title: Use of an endoscopic suturing device for laparoscopic resection of the apex of the bladder and umbilical structures in normal neonatal calves.
abstract: OBJECTIVE
  To develop a laparoscopic technique using an endoscopic suturing device for the resection of the apex of the bladder and the umbilical structures 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 was developed on 2 calf cadavers, then evaluated on 5 anesthetized calves. The calves were positioned in dorsal recumbency, and 4 ventral abdominal portals were used. The umbilical vessels were double-ligated using an endoscopic suturing device and subsequently transected. The apex of the bladder was transected between a row of laparoscopic clips applied near the apex and atraumatic laparoscopic forceps applied distally; then, the edges were apposed using an endoscopic suturing device. The dissected umbilical remnants were removed from the abdomen through a small incision centered at the umbilicus. One month later, the calves were euthanatized and a second-look laparoscopy performed; then, bladders were collected for gross and histologic examination.
  
  
  RESULTS
  No major complications occurred during or after surgery. The endoscopic suturing device permitted both effective ligation of the umbilical vessels and closure of the bladder. During second-look laparoscopy, healing of the peritoneal surface of the bladder and umbilical vessels was assessed to be excellent in 4 calves. A focal adhesion of omentum to the bladder suture line was observed in 1 calf. Focal adhesions of the omentum to the umbilical incision site occurred in 2 calves. The bladder mucosa was completely healed at the surgical sites.
  
  
  CONCLUSIONS
  Resection of the apex of the bladder and umbilical vessels in calves can be accomplished laparoscopically using an endoscopic suturing device.
authors.affiliation: Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada.
authors.forename: L
authors.initials: L
authors.lastname: Bouré
authors.forename: R A
authors.initials: RA
authors.lastname: Foster
authors.forename: M
authors.initials: M
authors.lastname: Palmer
authors.forename: A
authors.initials: A
authors.lastname: Hathway
mesh_terms: D000818:Animals; D000831:Animals, Newborn; D002417:Cattle / Q000601:surgery*; D019723:Endoscopes; D004724:Endoscopy / Q000379:methods / Q000662:veterinary*; D004867:Equipment Design; D010535:Laparoscopy / Q000379:methods / Q000662:veterinary*; D008297:Male; D013536:Suture Techniques / Q000662:veterinary*; D014469:Umbilical Arteries / Q000601:surgery*; D014471:Umbilical Veins / Q000601:surgery*; D001743:Urinary Bladder / Q000601:surgery*