minimally invasive surgeries are still restricted to some centers, with little research that seeks to advance techniques in small animals. Laparoscopic cholecystectomy is a recent minimally invasive surgical technique in veterinary medicine. Randomized, live studies evaluating different methods of laparoscopic extrahepatic bile duct ligation and dissection bring benefits to patients. The purpose of our study was to describe two techniques of laparoscopic cholecystectomy and to compare two methods of occlusion of the cystic duct, reporting complications and trans and postoperative results, as well as proposing a modification of the technique of laparoscopic cholecystectomy. Thus, 20 rabbits will be used as an experimental model. Laparoscopic cholecystectomy technique by gallbladder dissection prior to cystic duct dissection and hand tied loop application (n = 10), and laparoscopic cholecystectomy technique using vessel sealant device for cystic duct ligation through four portals (n = 10). The total time of surgery and each operative stage will be measured for the proposed techniques. Serial ultrasonographic evaluations will be performed postoperatively in order to verify the absence of biliary leakage and biliary peritonitis. Abnormal macroscopic changes will be verified at the fifteenth postoperative day by means of the necropsy of the twenty animals, and the vessel-sealing device enables adequate occlusion of the cystic duct comparable to the hand tied loop. We hypothesized that there would be no difference between the quality of the seal between the vessel sealant device and the hand tied loop for cystic duct ligation and we expect that the modification of the laparoscopic cholecystectomy technique by performing the gallbladder dissection prior to the cystic duct will be a viable and safe option. (AU)