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Williamson AJ, McKinnon AO. Transurethral removal of a cystic urolith in a mare using a laparoscopic specimen pouch. Aust Vet J 2017; 95:174-177. [PMID: 28444749 DOI: 10.1111/avj.12580] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2015] [Revised: 05/02/2016] [Accepted: 07/24/2016] [Indexed: 11/27/2022]
Abstract
CASE REPORT Cystic urolithiasis is the most common form of urolithiasis reported in horses. In contrast to the gelding or stallion, clinical disease is less common in the mare and manual removal techniques are possible because of their shorter, wider urethral anatomy. However, these manual removal techniques can be traumatic and are limited by the size of the urolith. This report describes the use of a commercial laparoscopic specimen pouch to remove a cystic urolith in a mare. CONCLUSION This approach may allow the extraction of larger uroliths per urethra in the mare, while affording some protection to the mucosa of the bladder neck and urethra.
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Affiliation(s)
- A J Williamson
- Faculty of Veterinary Science, University of Melbourne, 250 Princes Highway, Werribee, Victoria 3030, Australia
| | - A O McKinnon
- Goulburn Valley Equine Hospital, Congupna, Victoria, Australia
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Lynam S, Young L, Morozov V, Rao G, Roque DM. Risk, risk reduction and management of occult malignancy diagnosed after uterine morcellation: a commentary. ACTA ACUST UNITED AC 2015; 11:929-44. [PMID: 26673851 DOI: 10.2217/whe.15.63] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Minimally invasive surgical techniques compared with laparotomy offer the advantages of less intraoperative blood loss, shorter hospitalization, fewer wound complications and faster return to baseline activity for both hysterectomy and myomectomy. While morcellation allows for the laparoscopic removal of large specimens, it may result in intraperitoneal dissemination of benign disease or upstaging of occult malignancy leading to compromised survival. There has been heightened scrutiny over appropriate patient selection and preoperative assessment in light of recent warnings against power morcellation issued by the US FDA. This commentary therefore summarizes the magnitude of such risks associated with uterine morcellation, current national regulatory statements and potential merits of risk-reducing approaches such as contained morcellation. The importance of patient counseling is underscored.
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Affiliation(s)
- Sarah Lynam
- Department of Obstetrics, Gynecology, & Reproductive Sciences, University of Maryland School of Medicine, Baltimore, MD 21201, USA
| | - Laura Young
- Department of Obstetrics, Gynecology, & Reproductive Sciences, University of Maryland School of Medicine, Baltimore, MD 21201, USA
| | - Vadim Morozov
- Department of Obstetrics, Gynecology, & Reproductive Sciences, University of Maryland School of Medicine, Baltimore, MD 21201, USA.,Center of Excellence in Minimally Invasive Gynecology, University of Maryland School of Medicine, Baltimore, MD 21201, USA
| | - Gautam Rao
- Department of Obstetrics, Gynecology, & Reproductive Sciences, University of Maryland School of Medicine, Baltimore, MD 21201, USA.,Division of Gynecologic Oncology, Greenebaum Cancer Center, University of Maryland School of Medicine, Baltimore, MD 21201, USA
| | - Dana M Roque
- Department of Obstetrics, Gynecology, & Reproductive Sciences, University of Maryland School of Medicine, Baltimore, MD 21201, USA.,Division of Gynecologic Oncology, Greenebaum Cancer Center, University of Maryland School of Medicine, Baltimore, MD 21201, USA
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Inés MM, Fitch G. Use of a laparoscopic retrieval device for urolith removal through a perineal urethrotomy. Vet Surg 2012; 41:629-33. [PMID: 22380755 DOI: 10.1111/j.1532-950x.2012.00967.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To report the use of a laparoscopic retrieval device for removal of uroliths via a perineal urethrotomy. STUDY DESIGN Case report. ANIMALS A 12-year-old Konenklijk Warmbloed Paardenstamboek Nederland (KWPN) gelding and a 15-year-old Holsteiner gelding. METHODS Perineal urethrotomy was performed on 2 standing sedated geldings and the urolith was removed using a laparoscopic retrieval device. RESULTS In both cases, uroliths were removed successfully with no short- or long-term complications. The larger of the 2 uroliths measured 6 cm in length and 4.6 cm in width. CONCLUSIONS Removal of a urolith via a perineal urethrotomy using a laparoscopic retrieval device was an expedient and minimally traumatic method that obviated the need for fragmentation before removal.
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Affiliation(s)
- Martín Menéndez Inés
- Servicio de Cirugía Equina Hospital Clínico Veterinario Universidad Alfonso X el Sabio Avenida de la Universidad N°1 CP: 28691, Villanueva de la Cañada, Madrid, Spain
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