Page 14 - Journal of Laparoscopic Surgery

Anburaja Mahalingam et al

Table 4: Mean ± SE values of cortisol and testasterone recorded at different time intervals
Parameters Groups Before Immediately after Day 1 Day 3 Day 5 Day 7
operation operation PO PO PO PO
Cortisol (nM/l) I 25.59 ± 17.37 46.85 ± 16.39 31.99 ± 9.29 27.29 ± 16.48 27.88 ± 13.19 27.40 ± 8.45
II 46.83 ± 4.99 129.08 ± 23.46 ** 59.41 ± 21.03 38.68b ± 12.78 23.55 ± 8.20 25.52 ± 5.36
Testosterone (ng/ml) I 0.418 ± 0.05 0.321 ± 0.03 0.396 ± 0.08 0.438 ± 0.09 0.369 ± 0.03 0.372 ± 0.04
**
**
**
**
II 0.437 ± 0.08 0.159 ± 0.03 0.101 ± 0.02 0.024 ± 0.00 0.025 ± 0.01 0.015 ± 0.01**
**Differ significantly (p < 0.01) from base values (before operation)
of the present study concurred with the observations of The electrocautery with 60 W monopolar current revea-
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Dharmaceelan et al. The total utilization of CO during led a good hemostatic measure in both groups. Rodgerson
2
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surgical procedures was recorded. Comparatively, less et al found that application of coagulation current from
utilization of CO was observed in group I because of less monoplar electrocautery alone was sufficient for effective
2
time taken to perform bilateral vasectomy. This method hemostasis for equine mesoovarium. However, before
was comparatively simple, quick and easier than method of final withdrawal of telescope in all the animals of lapa-
group II. In group II, utilization of CO was significantly roscopy groups the resected sites were closely observed.
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higher (p < 0.01) than that of group I, may be due to the The mean surgical operating time was significantly lower
longer operative time and may also be due to leakage of CO (p < 0.05) in group I as compared to group II. The decreased
2
during removal of resected tissue through 10 mm ports by surgical operating time in group I was due to the reason
5 mm forceps. that this technique was simple, quick and easier than other
The instruments used were differed in both groups. In two groups. Wildt et al reported the lower operative time
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group I, all the three ports were of 5 mm in size, two ports required for bilateral vasectomy in dog. Increased surgical
were created at left and right paramedian site distally to the operative time in laparoscopic bilateral vasectomy with
telescope insertion site and 4 to 6 cm laterally at the inguinal occlusion spermatic artery-vein plexus (group II) was due to
regions and the rest one was at umblical site for insertion of additional time required for application of endoclips. All the
telescope. In the group II, two ports were 10 mm in size and animals were returned to their normal feeding habits within
the rest one was 5 mm for telescopic insertion at the same 8 to 10 hours after surgery. Urination and defecation were
sites as described in group I. These two 10 mm ports were normal upto 7th postoperative day. The animals appeared
needed mainly to insert the 10 mm clip applicator toward quite alert and responsive. There was no postoperative infec-
the contralateral spermatic artery-vein plexus and were tion, emphysema, port-site herniation as well as wound
converted into 5 mm size by applying adaptor for inserting dehiscence in any animal.
fenestered grasping forceps to manipulate the vas deferens
and testicular vessels for vasectomy as well as for clip appli-
cation respectively. However, regarding the number of Clinical observations
trocars and their respective sites, the present study concurred No significant difference in physiological parameters, such
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with the findings of Wildt et al. The urinary bladder was as heart rate, respiration rate and rectal temperature, was
visualized first with the introduction of telescope into the observed at different time intervals. Heart rate, respiration
abdominal cavity and it was identified by its characteristics rate and rectal temperature did not change significantly after
tortuous structures of blood vessels on it. surgery, so these variables could not be considered useful in
The 30º forward oblique, 5 mm rigid telescope used in the recognition of postoperative pain. In both the groups,
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this study covered sufficiently big exposure operative area there was a decrease in respiration as well as in heart rate
in a single view without any remarkable loss of resolution immediately after operation might be attributed to post-
and visibility. Most of the clinicians have reported the use anesthetic effect of xylazine, also reported by Ilback and
of 5 mm telescope during ovariohysterectomy in dogs. 11,14,15 Stalhandske in dogs. Luna et al also reported xylazine
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laparoscopic occlusion of ductus deferens in male dogs and ketamine combination causes reduction in heart rate and
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and cats and laparoscopic vasectomy in male dogs. The respiration rate in dogs.
separation of intra-abdominal organs from the ventral as
well as lateral abdominal walls were adequate at 10 mm Hg hematobiochemical observations
pressure gradient intraperitoneally. Also, proper fasting
prior to surgery emptied colon and urinary bladder and A significant increase (p < 0.05) in neutrophils and compara-
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thereby facilitated proper visualization of the vas deferens tive lymphopenia was observed on 3rd postoperative day
and spermatic artery-vein plexus. may be the result of release of endogenous glucocorticoids
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