Complications related to entry techniques for laparoscopy in 159 dogs and cats

Objective To report the frequency and risk factors of complications related to 3 entry techniques for laparoscopy in small animals. Study design Single-institution retrospective case series. Animals 159 client-owned dogs and cats. Methods Medical records were reviewed for dogs and cats undergoing laparoscopic surgery with carbon dioxide (CO2) insufflation between 2006 and 2018. Data including entry site, entry technique, signalment, body conformation, complications, and operating surgeon/resident were analyzed by univariate regression analysis. Factors with P < .25 were included in multivariate regression analysis. Results Complications occurred in 33 of 159 (21%) surgeries and were considered minor (CO2 leaks, omental insufflation, repeated entry) in 30 of 33 (91%) cases. The Ternamian visual entry, modified Hasson, and Veress needle entry techniques were associated with complications in 7 (9%), 17 (26%), and 9 (60%) surgeries, respectively. Major complications occurred in 3 of 159 (2%) surgeries, in which entry-related hemorrhage prompted conversion to an open technique (2 [13%] entries with Veress needle) and 1 [1%] with the Ternamian visual). Entry location and entry technique remained significant in the final multivariate model. Complications were 11.7 times more likely after a paramedian entry than after a midline entry; the odds ratio of complications were 5 and 28 times higher after modified Hasson and Veress needle entries, respectively, than after Ternamian visual entry. Conclusion In this study, a Ternamian visual entry technique and midline entry site appeared associated with fewer complications than 2 other techniques. Clinical significance The findings in this study are preliminary, and superiority of any entry technique must be reevaluated in a prospective randomized controlled study.