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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.
Complications in laparoscopic surgery. As laparoscopic surgery gains popularity, it becomes crucial to understand complications associated with the procedure. The potential complications of laparoscopy include those related to laparoscopy and those related to the surgical procedure. As new applications for laparoscopic surgery emerge, it is important for the surgeon to become familiar with potential complications.
Thoracoscopy in horses. With the recent development of video-assisted thoracic surgery, visual inspection of the thoracic cavity has been used to provide a more accurate diagnosis and prognosis of thoracic diseases and to better manage these diseases. Equipment, techniques, and complications for standing thoracoscopy in horses are described.
Gastrointestinal endoscopic surgery. A working knowledge of normal endoscopic anatomy and the effects of positioning must be mastered to take advantage of endoscopic procedures involving the gastrointestinal system. Endoscopic procedures involving the gastrointestinal system offer advantages over conventional surgery in that they are less invasive and provide direct visualization. Laparoscopy can be used to evaluate horses with abdominal pain before and after surgery. It can be used to evaluate and biopsy abdominal masses and parenchymal organs such as the spleen, liver, and kidney. Endoscopic gastrointestinal surgical procedures...
Standing female equine urogenital endoscopic surgery. Standing female urogenital endoscopic surgery is facilitated by the more dorsal location of the organs of the female reproduction tract. The most common reason for laparoscopic surgery on the female urogenital system is ovariectomy; however, the technique has been used to diagnose periparturient or reproductive diseases and to perform surgical embryo transfer. Standing surgical approaches avoid the risk and expense of general anesthesia, but these techniques are limited by the temperament and size of the patient and the availability of facilities for restraint. Owner acceptance of laparoscopic...
History, instrumentation, and techniques of flexible endoscopic laser surgery in horses. There are clearly a number of applications for which flexible endoscopic laser surgery has become the state of the art in equine surgery, and the Nd:YAG laser seems to be the most versatile instrument for this type of surgery. Nevertheless, it is critical to understand the advantages and disadvantages of each laser technique. For example, the Nd:YAG laser used in a noncontact fashion seems to be superior when ablation of tissue is required such as treatment of upper airway masses. Conversely, contact Nd:YAG laser techniques have proven themselves to be superior when more precise cutting is adv...
Dorsally recumbent urinary endoscopic surgery. Laparoscopic cystotomy is the method of choice for treatment of a cystic calculus in the horse. The main advantage of this procedure over others is the excellent ability to view and gain operative access to the urinary bladder. This article describes the procedure, including techniques, instrumentation, preoperative and postoperative care, and complications.
History and instrumentation of laparoscopic surgery. Equine surgery continues to benefit from advances in endoscopic surgical techniques. Much of what we have learned in equine endoscopy comes from techniques used in humans. Descriptions of the normal anatomy of the standing horse and advances in instrumentation have improved our ability to perform laparoscopic surgery in standing and dorsally recumbent horses. This article describes the history of laparoscopy and available instrumentation.
Dorsally recumbent female equine urogenital endoscopic surgery. The ventral abdominal approach for laparoscopy is versatile. Reported techniques using a ventral approach in the mare include bilateral ovariectomy and granulosa cell tumor removal. Laparoscopic ovariectomy is performed by way of four instrument portals in the caudoventral aspect of the insufflated abdomen. The procedure has several advantages over the traditional approaches of colpotomy and celiotomy, including tension-free closure of all incisions and minimal invasiveness.
Standing male equine urogenital endoscopic surgery. Standing laparoscopy in the horse was used initially as a diagnostic tool to assist in the diagnosis of a cryptorchid testicle. Now, this technique is also used for treatment of cryptorchid testicles. The focus of this article is the standing laparoscopic cryptorchidectomy, the most common laparoscopic procedure performed on the male equine urogenital tract. Advantages, disadvantages, instrumentation, and general procedure are discussed.
Dorsally recumbent male equine urogenital endoscopic surgery. Possibly no other development has revolutionized general surgery more dramatically than laparoscopic surgery in human patients. The development of instrumentation suitable for use in horses has allowed the veterinary surgeon to begin to introduce minimally invasive procedures. Clearly, in people, one of the greatest benefits is reduced patient morbidity and earlier return to function. The author's experience with laparoscopic procedures in the horse would tend to reinforce those observations. The most significant obstacle to widespread acceptance of minimally invasive surgery in the horse is p...
In situ coagulation and transection of the ovarian pedicle: an alternative to laparoscopic ovariectomy in juvenile horses. The feasibility of leaving the ovaries within the peritoneal cavity after laparoscopic coagulation and transection of the ovarian pedicle was assessed in the juvenile horse. Elective ovariectomy was performed on 10 quarter horses, aged 4 to 5 mo, with the fillies in a Trendelenburg position. The mesovarium was isolated, and multiple coagulation and transection cycles were performed until all ovarian attachments had been severed. The ovaries were dropped within the abdomen, and hemostasis of the transected mesovarium was evaluated before closure. The mean surgical time was 33 min (range, 23 to ...
Measurement of respiratory function by impulse oscillometry in horses. Due to technical implementations and lack of sensitivity, pulmonary function tests are seldom used in clinical practice. Impulse oscillometry (IOS) could represent an alternative method. Objective: To define feasibility, methodology and repeatability of IOS, a forced oscillation technique that measures respiratory resistance (Rrs) and reactance (Xrs) from 5 to 35 Hz during spontaneous breathing, in horses. Methods: Using 38 healthy horses, Rrs and Xrs reference values were defined and influence of individual biometrical parameters was investigated. In addition, IOS measurements of 6 horses sho...
Laparoscopic repair of a small intestinal mesenteric rent in a broodmare. To describe standing laparoscopic repair of mesoduodenal rent inaccessible by ventral median celiotomy. Methods: Clinical case report. Methods: A 6-year-old Thoroughbred broodmare with a right displacement of the dorsal colon and small intestinal incarceration in a mesoduodenal rent. Methods: Two days after correction of a right dorsal displacement of the ascending colon, small intestinal incarceration, and partial closure of mesoduodenal rent, standing left and right flank laparoscopy was used to explore the abdomen to identify the mesoduodenal defect. The mesenteric rent was repaired from ri...
Complications associated with cannula insertion techniques used for laparoscopy in standing horses. To report our experience and complications associated with different cannula insertion techniques for laparoscopy in standing horses. Methods: Retrospective study. Methods: Forty horses that had laparoscopy for diagnostic or surgical purposes. Methods: After a physical examination, including rectal palpation, standing laparoscopy was performed in 40 sedated horses. Local anesthetic was injected at each site of cannula insertion in the left flank. Horses were divided into 5 groups: Pneumoperitoneum was induced before cannula insertion using a Verres needle (group 1, n = 3) or a 12-g catheter (g...
[Thermal injury and wound healing of the endometrium subsequent to minimally invasive transendoscopic use of Nd:YAG-laser-and electrosurgery in horses]. Transendoscopic thermal preparation techniques like laser- or electrosurgery have proved to be most reliable for minimal invasive intrauterine surgery during operative hysteroscopy in mares. To determine the effect of Nd:YAG laser surgery on the endometrium and the complete uterine wall compared with electrosurgery, standard lesions were obtained by transendoscopic monopolar electrosurgery (loop electrode, cutting blade) and Nd:YAG laser surgery (contact, bare fibre, 25 Watt, exposure time four seconds, non contact, 80 Watt, exposure time four seconds) in five healthy mares on days d 0, 7, 14,...
Laparoscopic colopexy in a horse. An 11-year-old Trakehner gelding required 2 ventral midline celiotomies for correction of a large colon volvulus and a large colon displacement, respectively. Laparoscopic colopexy was performed 50 days following the 2nd celiotomy. Delayed laparoscopic colopexy is minimally invasive and does not disrupt the ventral midline incision following abdominal exploration.
Tenoscopic release of the equine carpal canal. To develop a tenoscopic method to divide the carpal flexor retinaculum and decompress the carpal canal. Methods: Cadaver specimen study and prospective trial. Methods: Twelve cadaveric limbs, 4 clinically normal horses, and 2 clinically affected horses. Methods-A tenoscopic approach to the proximolateral aspect of the carpal sheath was used to identify and facilitate endoscopic division of the inner and outer layers of the carpal flexor retinaculum in cadaver limbs. The technique was further evaluated in 4 normal and 2 clinically affected horses. Results: Anatomic dissection, intraoperative ob...
Hand-assisted laparoscopic left nephrectomy in standing horses. To describe a hand-assisted, laparoscopic technique to remove the left kidney in standing horses. Methods: Prospective evaluation. Methods: Eight horses. Methods: Food was withheld for a minimum of 12 hours. Horses were sedated with detomidine hydrochloride (0.01-0.02 mg/kg, intravenously) and restrained in standing stocks. The left paralumbar fossa was prepared for surgery, and the surgical site was infiltrated with 2% mepivacaine. Hand-assisted, laparoscopic removal of the left kidney was performed through an incision in the center of the paralumbar fossa; the surgeon's hand was used to isol...
Evaluation of the harmonic scalpel for laparoscopic bilateral ovariectomy in standing horses. To evaluate use of the Harmonic Scalpel (Ethicon Endo-Surgery Inc., Cincinnati, OH) for performing laparoscopic bilateral ovariectomy in standing horses. Methods: Experimental study. Methods: Eight mares aged 2-20 years and weighing 410-540 kg. Methods: Standing laparoscopic bilateral ovariectomy was performed in 8 mares with normal reproductive tract anatomy. The Harmonic Scalpel (an ultrasonically activated instrument) was used to simultaneously transect and obtain hemostasis of the ovarian pedicle. Necropsy was performed on 4 mares 3 days after surgery and 4 mares 30 days after surgery. Gro...
[Experimental studies on the therapy of epiglottis hypoplasia in horses–transendoscopic injection of collagen and polytetrafluoroethylene]. Epiglottic augmentation by transendoscopic injection of an implant material was performed on ten clinically healthy horses. In six cases bovine collagen (Zyplast) was used, in the remaining four horses the injection was done with polytetrafluorethylene (PTFE-Paste). The results of the surgery were observed endoscopically and by contrast radiography. Using the radiographs, epiglottic length and thickness were measured. For necropsy and histologic assessment the horses, three and two animals of the two groups, were euthanized at three and 12 weeks after surgery. The data obtained from the measur...
The use of lasers for treatment of upper respiratory tract disorders. Lasers have become important tools for the equine surgeon in the treatment of upper respiratory tract disease in the horse. Multiple wavelengths and delivery systems are available. Indications for the use of lasers in the upper respiratory tract primarily include minimally invasive procedures not possible with conventional surgical instrumentation. New applications for the use of lasers to treat upper respiratory disease are likely to evolve with the development and introduction of new wavelengths and delivery systems.
Laparoscopic repair of ruptured urinary bladder in a stallion. A 12-year-old stallion was evaluated because of pollakiuria; endoscopy of the urinary tract during general anesthesia revealed that the urinary bladder was intact. After recovery, the stallion developed clinical and biochemical signs of bladder rupture, which was confirmed by endoscopy. Cystoplasty in adult stallions represents a unique surgical dilemma; the large distance between the incision site and the bladder necessitates the repair be accomplished under maximum tension with minimal exposure. Because traditional surgical approaches through ventral midline or paramedian incisions provide l...
Evaluation of a cranial arthroscopic approach to the stifle joint for the treatment of femorotibial joint disease in horses: 23 cases (1998-1999). To describe a single-portal cranial arthroscopic approach to the stifle joint in horses and to determine the clinical outcome in horses with femorotibial joint disease in which this approach was used. Methods: Retrospective study. Methods: 23 adult horses. Methods: Medical records were reviewed to obtain information on clinical outcome in horses in which the single-portal cranial arthroscopic approach was used. Results: Twenty-nine stifle joints of 23 horses were examined arthroscopically, using the described approach. Subchondral bone cysts were treated in 19 medial femoral condyles of 12 hor...
Exercise-induced pulmonary perfusion redistribution in heaves. This study aimed to compare exercise-induced pulmonary perfusion redistribution in healthy vs. 'heavey' horses using scintigraphy, a minimally invasive technique. Six healthy (A) and 5 'heavey' horses in remission (B(I)) and during clinical signs of disease (B(II)) were investigated. Dimensions of the exercising pulmonary perfusion (QE) images were expressed in percent of the resting perfusion (QR) images. Computed QE to QR ratios (QE/QR) images enabled the definition of the region more perfused at exercise than at rest (R1). In all groups, exercise induced a major enlargement of the Q image b...
Safety and efficacy of a technique for thoracoscopically guided pulmonary wedge resection in horses. To evaluate the safety and efficacy of thoracoscopically guided pulmonary wedge resection in horses. Methods: 10 horses (5 control horses and 5 horses affected with recurrent airway obstruction [ie, heaves]). Methods: Each horse underwent a thoracoscopically guided pulmonary wedge resection. Before, during, and after surgery, heart rate, respiratory rate, arterial blood gases, and systemic and pulmonary arterial pressures were measured. Physical examination, CBC, and thoracic radiography and ultrasonography were performed 24 hours before and 2 and 48 hours after surgery. Pulmonary specimens we...
Effect of general anesthesia and minor surgical trauma on urine and serum measurements in horses. To characterize the effect of general anesthesia and minor surgery on renal function in horses. Methods: 9 mares with a mean (+/- SE) age and body weight of 9+/-2 years and 492+/-17 kg, respectively. Methods: The day before anesthesia, urine was collected (catheterization) for 3 hours to quantitate baseline values, and serum biochemical analysis was performed. The following day, xylazine (1.1 mg/kg, IV) was administered, and general anesthesia was induced 5 minutes later with diazepam (0.04 mg/kg, IV) and ketamine (2.2 mg/kg, IV). During 2 hours of anesthesia with isoflurane, Paco2 was maintai...
Endoscopic-assisted disruption of urinary calculi using a holmium:YAG laser in standing horses. To describe a technique for endoscope-assisted disruption and removal of urinary calculi using a holmium:YAG laser in sedated, standing horses. Methods: Retrospective study. Methods: Six horses with urinary calculi. Methods: A holmium:YAG laser was used to disrupt naturally occurring urinary calculi in horses (4 geldings, 1 stallion, 1 mare). Ischial urethrotomy was performed in male horses to provide a portal for the endoscope and laser fiber. Calculus fragments were removed by a combination of lavage, transendoscopic basket snare removal, forceps, and digital manipulation. Ischial urethrotom...
