Large animals such as horses, cattle, llamas and alpacas, and even smaller livestock such as goats, sheep, and pigs all offer their own anatomic constraints and require quiet different laparoscopic surgery techniques to smaller companion animals and humans

Two-step laparoscopic abomasopexy in cattle with left abomasal displacement (Doga Temizsoylu)
This technique was originally described by Janowitz in 1998 (Janowitz, 1998). The Janowitz technique is a laparoscopy-guided toggle pin fixation of a left displaced abomasum (Janowitz, Temizsoylu et al). The first stage of the procedure is performed through the left flank of the standing animal. The surgical site on the animal is prepared following standard procedure, and the points of entry for the trocars are infiltrated with lidocaine. The entry site for the 10-mm trocar gives access to the laparoscope through the left paralumbar fossa behind the ribs and beneath the transverse processes. The point of entry of the 5-mm trocar that gives access to the long trocar used for the placement of the toggle and for emptying the air from the abomasum is situated in the dorsal third of the 11th intercostal space. A Veress needle is introduced through a cutaneous incision 1 cm in length, and a pneumoperitoneum is induced. The 10-mm trocar is inserted into the abdominal cavity. Next, the 10-mm laparoscope is introduced by the cannula into the abdominal cavity. The abdominal cavity is explored to ensure that there are no abnormalities that could prevent the continuation of the procedure. Next a 5-mm trocar is inserted in the 11th intercostal space under laparoscopic guidance. The long 5-mm trocar is passed through this cannula and into the abdominal cavity, where it is inserted into the greater curvature of the abomasum. The toggle is introduced into this cannula and is pushed into the left displaced abomasum with a blunt-ended trocar. The air is emptied form the abomasum through the trocar. All instruments are then removed, and the incisions are closed in a routine manner.The second stage of the surgery, the animal is placed in dorsal recumbency on the hydrolic operation table. The points of entry for the trocars are infiltrated with lidocaine. The first 10-mm trocar is placed to the right and cranial to the umbilicus. For the second 5-mm trocar is placed 10 cm cranial to the first trocar. Both trocars are inserted into the abdomen. The laparoscope is passed through the first cannula. The two sutures are retrieved with grasping forceps and are pulled through the second portal. The sutures are left in place for 3 to 4 weeks (Janowitz, Temizsoylu et al).
• Janowitz H. [Laparoscopic reposition and fixation of the left displaced abomasum in cattle] [German]. Tierarztl Prax Ausg G Grosstiere Nutztiere 1998;26:308-13.
• Temizsoylu MD, Avki S, Yigitarslan K: Ineklerde sola abomasum deplasmaninin laparoskopik cerrahi ile sagaltimi. [Treatment of Left Sided Abomasal Dispacement in Cattle by Laparoscopic Surgery] [Turkish]. Kafkas Univ Vet Fak Derg, 16, 217-224, 2010.

Laparoscopic surgery in pigs (Paul Coronel Reyes). Note the use of the verres needle for insufflation. Pigs are commonly used as model for human laparoscopic surgery research.


Diagnostic laparoscopy in a pig, demonstratig normal abdominal anatomy (Paul Coronel Reyes)

Optical trocar access in a pig. This video demonstrates the use of an Ethicon optical controlled trocar for primary access in a pig laparoscopy (Paul Coronel Reyes). This may be compared to the Covidien "Visiport" cutting optical trocar video in the surgical video section.