LAPAROSCOPIC COMPLICATIONS AND MANAGEMENT

摘要

While laparoscopic surgery is considered minimally invasive with improved visualization and shorter recovery times, complications can and do occur. Some complications are unique to laparoscopic procedures (gas emboli) while others are seen in both laparoscopic and open procedures (incisional complications, electrical burns, etc.). When complications occur, it is important to recognize them and have a plan in place on how to deal with them. Poor planning generates many complications and can be compounded by inadequate equipment and facilities and the lack of experience in laparoscopic surgery. It is important to have a way to restrain the horse adequately in both standing and recumbent horses. Excessive movement during a surgery or the horse slidingoff of the table when tilted makes the procedure difficult to complete. It is important to have backup equipment for the times when equipment fails. Familiarity with the regional anatomy and the steps of the surgical procedure helps to minimize complications. Inadequate sedation/analgesia may cause the horse discomfort and increase its movements and the difficulty of the procedure and lead to surgical complications. Excessive sedation/analgesia may cause the horse to go down in the stocks. Nasal and head edema may occur from excessive time in Trendelenberg position leading to respiratory difficulties in recovery. Nasal decongestants applied at the beginning of surgery, during and at the end help prevent this. Nasotracheal entubation also provides a protected open airway for recovery from general anesthesia.