Laparoscopic surgical approach and anatomy of the abdomen in llamas.
OBJECTIVE: To describe 3 laparoscopic approaches for, and the normal laparoscopic anatomy of, the abdomen in adult llamas and to evaluate the effects of laparoscopy in those llamas. DESIGN: Prospective clinical trial. ANIMALS: Six adult castrated male llamas. PROCEDURE: After induction of general anesthesia, 3 surgical approaches to the abdomen were performed: left paralumbar, ventral midline, and right paralumbar. The abdomen was systematically examined, and anatomic features described. After recovery from anesthesia, all llamas were examined daily for 10 days and CBC was repeated 24, 72, and 120 hours after laparoscopy. RESULTS: Laparoscopy was successfully performed in all llamas by use of the ventral midline and right paralumbar approaches. The laparoscope was inadvertently placed into the left retroperitoneal space in 1 of the 6 llamas when the left paralumbar approach was used. Also, hemorrhage into the abdomen limited the view from the left side in another llama. Various approaches allowed viewing of the first and third forestomach compartments, liver, spleen, kidneys, small intestine, ileum, proximal loop of the ascending colon, spiral colon, and urinary bladder. Postoperative findings included subcutaneous emphysema and edema. Mean WBC count peaked 24 hours after surgery (mean, 23,500 cells/microliter). Generally, neutrophil count increased and lymphocyte count decreased during the 120 hours after surgery. CLINICAL IMPLICATIONS: Laparoscopy may be used for differentiation of medical and surgical lesions in the abdomen of llamas. The site for laparoscopy should be chosen on the basis of the most likely site of the suspected lesion.