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ISSN 1665-2576 (Print)

2003, Number 2

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Rev Mex Cir Endoscop 2003; 4 (2)

Portocaval derivation of small diameter for laparoscopic shunt

Padilla L, Figueroa S, Aguilar O, Esperante S, Schalch P, Ávila G, Chousleb A, Di Silvio M

Language: Spanish
References: 25
Page: 60-65
PDF size: 115.05 Kb.


ABSTRACT

Background: To describe a small diameter (8 mm) side to side laparoscopic portocaval shunt in dogs. Methods: Twelve mongrel dogs of both genders were used, average weight 15 to 30 kg. Under general anesthesia a pneumoperitoneum was accomplished. Through seven trocars, dissection, clamping and 8 mm venotomies of the cava and portal veins were performed. Vascular anastomosis was performed with 5-0 prolene. In order to guarantee the diameter of the shunt a Silastic® ring of 2.5 cm in lenght was placed and secured with 2-0 prolene which results in a controlled diameter of 8 mm. Results: From 12 experimental subjects, only 7 got a permeable anastomosis with complete recuperation of the intestinal ischemia. The first five cases established the learning curve to define the adequate management of the vessels and its distances, intracorporeal performance of the prolene knotting in order to complete the anastomosis. We maintained the same surgical team in all cases. There were not survival follow-up or angiographic studies, all experiments were acute. Conclusions: This vascular laparoscopic technique, of 8 mm portocaval shunt, offers the benefits of the minimal invasive surgery. By the application of the 8 mm Silastic ring is possible to control the long term diameter avoiding dilatation of the shunt.


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