The accidental capture of sea turtles with longline is a frequent event in the Mediterranean sea. Frequently hooks are located in oral cavity or oesophagus and surgical removal is relatively easy; whereas in many other cases hooks and especially lines are located in lower digestive tract, often causing severe damages, as serious injuries on the intestinal wall. Recently, effective surgical techniques have been proposed for hook and line extraction from different districts of digestive tract. The access to the coelomic cavity through the prefemoral soft tissues allows the removal of hooks and lines from the caudal portions of the digestive tract and it is often employed in conjunction with cervical or axillary approach, if one or more hooks are located in oesophagus or stomach and lines cross the entire digestive tract. In this study, the left inguinal approach is compared to the right one, and results are reported concerning 97 turtles treated by these routes for the extraction of foreign bodies from digestive tract. The surgical approach through soft tissues of the right inguinal region was performed in 63 turtles. In 23 cases a unique approach was used to remove hooks lodged in the lower digestive tract and lines extended through the entire digestive tract. In 40 cases this approach was performed together with cervical and left axillary surgical approaches, to remove hooks lodged in oesophagus or stomach, and lines crossing the lower digestive tract. The surgical approach through the soft tissues of the left inguinal region was performed in 34 turtles. This technique was employed as a single approach in 5 cases to remove hooks stopped in the pyloric portion of the stomach, and in 10 cases to remove lines crossing the entire digestive tract. In the remaining 19 cases the left inguinal approach was employed additionally to the cervical one, to remove hooks lodged in the oesophagus and lines extended through the entire digestive tract. To remove hooks located in the intestine, we chose the side closest to the site of the foreign body. To remove line crossing all the digestive tract, the choice of the side access was initially random, but experience showed how the right inguinal approach is to be preferred. Indeed, we tested how this approach allows the exteriorization of longer tracts of intestine, whereas with the left inguinal approach is often difficult to expose the tract between jejunum and ileum, because this portion is more subject than others to plication, intussusceptions and severe lacerations of walls, because of the major tensions that line induces there. To guarantee the survival of the patient, our direct experience show definitely how it is important to operate as soon as possible, in particular when it could be present a line in the digestive tract. The choice of the surgical approach appears crucial to solve lifethreatening situations, in which lines cross the entire digestive tube.

Comparision between left and right surgical approach through the soft tissues of the inguinal region in sea turtles.

DI BELLO, Antonio Vito Francesco;VALASTRO, CARMELA
2011

Abstract

The accidental capture of sea turtles with longline is a frequent event in the Mediterranean sea. Frequently hooks are located in oral cavity or oesophagus and surgical removal is relatively easy; whereas in many other cases hooks and especially lines are located in lower digestive tract, often causing severe damages, as serious injuries on the intestinal wall. Recently, effective surgical techniques have been proposed for hook and line extraction from different districts of digestive tract. The access to the coelomic cavity through the prefemoral soft tissues allows the removal of hooks and lines from the caudal portions of the digestive tract and it is often employed in conjunction with cervical or axillary approach, if one or more hooks are located in oesophagus or stomach and lines cross the entire digestive tract. In this study, the left inguinal approach is compared to the right one, and results are reported concerning 97 turtles treated by these routes for the extraction of foreign bodies from digestive tract. The surgical approach through soft tissues of the right inguinal region was performed in 63 turtles. In 23 cases a unique approach was used to remove hooks lodged in the lower digestive tract and lines extended through the entire digestive tract. In 40 cases this approach was performed together with cervical and left axillary surgical approaches, to remove hooks lodged in oesophagus or stomach, and lines crossing the lower digestive tract. The surgical approach through the soft tissues of the left inguinal region was performed in 34 turtles. This technique was employed as a single approach in 5 cases to remove hooks stopped in the pyloric portion of the stomach, and in 10 cases to remove lines crossing the entire digestive tract. In the remaining 19 cases the left inguinal approach was employed additionally to the cervical one, to remove hooks lodged in the oesophagus and lines extended through the entire digestive tract. To remove hooks located in the intestine, we chose the side closest to the site of the foreign body. To remove line crossing all the digestive tract, the choice of the side access was initially random, but experience showed how the right inguinal approach is to be preferred. Indeed, we tested how this approach allows the exteriorization of longer tracts of intestine, whereas with the left inguinal approach is often difficult to expose the tract between jejunum and ileum, because this portion is more subject than others to plication, intussusceptions and severe lacerations of walls, because of the major tensions that line induces there. To guarantee the survival of the patient, our direct experience show definitely how it is important to operate as soon as possible, in particular when it could be present a line in the digestive tract. The choice of the surgical approach appears crucial to solve lifethreatening situations, in which lines cross the entire digestive tube.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11586/137628
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