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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.
Maggot debridement therapy for laminitis. Maggot debridement therapy is a nontraumatic, minimally invasive method to treat infections in a foot compromised by chronic laminitis. A mechanical strategy must first be in place to address the instability of the distal phalanx and hoof capsule. Adverse reactions to maggot debridement therapy are uncommon and the only side effect observed has been irritation or hypersensitivity at the site. Chronic laminitic cases of sepsis/necrosis within the hoof benefit from this procedure due to the noninvasive, continuous debridement and healing properties provided by the larvae.
Evaluation of a transvaginal laparoscopic natural orifice transluminal endoscopic surgery approach to the abdomen of mares. To report natural orifice transluminal endoscopic surgery (NOTES) using laparoscopic and endoscopic instrumentation transvaginally into the mare's abdomen and identify structures visible using this approach. Methods: Descriptive experimental study. Methods: Mares (n=8). Methods: A standing, transvaginal approach was made in the cranial vaginal vault at either the 1 (right; 4 mares) or 11 (left; 4 mares) o'clock position relative to the cervix. The abdomen was visually explored and the viscera evaluated using a 2 m flexible endoscope followed by a 62 cm laparoscope. Incisional healing was monit...
Use of a pinless external fixator for unilateral mandibular fracture repair in nine equids. To report use of a pinless external fixator (PEF) for unilateral mandibular fractures in 9 equids. Methods: Case series. Methods: Equids (n=9) with unilateral mandibular fractures. Methods: All fractures were stabilized with the AO/ASIF PEF using a minimum of 4 clamps, under general anesthesia. Fracture configuration, complications, outcome, and owner satisfaction were evaluated. Results: All fractures were stabilized; 2 equids were euthanatized; 1 because of an inability to stand after surgery and 1 because of owner decision after PEF dislodgement. Seven repairs healed with good outcome and o...
Standing laparoscopic ovariectomy technique with intraabdominal dissection for removal of large pathologic ovaries in mares. To describe a standing laparoscopic ovariectomy technique with intraabdominal ovarian dissection inside a specimen retrieval bag for removal of large pathologic ovaries through small incisions. Methods: Case series. Methods: Mares (n=43) aged 2-21 years and weighing 380-680 kg. Methods: Unilateral laparoscopic ovariectomy was performed on 43 standing sedated mares. Ovaries were approached via 3 portal sites, 2 in the paralumbar fossa and a 3rd between the 17th and 18th ribs on the ipsilateral side. Ovaries were dissected free using either a LiNA Tripol-bipolar laparoscopic forceps or a Ligasur...
Debridement of cartilage lesions before autologous chondrocyte implantation by open or transarthroscopic techniques: a comparative study using post-mortem materials. We compared the quality of debridement of chondral lesions performed by four arthroscopic (SH, shaver; CU, curette; SHCU, shaver and curette; BP, bipolar electrodes) and one open technique (OPEN, scalpel and curette) which are used prior to autologous chondrocyte implantation (ACI). The ex vivo simulation of all five techniques was carried out on six juvenile equine stifle joints. The OPEN, SH and SHCU techniques were tested on knees harvested from six adult human cadavers. The most vertical walls with the least adjacent damage to cartilage were obtained with the OPEN technique. The CU and SHC...
Evaluation of a motorized morcellator for laparoscopic removal of granulosa-theca cell tumors in standing mares. To describe a motorized morcellator technique for laparoscopic removal of granulosa-theca cell tumors (GCT) in standing mares and to evaluate long-term outcome. Methods: Case series. Methods: Mares (n=7) aged 4-15 years, with unilateral GCT. Methods: Tumor size was determined by transrectal palpation and ultrasonography. Standing sedated mares had 3 laparoscopic portal sites in the paralumbar fossa. After laparoscopic observation of the GCT, the mesovarium was desensitized, the ovarian pedicle transected with a LigaSure device, and the ovary grasped with forceps and cut in cylindrical tissue b...
Laparoscopic removal of a large abdominal testicular teratoma in a standing horse. To describe laparoscopic removal of a large testicular teratoma in a standing horse. Methods: Clinical report. Methods: Thoroughbred horse (11 months) with a testicular teratoma. Methods: A unilateral cryptorchid testicle could not be removed by an inguinal approach under general anesthesia because of it s large size. After recovery from general anesthesia, ultrasound evaluation revealed a 24 x 19 cm fluid-filled testicular mass. The mass was removed by paralumbar fossa laparoscopy with the horse in a standing position. After fluid aspiration of the mass, the mesorchium and ductus deferens wer...
A technique for laser-facilitated equine pastern arthrodesis using parallel screws inserted in lag fashion. To report a technique for laser-facilitated, minimally invasive proximal interphalangeal joint (PIJ) arthrodesis in horses. Methods: Case series. Methods: Horses (n=6); 5 thoracic and 2 pelvic limb PIJ. Methods: PIJ osteoarthritis (OA) diagnosis was confirmed by radiography. A diode laser was used to apply 2000 J of energy to the joint followed by insertion of 3 parallel 5.5 mm screws in lag fashion through stab incisions to achieve PIJ arthrodesis. After anesthetic recovery, limbs were maintained in bandages (n=2) or bandage casts (5) for 3 weeks. Horses were allowed exercise or turnout by 3 ...
Modified tenoscopic method for carpal flexor retinaculum release in a horse. To report the use of a proximolateral endoscopic portal with a distolateral instrument portal for carpal retinaculum release in a horse clinically affected with carpal canal syndrome. Methods: Clinical report. Methods: A 4-year-old Thoroughbred female. Methods: Carpal canal syndrome secondary to traumatic suppurative tenosynovitis was treated by accessory carpal bone debridement and carpal retinaculum release using a tenoscopic approach to the carpal flexor synovial sheath through a proximolateral endoscope portal and a distolateral instrument portal. Results: Resolution of carpal sheath effus...
A non-invasive technique for standing surgical repair of urinary bladder rupture in a post-partum mare: a case report. An 11-year-old mare presented 36 hours after foaling with a ruptured bladder. Uroperitoneum was diagnosed on ultrasound and from the creatinine concentration of the peritoneal fluid. Bladder endoscopy demonstrated tissue necrosis and a rent in the dorsocranial aspect of the bladder. Following stabilisation, including abdominal drainage and lavage, the mare was taken to standing surgery. Under continuous sedation and epidural anaesthesia, and after surgical preparation, a Balfour retractor was placed in the vagina. Using sterile lubricant and moderate force, it was possible to insert a hand int...
Abdominal wall reconstruction using biological tissue grafts. Synthetic mesh products have been used to repair abdominal wall defects (eg, hernias) for many years. Biological mesh products are now available as an option when synthetic mesh products are not appropriate. To correctly prepare biological tissue grafts for use in the OR, perioperative nurses must understand the types of grafts available. Biological tissue grafts may be harvested from human, porcine, bovine, or equine hosts and from skin, pericardium, or small intestine submucosa.
A description of the relationship between the nasomaxillary aperture and the paranasal sinus system of horses. Disease of the paranasal sinuses of the horse is common and treatment often involves lavage and sometimes surgery. The development of minimally-invasive, sinus-specific treatments, such as balloon sinuplasty, requires a thorough understanding of this complex anatomical region. To improve this understanding, 10 heads from dead horses of various ages were grossly dissected. The heads were transected sagittally and each half was dissected to expose the left and right nasomaxillary apertures and associated structures which were then photographed and measured. Entrances from the rostral and caudal ...
Laparoscopic mesh incisional hernioplasty in five horses. To report a technique for incisional hernioplasty in horses using laparoscopic placement of a prosthetic mesh. Methods: Case series. Methods: Horses (n=5) with ventral median abdominal incisional hernia. Methods: A telescope and 2 instrument portals were established bilaterally, lateral to and distant from the hernia margins. After exposure of the internal rectus sheath by removal of retroperitoneal fat with endoscopic scissors and monopolar cautery, a prosthetic mesh was introduced into the abdomen and secured intraperitoneally using transfascial sutures with or without supplemental endoscopi...
A limited surgical approach for pastern arthrodesis in horses with severe osteoarthritis. Osteoarthritis of the proximal interphalangeal joint (PIPJ) is a common cause of chronic lameness in the horse that requires surgical arthrodesis when medical management is no longer able to alleviate pain. Surgical principles for successful PIPJ arthrodesis include articular cartilage debridement and rigid fixation. To completely debride articular cartilage, the collateral ligaments and extensor tendon are transected, disarticulating the joint. The purpose of this study was to demonstrate that in chronically lame horses with periarticular new-bone formation and osteoarthritis, successful arth...
Bilateral sinus cysts in a filly treated by endoscopic sinus surgery. Bilateral cysts in the frontal and caudal maxillary sinuses in a filly treated by endoscopic sinus surgery (sinoscopy) and triangulation technique are described. Sinoscopy has the advantage of being a minimally invasive technique and permits a complete inspection of the frontal and maxillary sinuses, which is not possible through flap sinusotomy. Des kystes bilatéraux dans les sinus maxillaires frontal et caudal chez une pouliche traitée par une chirurgie endoscopique des sinus (sinoscopie) et une technique de triangulation sont décrits. La sinoscopie possède l’avantage d’être une te...
Complications of laparoscopic surgery. This article describes surgical complications associated with laparoscopy, how to avoid them, how to recognize them if they do happen, and how to deal with them in the most expedient method possible. Complications of sedation, anesthesia, positioning, the general surgical approach, and complications associated with specific surgical procedures are examined. The best defense against surgical complications is a thorough training program and an understanding of anatomy that will help the surgeon work in the three-dimensional environment while being limited to two dimensions on the monitor. The au...
Unilateral and bilateral laparoscopic ovariectomy of mares by electrocautery. Twelve horses underwent standing laparoscopic ovariectomy using electrocoagulation and fine dissection as the only means of achieving haemostasis of the severed ovarian pedicle. Four mares had bilateral ovariectomy performed as a treatment for aggressive behaviour thought to be associated with the oestrous cycle. Eight mares had unilateral ovariectomy performed for removal of a granulosa thecal cell tumour (GCT). Electrocoagulation provided an effective means of haemostasis in both normal and pathological ovaries. Only one case (removal of a GCT) had mild haemorrhage following electrocoagulati...
Use of intralesional formalin administration for treatment of a subepiglottic cyst in a horse. A 4-year-old horse was evaluated for chronic coughing, mucopurulent nasal discharge, and failure to thrive. Results: Endoscopy was performed on the larynx, pharynx, and trachea and revealed an approximately 2-cm fluctuant subepiglottic cyst. Results: The subepiglottic cyst was treated with intralesional formalin administration. Following 2 injections, 2 weeks apart, the cyst was completely resolved with no evidence of scarring or epiglottic deformity. Conclusions: Findings suggest that intralesional formalin administration for treatment of subepiglottic cysts may be a minimally invasive, econo...
Percutaneous endovascular retrieval of an intravascular foreign body in five dogs, a goat, and a horse. CASE DESCRIPTION-5 Dogs, 1 goat, and 1 horse underwent percutaneous endovascular retrieval of intravascular foreign bodies between 2002 and 2007. CLINICAL FINDINGS-Foreign bodies were IV catheters in 4 dogs, the horse, and the goat and a piece of a balloon valvuloplasty catheter in 1 dog. Location of the foreign bodies included the main pulmonary artery (1 dog), a branch of a pulmonary artery (4 dogs), the right ventricle (the goat), and a jugular vein (the horse). TREATMENT AND OUTCOME-The procedure of percutaneous endovascular retrieval of the foreign body was easy to perform in all instance...
Evaluation of a thoracoscopic technique using ligating loops to obtain large lung biopsies in standing healthy and heaves-affected horses. To evaluate use of pre-tied ligating loop to perform thoracoscopic, large lung biopsy in normal and heaves-affected horses. Methods: Prospective clinical study. Methods: Normal (n=5) and heaves-affected (n=6) horses. Methods: Lung biopsies, 1 from each hemithorax, were collected thoracoscopically using a pre-tied ligating loop. Horses were either normal (C) or heaves-affected with the latter being in remission (Ha) for the initial biopsy and in exacerbation (Hs) for the 2nd biopsy. Clinical variables, PaO(2), and PaCO(2) were used to determine the effect of surgical biopsy. Postoperative pneum...
Less invasive techniques for equine fracture repair and arthrodesis. To repair equine fractures successfully, surgeons traditionally have done aggressive open approaches with maximal internal fixation to achieve adequate stability and comfort. Although the need for stability is unquestionable, newer technologies and imaging modalities have allowed improvement in the biology of internal fixation in selected fractures and arthrodeses.
Intracorporeal suture closure of the internal inguinal and vaginal rings in foals and horses. To report a technique for repair or prevention of inguinal hernia in horses using intracorporeal suture closure of the internal inguinal and vaginal rings. Methods: Case series. Methods: Foals (n=6) and geldings (n=2). Methods: After selection of a peri-umbilical telescope portal, instrument portals were made unilaterally or bilaterally, as needed. Herniated viscera was reduced, castration (foals) or spermatic cord remnant transection at the internal inguinal ring (adults) performed, and then simple interrupted intracorporeal sutures of synthetic absorbable suture material were used to close t...
Left- and right-sided laparoscopic-assisted nephrectomy in standing horses with unilateral renal disease. To describe a technique for, and outcome after, left- or right-sided laparoscopic-assisted nephrectomy in standing horses with unilateral renal disease. Methods: Clinical report. Methods: Horses (n=3) with unilateral renal disease. Methods: Horses were sedated with detomidine (0.01 mg/kg intravenously [IV]) and levomethadone (0.05 mg/kg IV). Paravertebral anesthesia and infiltration-anesthesia with 2% lidocaine were used to create a surgical field incorporating the 17th intercostal space and paralumbar fossa. Two separate, ipsilateral portals and a mini-laparotomy were used. The perirenal peri...
Laparoscopic hernioplasty in recumbent horses using transposition of a peritoneal flap. To evaluate the efficacy of a laparoscopic peritoneal flap hernioplasty (PFH) to close anatomically the vaginal ring and to evaluate its protective effect in horses with a history of strangulated inguinal hernia (SIH) against future herniation. Methods: Prospective study. Methods: A first group of 5 ponies, 3 horses and 1 donkey with no history of SIH and a second group of 4 horses 'clinical cases' with a history of SIH. Methods: A laparoscopic PFH was effected on all horses under general anaesthesia. Peritoneum ventro-lateral to the vaginal ring was elevated and cut on 3 sides, separated from...
Standing enucleation in the horse: a report of 5 cases. Enucleation was performed in 5 horses under local anesthesia and sedation with the horse standing. Minimal hemorrhage occurred during the surgical procedure, and there were no other reported complications. Standing enucleation is a surgery that is safe to perform in horses. L’énucléation a été réalisée chez 5 chevaux en position debout sous anesthésie locale et sédation. Une hémorragie minime est survenue pendant la procédure chirurgicale et il n’y a pas eu de complications rapportées. L’énucléation debout est une chirurgie sécuritaire chez le cheval. (Traduit par Docteur ...
