Advancement of laparoscopic-guided abdominal approaches in cetacean species.

Abstract

Objective: Surgical procedures in small cetaceans are rarely considered as treatment options due to anatomic considerations limiting exposure, concerns with achieving a watertight incisional closure, and logistical complexities of both anesthesia and surgery in completely aquatic mammals. The objective is to provide a video tutorial on laparoscopic-guided abdominal approaches with the goal to expand diagnostic and treatment capabilities for common diseases in these species.

Animals: Small cetaceans undergoing laparoscopy for diagnostic or therapeutic purposes.

Methods: The patient is positioned in dorsolateral recumbency. The initial approach to the abdomen is made at the umbilicus (5- to 10-mm incision). A 10- to 12-mm-diameter X 15-cm-long optical cannula with a 10-mm X 30-cm, 0° laparoscope is inserted. The abdomen is insufflated (10 to 15 mm Hg) and a 30° laparoscope inserted. To access the cranial abdomen, instrument portals are made at 7 and 15 cm cranial to the umbilicus on midline. To access the caudal abdomen, portals are made 15 cm caudal to the umbilicus on midline (midway between the umbilicus and genital slit) and 15 cm lateral to the caudal portal bilaterally. Laparoscopic instruments (grasping forceps, laparoscopic sealing devices) may be inserted to facilitate the procedures.

Results: The cranial approach allows evaluation of the cranial digestive tract, liver, pancreas, and spleen. The caudal approach allows examination of the caudal digestive tract and urinary (kidneys, ureter, urinary bladder) and reproductive systems relevant to common indications for abdominal surgery.

Clinical relevance: Development of laparoscopic techniques in small cetaceans would mitigate many of the aforementioned surgical challenges, enhancing visualization of intraperitoneal structures and necessitating small incision sizes, leading to more secure closures for early return to aquatic habitats.