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Topic:Minimally Invasive Surgery
Minimally invasive surgery (MIS) in horses refers to surgical techniques that limit the size and number of incisions needed to perform procedures. These techniques often involve the use of specialized equipment such as endoscopes, cameras, and instruments designed for precision. MIS aims to reduce tissue trauma, potentially leading to shorter recovery times and decreased post-operative discomfort compared to traditional surgical methods. Common minimally invasive procedures in equine medicine include arthroscopy, laparoscopy, and thoracoscopy, which are used for diagnostic and therapeutic purposes. This page compiles peer-reviewed research studies and scholarly articles that explore the methodologies, applications, and outcomes of minimally invasive surgery in equine practice.
Novel technique for correcting urovagina via urethral transposition in the horse. Vesicovaginal reflux is a common cause of infertility in mares. Surgical correction is commonly recommended and involves caudal relocation of the urethral orifice which forces the urine to be expelled caudally. There have been several previously described techniques. Complications associated with caudal urethral extension occur in 11-33.3% of cases. Objective: To identify a novel technique for performing caudal urethral translocation that effectively corrects vesicovaginal reflux with minimal associated complications. Methods: In vivo experiment and clinical case series. Methods: The experimen...
Laser neoureterocystostomy to treat ectopic ureters. Ureteral ectopia is an uncommon but clinically important congenital abnormality in horses. If left untreated, it can lead to persistent dermatitis, urinary tract infections, and failure to thrive. Surgical correction is necessary, but traditional approaches have produced mixed results with high morbidity. Identification of a minimally invasive, effective technique would significantly improve prognosis. Objective: To describe the procedure and outcomes of cystoscopic guided laser neoureterocystostomy in three fillies. Methods: Case series. Methods: Retrospective review of three cases treated wi...
A Surgical Technique for Removal of Setaria digitata From the Anterior Chamber Under Standing Sedation: Outcomes in 12 Horses. To describe a rapid surgical technique for removal of the intraocular nematode Setaria digitata from the anterior chamber of horses under standing sedation and to report clinical outcomes. Methods: Twelve client-owned horses (2021-2026) presented with a motile intracameral worm. Methods: All surgeries were performed under field conditions using standing sedation (xylazine 1.1 mg kg and butorphanol 0.1 mg kg IV), regional nerve blocks (lidocaine 2%), and topical anesthesia (proparacaine). A 2.8 mm uniplanar oblique (~45°) corneal incision was created ventrolaterally approximately 2â€...
Ultrasound guidance aids in determining the success of equine temporomandibular joint arthrocentesis. The equine temporomandibular joint (TMJ) is divided into two non-communicating joint (discotemporal DTJ and discomandibular DMJ) compartments. Ultrasound has been extensively used as a diagnostic tool in the horse, but previous work has reported that ultrasound-guidance did not improve the success rate of TMJ arthrocentesis. However, this research focused only on the larger, easily accessed, DTJ compartment. However, most of the osseous pathology of the equine TMJ has been reported to be in the smaller DMJ. Unassigned: To determine whether using ultrasound-guidance would reduce the number of a...
Synchronization dynamics between rider and saddle motion across gaits revealed by IMU analysis. Effective rider-horse coordination is essential for performance and welfare, yet objective, field-based quantification of rider-saddle synchronization across gaits remains limited. Objective: To quantify dynamic synchronization between rider motion and saddle motion (as a proxy for horse trunk oscillations) across walk, trot, and canter using a minimal inertial measurement unit (IMU) setup, and to determine whether synchronization differs between rider body segments. Methods: Two experienced riders (8-20 years riding experience) rode their own or familiar warmblood horses (n = 2; age 6-14 year...
Review of articular cartilage repair techniques and their application in the horse. Articular cartilage lesions represent a significant career-limiting problem in athletic horses. A healthy articular cartilage surface is vital for optimal joint function, and defects can result in irreversible degenerative changes. Successful treatment of cartilage lesions remains a long-standing challenge for orthopaedic surgeons, prompting ongoing research into new surgical techniques for their management. This narrative review describes surgical procedures for the treatment of cartilage/osteochondral lesions, as well as the use of the horse as a highly translational preclinical model to hum...
Piezosurgical partial ostectomy of the incisive bone for an ossifying fibroma removal in a 4-year-old Warmblood gelding. Ossifying fibromas are uncommon in horses and complete surgical excision with premaxillectomy, maxillectomy or mandibulectomy is recommended. Piezosurgery has been previously used in equines only in one study. Objective: To report a case of ossifying fibroma treated with piezosurgery and to describe its follow-up. Methods: Clinical case report. Methods: A 4-year-old Zangersheide gelding was presented for a mass occupying the space of tooth 202. Histology confirmed the diagnosis of ossifying fibroma, which was removed by resection of soft tissues and a slice of the premaxilla with a piezotome. ...
Standing NanoNeedle Arthroscopy of the Distal Interphalangeal Joint for Removal of Osteochondral Fragments of Distal P2 and the Extensor Process in a Horse. In horses, standing arthroscopy offers a valuable alternative to general anesthesia for the reduction of anesthetic-associated risks, and provides improved visualization in joints where access is facilitated by weightbearing. These techniques are particularly advantageous for patients with increased anesthetic risk or financial limitations. To the authors' knowledge, the removal of osteochondral fragments from the distal interphalangeal joint in a standing, sedated horse using small-diameter arthroscopic equipment has not been previously reported. Methods: A 7-year-old American Quarter Horse-T...
Macroscopic comparison of open Metzenbaum and ultrasound-guided fasciotomy techniques for surgical treatment of the hindlimb proximal suspensory ligament desmopathy in horses: A cadaveric anatomical study. To macroscopically characterize and compare the open Metzenbaum (FOM) and ultrasound-guided (FUG) plantar fasciotomy techniques for decompression of the hindlimb proximal suspensory ligament (PSL), and to determine whether either approach induces intraligamentous splitting (ILS). Methods: Cadaveric experimental study. Methods: Paired hindlimbs from 10 adult horses with no history of hindlimb lameness. Methods: Each horse contributed one limb to FOM and the contralateral to FUG. All procedures were performed by a single surgeon, and incision measurements were obtained by a blinded examiner. Ski...
Ultrasound-guided intralesional tendon and ligament injections in the horse. To describe principles of ultrasound-guided injection techniques for intralesional delivery of regenerative orthobiologics into equine tendon and ligament core lesions. Unassigned: A university-owned horse and equine cadaver forelimbs. Unassigned: A reproducible protocol for ultrasound-guided injection is demonstrated with the superficial digital flexor tendon used as an example. Following diagnosis of the lesion, the horse should be sedated and the affected limb desensitized with perineural anesthesia. The lesion is identified ultrasonographically in transverse and longitudinal planes, marked...
Prolonged wireless measurement of intragastric pH in foals. The pathogenesis of gastric ulceration is not well understood in foals, and its relationship with gastric acidity requires further investigation. A wireless capsule, designed for intraesophageal pH monitoring in humans, was adapted to measure intragastric pH in adult horses. Objective: To (1) determine the feasibility of wireless intragastric pH measurement in foals; (2) determine capsule attachment duration; and (3) describe the intragastric pH profiles recorded. Methods: Eight healthy foals aged 24-98Â days. Methods: Prospective interventional study. Capsules were attached to the glandular g...
Adjunctive use of Maggot Debridement Therapy in the treatment of equine cutaneous pythiosis: A case report. Equine cutaneous pythiosis, caused by Pythium insidiosum, is a severe disease in tropical and subtropical regions, often leading to progressive granulomatous lesions with poor response to conventional therapies. Standard treatment includes surgical excision and immunotherapy, but recurrence is common, particularly in distal limb lesions. Maggot Debridement Therapy (MDT) with disinfected Lucilia cuprina larvae provides selective debridement, microbial control, and stimulation of granulation, representing a potential adjunctive option. This report describes the successful use of MDT combined wit...
Updates on Diagnosis and Treatment of Guttural Pouch Conditions. The complex anatomy and unique features of the equine guttural pouch create diagnostic and treatment challenges. Novel surgical approaches, as well as transendoscopic devices and medications, have improved the management of guttural pouch conditions, such as mycosis, empyema, tympany, and temporohyoid osteoarthropathy. Guidelines for Streptococcus equi subspecies equi diagnosis and disinfection protocols are strengthened by new evidence for point-of-care polymerase chain reaction, serial sampling for determining carrier status, and evaluation of disinfection techniques.
Manual graphic roadmap for transarterial coil embolization of guttural pouch arteries in horses: A technical note. This technical note describes the use of a manual graphic roadmap (MGR) to assist fluoroscopic guidance during transarterial coil embolization (TACE) for guttural pouch (GP) arterial hemorrhage. Horses underwent MGR-assisted TACE at the Equine Clinic, Free University of Berlin, between 2012 and 2024. Surgery was performed under general anesthesia with fluoroscopic guidance. Following the initial angiogram, a transparent foil was secured to the fluoroscopy monitor, and an assistant traced the vascular anatomy with a waterproof marker to create the MGR, which then served as a guide for catheter ...
3D printed aiming device for equine proximal interphalangeal joint arthrodesis: Ex vivo study. To determine the benefit of using a three-dimensional (3D)-printed titanium aiming device for placing two 5.5-mm transarticular screws during proximal interphalangeal joint (PIPJ) arthrodesis in equine species. Methods: Ex vivo study. Methods: A total of 40 cadaveric forelimbs from adult horses. Methods: A senior surgeon and a first-year resident each performed 20 constructs: 10 using the device and 10 using a freehand technique. Procedure duration and number of intraoperative radiographs were recorded. Final radiographs were evaluated by an ECVS-certified surgeon unaware of treatment group, b...
Confocal laser endomicroscopy: exploring endometrial image quality in relation to the oestrous cycle of mares. Assessment of the endometrium is an essential component of a breeding soundness examination in mares. The current reference standard for evaluating equine endometrial health is histopathological assessment of an endometrial biopsy, however, inconsistencies may arise when a single blinded biopsy is used. Confocal laser endomicroscopy (CLE) is non-invasive and enables real-time in-vivo imaging of the endometrium across multiple locations within the uterine lumen. An initial study revealed variation in CLE image quality between mares. Objective: This study aimed to compare the quality of endometr...
A pilot study to assess feasibility of a computer-assisted surgery system for navigation in the equine cervical spine. To validate the accuracy of the Synaptive Medical computer-assisted surgery (CAS) system for navigation in the equine cervical spine, focusing on anatomical targets that require precise localization. Unassigned: 3 equine cervical spine cadavers were used (C1-T1) for an experimental study design. A custom fiducial array was mounted into the dorsal spinous process of C2, with additional fiducial markers distributed for landmark registration. Four participants with varying surgical expertise used the Synaptive Medical CAS system to navigate 9 radiodense pins into 3 anatomical targets, including t...
Short- and Long-Term Outcomes in Horses Following Laparoscopic Nephrosplenic Space Ablation. Left dorsal displacement of the large colon (LDDLC) is a common cause of colic in horses and it is frequently associated with recurrent episodes, with significant implications for horse management, athletic performance, and owner satisfaction. Laparoscopic nephrosplenic space (NSS) ablation is a preventive surgical technique aimed at reducing recurrence in horses with a history of medically or surgically treated LDDLC. This retrospective study evaluated 48 horses that underwent laparoscopic NSS ablation in two Italian Veterinary Teaching Hospitals between 2016 and 2024. Short-term outcomes, in...
Current and Future Central Nervous System Surgery-Part 1: Cervical Spinal Cord Compression. Ventral cervical stabilization remains the primary surgical approach, in general, for horses with spinal cord compression. Advancements in volumetric imaging offer a more comprehensive understanding of central nervous system dysfunction elucidating that other modes of compression exist. Minimally invasive instrumentation and computer-assisted surgery are expanding therapeutic possibilities for cervical vertebral compressive myelopathy, radiculopathy, vertebral fractures, and intracranial or intraspinal masses. Emerging techniques-such as articular process joint fixation, targeted decompression...
Current and Future Central Nervous System Surgery-Part 2: Radiculopathy, Vertebral Fractures, and Intracranial Surgery. Equine neurosurgery is a challenge for many surgeons, particularly when central nervous system (CNS) disease is not addressed through ventral cervical stabilization, the most performed neurosurgical procedure. Advances in diagnostic imaging, minimally invasive instrumentation, and computer-assisted surgery are expanding therapeutic possibilities beyond cervical vertebral compressive myelopathy, including radiculopathy, vertebral fractures, and intracranial or intraspinal masses. Emerging techniques-such as percutaneous foraminotomy, facet fixation, targeted decompression, novel implant systems...
Laparoscopically assisted cecal cannulation in standing horses. Access to the equine cecum is required for various therapeutic and experimental procedures, including decompression, fluid therapy, and transfaunation. Traditional approaches via laparotomy are highly invasive. This study aimed to describe a minimally invasive, laparoscopically assisted technique for cecal cannulation in standing horses. Unassigned: Seven horses underwent the procedure under sedation and paravertebral anesthesia. Two right flank accesses were created: a 10-mm laparoscopic port for visualization and a 2-cm minilaparotomy for cecal exteriorization. A Foley catheter was inserted ...
Surgical Removal of a Large Maxillary Sinus Mass Containing Three Dental Structures in a Standing Horse. Dental masses such as odontogenic masses, heterotopic polydontia, or ectopic supernumerary teeth have been documented in the equine head. This is the first case report of a large maxillary sinus mass with 3 ectopic teeth in an adult horse. A 14-year-old warmblood gelding was presented for evaluation of chronic right-sided nasal discharge. After imaging exploration, surgery was performed on the standing horse with a conchofrontal sinus trephination and a large maxillary bone (MB) sinusotomy. The examinations revealed a sinusal mass in the right maxillary sinus covered by sinusal mucosa and surr...
Correction: An anatomical study of the subarachnoid space surrounding the trigeminal ganglion in horses-in preparation for a controlled glycerol rhizotomy in equids. [This corrects the article DOI: 10.3389/fvets.2024.1424890.].
Full-laparoscopic nephrosplenic space closure with barbed knotless sutures in horses with left dorsal colon displacement without previous colon repositioning. Nephrosplenic space entrapment (NSE) has reported recurrence rates of 8%‒23%, and closure of the nephrosplenic space (NSS) has been shown to lower the incidence. Described techniques for nephrosplenic space closure (NSC) with concurrent left dorsal displacement (LDD) of the colon at the time of surgery consist of reducing the displaced colon prior to closure. Methods: A retrospective study was performed to evaluate the medical records of horse undergoing NSC between 2017 and 2024. A total of 18 horses with LDD at time of NSC and 21 without displacement at time of NSC were evaluated. Short- a...
Use of a Fogarty balloon catheter for management of distal nasolacrimal duct atresia in a standing sedated horse. A 4-year-old Arabian cross paint mare was referred for evaluation of chronic mucopurulent discharge and epiphora of the left eye. Ophthalmic and radiographic evaluations confirmed distal nasolacrimal duct atresia with absence of the nasolacrimal orifice. Initial minimally invasive treatments, including guidewire-assisted catheterization and diode laser photoablation, were unsuccessful. Definitive treatment was achieved using a Fogarty arterial embolectomy catheter under standing sedation. Controlled balloon inflation and deflation enabled progressive dilation of the obstructed duct, and a surg...
Endoscopically assisted transcutaneous placement of a balloon catheter in the medial guttural pouch compartment of the horse: A surgical approach to local treatment. To describe and report clinical outcomes after transcutaneous guttural pouch (GP) catheterization (TGPC) in standing horses. Methods: Ex vivo study and case series. Methods: One cadaver head, records of 10 normal horses and 14 horses treated with TGPC. Methods: Relevant anatomical landmarks were determined through dissection of one cadaveric specimen and 10 normal radiographic studies. Records of horses diagnosed with empyema or mycosis and treated with standing TGPC were reviewed for complications that occurred during or after the operation. Results: Ex vivo and radiological studies identifie...
Four-step tenoscopic technique to resect a torn proximal manica flexoria while sparing the mesotendons of the deep digital flexor tendon in 30 horses. To describe a modified two-portal tenoscopic technique for proximal manica flexoria (MF) resection designed to preserve the mesotendons (MTs) of the deep digital flexor tendon (DDFT). Methods: Prospective clinical study. Methods: Client-owned horses (n = 30). Methods: MF resection was performed in four steps: (1) Transection of the lateral attachment of the MF to the superficial digital flexor tendon (SDFT), staying abaxial to the lateral MT; (2) transection of the medial attachment of the MF to the SDFT between the flexor tendons from distal to proximal until reaching the level of the med...
Reconstruction of an orbital fracture in a mare using a 3D-printed patient-specific implant. To describe surgical repair of an orbital wall fracture communicating with the caudal maxillary sinus using a three dimensional (3D)-printed, patient-specific implant (PSI). Methods: Case report. Methods: A 25-year-old Haflinger mare (370 kg). Methods: The mare presented with severe chemosis and emphysema of the left upper and lower eyelid of 2-weeks duration due to a fracture of the ventral floor and inner wall of the left orbit that communicated with the caudal maxillary sinus. Computed tomographic (CT) data were used to design a PSI replicating the inner surface of the unfractured orbit. ...
