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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.
Prolonged wireless measurement of intragastric pH and pharmacodynamics of extended-release injectable omeprazole in horses. Adaptation of wireless capsules for intragastric pH measurement in horses has a short, variable attachment duration. Prolonged measurement is important for pharmacodynamic studies. Extended-release injectable omeprazole (ERIO) induces acid suppression for ≤ 7 days. Five-day dosing intervals are now recommended for improved healing rates. Objective: To (1) optimize the methodology to achieve 5-7 days of capsule attachment; (2) determine whether capsules can detect a treatment effect of ERIO; and (3) describe the pharmacodynamics of ERIO. Methods: Twelve healthy adult horses. Methods: Caps...
Treatment of a concealed accessory pathway by radiofrequency catheter ablation in a horse. Accessory pathways (APs) are myocardial bundles directly connecting the atria and the ventricles, bypassing the atrioventricular node-His-Purkinje system. Retrograde AP conduction in horses can result in orthodromic atrioventricular re-entry tachycardia or bradycardia. Radiofrequency catheter ablation (RFCA) can provide a permanent treatment by eliminating the retrograde conducting AP, but was previously unsuccessful in one case. Objective: To report the use of three-dimensional electro-anatomical mapping (3D EAM) to identify a concealed AP and treatment by RFCA in a horse. Methods: Retrospect...
Case Report: Diode laser fenestration for treating conchal malformation in a miniature pony. Chronic unilateral nasal discharge in miniature horses is often caused by dental disease, infection, or anatomical abnormalities. Miniature breeds may be predisposed to sino-nasal obstruction due to disproportionately large teeth and retained juvenile cranial features, which can impair sinus drainage. Congenital or developmental sino-nasal malformations are rarely reported in equids. Unassigned: A one-year-old Shetland pony filly presented with an eight-week history of unilateral nasal discharge unresponsive to antimicrobial therapy. Endoscopy revealed a displaced dorsal concha overlapping a h...
Liposomal bupivacaine local analgesia reduces systemic inflammatory responses following equine laparoscopic surgery. Liposomal local anesthetics have been shown to extend analgesia duration and improve pain scores dose-dependently in horses. Our objective was to assess concurrent impact on systemic inflammatory markers. Unassigned: 18 mares (age, 2 to 20 years) with normal ovarian anatomy were enrolled. Laparoscopic bilateral ovariectomies were performed standing with sedation. Local analgesia was: 80 mL bupivacaine hydrochloride (BHCl; n = 6), 30 mL 0.75% BHCl + 20 mL (low-dose) liposomal bupivacaine (LB) expanded to 80 mL with saline (LB20, n = 6), or 30 mL 0.75% BHCl + 40 mL (high-dose) LB expanded to equ...
Diagnostic and Therapeutic Standing Needle Arthroscopy of the Distal Interphalangeal Joint in 36 Horses. The objective of this study is to describe the technique, complications, and outcomes of standing needle arthroscopy of the distal interphalangeal joint (DIPJ) in horses. Unassigned: This is a retrospective study. Unassigned: Five cadaver forelimbs; 36 client-owned horses. Unassigned: A 1.9-mm needle arthroscope was used to evaluate the DIPJ in cadaver limbs and clinical cases. Horses underwent diagnostic and/or therapeutic arthroscopy under standing sedation and local anaesthesia. Data collected included signalment, diagnostic imaging findings, intraoperative findings, complications, and outc...
Comparison of Fogarty and Vollmar thrombectomy for chronic jugular thrombosis in horses. Chronic jugular vein thrombosis may result in persistent venous obstruction and impaired head drainage. Although surgical thrombectomy is performed in selected cases, experimental comparisons between mechanical techniques for chronic thrombus removal in horses are lacking. Objective: To compare Fogarty catheter thrombectomy alone with a combined Vollmar ring-Fogarty technique for restoration and maintenance of luminal patency in experimentally induced chronic jugular thrombosis. Methods: Randomised in vivo study. Methods: Chronic right jugular thrombosis was induced in 10 healthy adult horses....
Core decompression augmented with bone marrow aspirate concentrate for refractory distal sesamoid bone pathology in horses: A retrospective clinical study. To determine short- and long-term outcomes of core decompression combined with autologous bone marrow aspirate concentrate (BMAC) in treating moderate-to-severe refractory distal sesamoid bone (DSB) trabecular pathology in horses. Methods: Retrospective observational study. Methods: A total of 21 client-owned Warmblood horses with DSB pathology unresponsive to conservative management. Methods: Preoperative diagnosis included lameness localization by diagnostic analgesia and magnetic resonance imaging (MRI) confirmation of DSB trabecular pathology. Horses underwent arthroscopic core decompressi...
First experience with radiofrequency catheter ablation in horses with recurrent, persistent naturally occurring atrial fibrillation. Myocardial sleeves in the caudal vena cava and pulmonary veins are a potential trigger for initiation and perpetuation of atrial fibrillation (AF) in horses. Objective: Isolation of myocardial sleeves in the caudal vena cava or pulmonary veins might reduce the risk for AF recurrence. Methods: Case series. Methods: Records from seven horses with persistent, recurrent, naturally-occurring AF that were treated with three-dimensional electro-anatomical mapping and radiofrequency catheter ablation (RFCA) in order to reduce recurrence risk were reviewed. Mapping of the caudal vena cava was performed...
Intratumoral para-toluenesulfonamide as a tumor-ablative therapy for equine cutaneous tumors: a case series of three horses. Equine neoplasia, including sarcoids, melanomas, and squamous cell carcinomas, presents therapeutic challenges due to recurrence and limitations of conventional treatments. Para-toluenesulfonamide (p-TLS) is a tumor-ablating agent that is associated with localized tumor necrosis and subsequent lesion resolution. It has been evaluated in human clinical settings as an intratumoral treatment of malignant airway obstruction caused by non-small cell lung cancer. This study aimed to describe the clinical outcomes and tolerability of intratumoral p-TLS in equine neoplasia. Three equine cases, includi...
Radiation exposure to equine surgeons during simulated digital radiography and fluoroscopy-guided fracture fixation of the distal limb. Despite known occupational radiation risks, data on exposure during digital radiography (DR) or fluoroscopy-guided equine fracture repair are lacking. This study quantified radiation doses to a model surgeon's hand, lenses, thyroid, and gonads, and assessed protective effects of radiation-reducing surgical gloves and attenuating ointment. Methods: Comparative, controlled, simulation-based study. Unassigned: Anthropomorphic model. Methods: Distal limb fracture fixation was simulated using a model with dosimeters at the region of the lenses, thyroid, gonads, drill-holding hand, and under a lead ...
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...
Mitigating and addressing complications in equine laparoscopy. The purpose of this article was to report a condensed overview of current strategies for mitigating and managing complications in equine laparoscopic surgery. Minimally invasive surgical techniques have become standard in equine surgery for a variety of diagnostic and therapeutic procedures, with purported advantages including reduced postoperative pain, expedited recovery, fewer incisional complications, and enhanced visual imagery for the surgeon compared to traditional open approaches. Despite these benefits, complications can arise, and the literature demonstrates variability in definition...
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...
Historical perspectives guide advances in equine minimally invasive soft tissue surgery. Equine minimally invasive soft tissue surgical techniques have increased in demand and frequency with concurrent expansion of training programs under the oversight of the American College of Veterinary Surgeons. Benefits of recent advances in laparoscopic techniques include reduced cost and risk associated with general anesthesia and anesthetic recovery, improved visualization of the surgical field relative to open procedures, and more rapid return to performance, further improving patient welfare and limiting economic loss to the industry following surgical interventions. The evolution of lap...
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...
