Evaluation of a Veress needle for the fluid egress system of stifle arthroscopy in toy dog breeds

Jae-Gwan Cha; Hae Beom Lee; Hye-Yeon Cheong; Su-Young Heo; Guillaume R. Ragetly

doi:10.3415/VCOT-15-04-0065

Veterinary and Comparative Orthopaedics and Traumatology, Table of Contents

Vet Comp Orthop Traumatol 2016; 29(02): 149-155
DOI: 10.3415/VCOT-15-04-0065

Original Research

Schattauer GmbH

Evaluation of a Veress needle for the fluid egress system of stifle arthroscopy in toy dog breeds

Authors

Jae-Gwan Cha^*

¹Department of Veterinary Surgery, College of Veterinary Medicine, Chonbuk National University, Iksan, Republic of Korea
Hae Beom Lee^*

²Department of Veterinary Surgery, College of Veterinary Medicine, Chungnam National University, Daejeon, Republic of Korea
Hye-Yeon Cheong

¹Department of Veterinary Surgery, College of Veterinary Medicine, Chonbuk National University, Iksan, Republic of Korea
Su-Young Heo

¹Department of Veterinary Surgery, College of Veterinary Medicine, Chonbuk National University, Iksan, Republic of Korea
Guillaume R. Ragetly

³Department of Surgery, Centre Hospitalier Vétérinaire Frégis, Arcueil, France

Abstract

Summary

Objectives: The aim of this study was to evaluate the use of a Veress needle as a fluid egress system for stifle arthroscopy in toy dog breeds.

Methods: Cadaveric canine stifle joints (n = 32) were prepared to induce an artificial intra-articular haemorrhagic effect, followed by stifle arthroscopy. The stifles were randomly assigned to one of three groups, and a fluid egress portal was established using a Veress needle (VN), a standard egress cannula (SE), or an intravenous catheter stylet (CS). Time to establish the egress portal, arthroscopic visibility, and egress portal performance were evaluated during the arthroscopy. After the arthroscopic examinations, iatrogenic cartilage lesions were identified and analysed using the percentage area of cartilage damage (%ACD).

Results: The overall arthroscopic visibility and egress portal performance were not significantly different among the groups. The egress portal establishment was faster for the VN (33 sec) and the CS (34 sec) groups than for the SE (43 sec) group (p = 0.001). On gross joint examination, no iatrogenic laceration was found in the VN group, whereas four out of 10 of the SE and two out of 10 of the CS specimens had linear cartilage excoriation on the stifle joints. The %ACD score of the VN group was lower than those of the SE group (p = 0.009) and the CS group (p = 0.001).

Clinical significance: The Veress needle method used in this study was useful to establish a fluid egress system and limit iatrogenic cartilage excoriations. This technique could become the method of choice for stifle arthroscopy, especially in smaller dogs.

Keywords

Stifle - arthroscopy - egress portal - dog - Veress needle

Full Text

References

References
1 Hoelzler MG, Millis DL, Francis DA. et al. Results of arthroscopic versus open arthrotomy for surgical management of cranial cruciate ligament deficiency in dogs. Vet Surg 2004; 33: 146-153.
2 Pozzi A, Hildreth 3rd BE , Rajala-Schultz PJ. Comparison of arthroscopy and arthrotomy for diagnosis of medial meniscal pathology: an ex vivo study. Vet Surg 2008; 37: 749-755.
3 Plesman R, Gilbert P, Campbell J. Detection of meniscal tears by arthroscopy and arthrotomy in dogs with cranial cruciate ligament rupture: a retrospective, cohort study. Vet Comp Orthop Traumatol 2013; 26: 42-46.
4 Fitzpatrick N, Yeadon R, van Terheijden C. et al. Osteochondral autograft transfer for the treatment of osteochondritis dissecans of the medial femoral condyle in dogs. Vet Comp Orthop Traumatol 2012; 25: 135-143.
5 Arias I J, Torres C, Saez D. Synovial hemangioma in a dog. Vet Surg 2009; 38: 463-466.
6 Tuijthof GJ, Sierevelt IN, van Dijk CN. Disturbances in the arthroscopic view defined with video analysis. Knee Surg Sports Traumatol Arthrosc 2007; 15: 1101-1106.
7 Whitney WO. Arthroscopically assisted surgery of the stifle joint. In Beale B, Hulse D, Schultz L. et al. editors. Small Animal Arthroscopy. Philadelphia: Saunders; 2003. pg 117-157
8 Payne JT. Arthroscopy. In Tams TR, Rawlings CA. editors Small Animal Endoscopy. St.Louis: Mosby; 2011. pg 607-621
9 Warnock JJ, Nemanic S, O'Donnell MD. et al. Comparison of 2 fluid ingress/egress systems for canine stifle arthroscopy using computed tomography. Vet Surg 2014; 43: 944-951.
10 Morton M, Whitelock R. Arthroscopy in companion animals. In Practice 2012; 34: 572-577.
11 Beale B. Feline arthroscopy. In Montavon PM, Voss K, Langley Hobbs SJ. editors Feline Orthopedic Surgery and Musculoskeletal Disease: Saunders Ltd.; 2009. pg 283-307
12 Beale BS. Arthroscopic Instrumentation. In Beale BS, Hulse DA, Schulz K. et al. editors Small Animal Srthroscopy. Philadelpia: Saunders; 2003. pg 4-21
13 Azevedo JL, Azevedo OC, Miyahira SA. et al. Injuries caused by Veress needle insertion for creation of pneumoperitoneum: a systematic literature review. Surg Endosc 2009; 23: 1428-1432.
14 Hannink G, van Tienen TG, Schouten AJ. et al. Changes in articular cartilage after meniscectomy and meniscus replacement using a biodegradable porous polymer implant. Knee Surg Sports Traumatol Arthrosc 2011; 19: 441-451.
15 Ewing JW, Noe DA, Kitaoka HB. et al. Intra-articular pressures during arthroscopic knee surgery. Arthroscopy 1986; 2: 264-269.
16 Tuijthof GJ, de Vaal MM, Sierevelt IN. et al. Performance of arthroscopic irrigation systems assessed with automatic blood detection. Knee Surg Sports Traumatol Arthrosc 2011; 19: 1948-1954.
17 Jardel N, Crevier-Denoix N, Moissonnier P. et al. Anatomical and safety considerations in establishing portals used for canine elbow arthroscopy. Vet Comp Orthop Traumatol 2010; 23: 75-80.
18 Coppieters E, Gielen I, Verhoeven G. et al. Erosion of the medial compartment of the canine elbow: occurrence, diagnosis and currently available treatment options. Vet Comp Orthop Traumatol 2015; 28: 9-18.
19 Tuijthof GJ, Dusee L, Herder JL. et al. Behavior of arthroscopic irrigation systems. Knee Surg Sports Traumatol Arthrosc 2005; 13: 238-246.