Use of an endoscopic suturing device for laparoscopic resection of the apex of the bladder and umbilical structures in normal neonatal calves

Objective-To develop a laparoscopic technique using an endoscopic suturing device for the resection of the apex of the bladder and the umbilical struc tures in large-animal neonates. Study Design-Experimental study. Animals or Sample Population-Seven healthy male Holstein calves. Methods-A laparoscopic technique for resection of the apex of the bladder w as developed on 2 calf cadavers, then evaluated on 5 anesthetized calves, T he calves were positioned in dorsal recumbency, and 3 ventral abdominal por tals were used. The umbilical vessels were double-ligated using an endoscop ic suturing device and subsequently transected. The apex of the bladder was transected between a row of laparoscopic clips applied near the apex and a traumatic laparoscopic forceps applied distally, then, the edges were appos ed using an endoscopic suturing device. The dissected umbilical remnants we re removed from the abdomen through a small incision centered at the umbili cus. One month later, the calves were euthanatized and a second-look laparo scopy performed; then, bladders were collected for gross and histologic exa mination. Results-No major complications occurred during or after surgery. The endosc opic suturing device permitted both effective ligation of the umbilical ves sels and closure of the bladder. During second-look laparoscopy, healing of the peritoneal surface of the bladder and umbilical vessels was assessed t o be excellent in 4 calves. A focal adhesion of omentum to the bladder sutu re line was observed in 1 calf. Focal adhesions of the omentum to the umbil ical incision site occurred in 2 calves. The bladder mucosa was completely healed at the surgical sites. Conclusion and Clinical Relevance-Resection of the apex of the bladder and umbilical vessels in calves can be accomplished laparoscopically using an e ndoscopic suturing device. (C) Copyright 2001 by It American College of Vet erinary Surgeons.