Laparoscopic-assisted cystotomy: an experimental study in male sheep

Aim: To describe a technique of laparoscopic-assisted cystotomy in male sheep. Experimental animals: five healthy male sheep aged approximately nine months (mean weight: 39.6 ± 1.51 kg). Laparoscopy was performed on sheep placed under general anaesthesia in dorsal recumbency. A 10-mm laparoscope was inserted through the right paramedian region between the xiphoid and preputial orifice. After creation of a capnoperitoneum, grasping forceps were inserted through the left paramedian region close to the last pair of teats. The urinary bladder was elevated using grasping forceps and exteriorized through an abdominal incision. The bladder was opened extracorporeally, lavaged, closed, and then repositioned. A pigtail balloon catheter was subsequently inserted percutaneously under laparoscopic control and removed ten days later. A repeat laparoscopy was performed at 14 days after the first procedure to assess gross pathological changes. Laparoscopic-assisted cystotomy was successfully performed on all sheep. In one sheep, both the ventral and dorsal bladder walls were inadvertently perforated when placing the urinary catheter. The postoperative course was favourable: all sheep had a good appetite and showed no pathological findings during physical examination. During the repeat laparoscopy, it was observed that one sheep had developed a focal adhesion of the parietal peritoneum to the bladder catheter portal site. Laparoscopic-assisted cystotomy with catheter implantation is shown to be feasible in male sheep. This technique may be useful for removal of uroliths in patients suffering from obstructive urolithiasis opening the urinary bladder and for performing urinary diversion.