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.
Sullins KE.Indications for performing orthopedic surgery on the standing horse include inability to tolerate general anesthesia, risk of worsening an injury during recovery from anesthesia, and cost. The surgeon should be aware that performing surgery in the standing horse can be more demanding and require more experience than the same procedures when the time and convenience of general anesthesia are available. Improved sedatives and analgesics have allowed more latitude because the horses now are more tolerant than when older agents were used. Common sense should be applied to each situation before the...
Sullins KE.Common equine upper respiratory conditions are diagnosed via endoscopy. Endoscopic surgery facilitates correction of many conditions without general anesthesia or laryngotomy, reducing the morbidity and cost of the procedures. Modalities of endoscopic surgery include the Nd-YAG laser or electrosurgery, which may be complementary. The least expensive method is electrosurgery, and instruments are available that can be passed through the biopsy channel of the endoscope. Conditions amenable to such procedures include entrapped epiglottis, rostral displacement of the palatopharyngeal arch, pharynge...
Palmer SE.The use of carbon dioxide and Nd:YAG lasers has expanded the capabilities of equine surgeons. These lasers are used to incise, vaporize, and coagulate tissue with minimal hemorrhage and reduced morbidity to the patient. In this article, practical fundamentals of laser surgery are briefly reviewed, and selected standing laser procedures of the head and neck are discussed.
Beard W.Caslick's, episioplasty, urethroplasty, cervical, and rectovestibular laceration repair are, by preference, performed in the standing patient. Normal castration is performed routinely uneventfully in the standing patient. The duration of the procedures and the ease with which they are accomplished in a standing horse of normal temperament make general anesthesia unnecessary. More invasive procedures, such as removal of urinary bladder calculi in male horses or removal of a neoplastic ovary in a mare, can be accomplished in a standing patient but serious consideration should be given to the use...
Seahorn TL, Schumacher J.Chondroid masses were successfully removed from the guttural pouches of 2 horses, using an endoscope, a snare, and a vacuum pump. This technique is an alternative to surgical removal of chondroid masses in patients when basic lavage of the affected guttural pouch is ineffective. Complications were not encountered. Advantages of this snare technique include avoidance of surgery and its potential complications, minimal recovery time, and minimal expense.
Hoskinson JJ, Wooten P, Evans R.Nonsurgical, percutaneous, transvenous removal of a catheter fragment embolus was performed in a 14-day-old Thoroughbred foal. A basket retrieval catheter was introduced into the jugular vein and manipulated under fluoroscopic guidance to remove the fragment from the right side of the heart. Percutaneous retrieval should be considered as an alternative to thoracotomy for retrieval of intracardiac or intravascular foreign bodies.
Tate LP.The advantages and disadvantages of various surgical lasers are discussed. Included are aspects of laser safety, anesthesia and analgesia considerations for laser surgery, and diagnostic considerations. Horses with lesions such as ethmoid hematomas, nasal polyps, and lymphoid masses are ideal candidates for laser treatment. Other conditions that are suitably treated with lasers, such as dorsal displacement of the soft palate and entrapment of the epiglottis, are described.
Baxter GM, Humphries GB.A large abscess in the lateral neck region of a horse was treated with percutaneous drainage. The abscess was localized with ultrasonography and aspirated by use of a 7.7-cm spinal needle. A stainless-steel guide wire was passed through the needle, and tissue dilators were used to enlarge the percutaneous hole. A multiperforated polyvinylchloride catheter that was placed within the abscess cavity permitted aspiration and lavage of the abscess. The abscess resolved over the next 10 days with no complications. Percutaneous abscess drainage is commonly performed in people and may have application...
Stewart RH, Robertson JT.A grade-4 rectal tear in a mare was successfully repaired per rectum, using a surgical stapling device. The mare had only minor postoperative complications. This technique has some advantages over previously described procedures, but should be reserved for use in selected cases.
Doran R, Allen D, Gordon B.Ovarian granulosa theca cell tumours were removed surgically in 10 mares. Stapling instruments were used to facilitate haemostasis of the ovarian pedicle in five out of 10 cases and as a sole method of haemostasis in the remaining five cases. Postoperative haemorrhage from the ovarian pedicle was suspected in only one case. All cases survived long term follow-up from six months to four years. Results from this series of cases indicate that stapling instruments provide a rapid, easy and efficient means of ligating ovarian pedicles when performing ovariectomy in the mare.
Moll HD, Slone DE, Juzwiak JS, Garrett PD.A diagonal paramedian approach to the abdomen was used for unilateral ovariectomy in 15 mares. In each case, surgery was performed for removal of a granulosa cell tumor. All horses recovered from surgery with minimal complications. Surgical exposure of the affected ovary was adequate to allow exteriorization and ligation. Other advantages of this approach were ease of closure and lack of postsurgical complications.
Rigg DL, Reinertson EL, Buttrick ML.Splenectomy was performed electively on 80 ponies, horses, and donkeys for preparation in collecting Babesia antigens. Access to the abdomen was by resection of the sixteenth left rib and incision of the diaphragm. The technique afforded good exposure of the splenic vessels and attachments. Closure was facilitated by preservation of the periosteum of the resected rib. Difficulty was encountered both in surgical technique and postoperative complications in obese animals. The transthoracic approach was found to be a useful technique for equine splenectomy.
Richardson DW.A technique involving internal fixation guided by arthroscopy was used to repair third carpal slab fractures in 23 horses. The technique allowed good reduction and compression of the fractures, with minimal surgical trauma. Ten of 17 horses with a 6-month or longer follow-up have returned to race successfully.
Tate LP, Newman HC, Cullen JM, Sweeney C.Laryngeal surgery in the equine is customarily and routinely performed by means of a ventral laryngotomy incision. Such procedures are usually performed under deep general anesthesia with the horse in dorsal recumbency. The objective of this work was to determine the efficacy of an endoscopic approach coupled to a Nd:YAG laser fiber in performing arytenoidectomy. Arytenoidectomy is commonly indicated in the treatment of arytenoid chondritis and in the failure of prosthetic implantation for left laryngeal hemiplegia. This preliminary study was undertaken to determine the feasibility of the endo...
McIlwraith CW.This paper reviews the current status of diagnostic and surgical arthroscopy in the horse. Arthroscopy has been used as a diagnostic aid since 1974 and is useful for evaluation of abnormalities in synovial membrane and articular cartilage. Surgical arthroscopy is a more recent advance that has replaced conventional arthrotomy in 90 per cent of the author's cases. Clinical conditions currently being treated using arthroscopic techniques rather than arthrotomy include all chip fractures in the carpus, chip fractures of the first phalanx, chronic proliferative synovitis in the fetlock and osteoch...
Valdez H, McMullan WC, Hobson HP, Hanselka DV.A 6-month-old Appaloosa colt had a deviation of the premaxilla and nasal septum as well as a dorsal hump of the nasal bone and maxillomandibular malocclusion. Two surgical procedures were performed 12 weeks apart to correct these anomalies. An intraoral approach and autogenous rib graft were used to correct the malocclusion and deviation of the premaxilla. Osteotomy of the nasal bone and removal of the nasal septum were performed to help correct the deviation and to facilitate free air passage through the nares.
Heinze H.A method of endoscopic examination of the internal genital (pelvic) organs of the mare is described. Special emphasis is placed on the induction of artificial pneumoperitoneum and the installation of an endoscopic peritoneal fistula device for prolonged observation. The potential of pelviscopy in the mare as a diagnostic aid, a new device for research in equine reproduction and as an auxillary aid to teaching is discussed.
Bardhi A, Barbarossa A, Joubert A, Gehring R, Lambertini C, Romagnoli N.Dried blood spot (DBS) sampling has emerged as a promising microsampling technique in biomedical and clinical research, offering advantages such as reduced invasiveness, minimal blood volume requirements, and enhanced analyte stability. Although well established in human medicine for neonatal screening and diagnostic applications, its potential in veterinary pharmacology remains underexplored. This study investigated the feasibility of using DBS samples to quantify anesthetic agents-ketamine and medetomidine in cats and lidocaine in horses-during routine surgical procedures at a veterinary tea...
Sterkenburgh TR, Ordieres-Meré J, Villalba-Diez J.We outlined a monitoring system as a demonstration of the Internet of Medical Things (IoMT) in horses that provided the ability to record aspects of the equine chewing process. Here we take up the idea of a Molograph, which was already proposed in the mechanical form in 1941 by Leue and transferred into today's world. As a substantial practical advantage, the system now involved a non-invasive measurement that was taken in the horse's familiar environment. All patients were fed roughage. In terms of the examination scenario, we focused on the determination of the direction of chewing. The syst...
Foucaud M, Haegeman L, Kadic D, Vinardell T, Mariën T, Declercq J.To describe a direct arthroscopic approach of the distal pouch of the palmar/plantar recess of the fetlock to facilitate fragment removal, highlighting its advantages over previously described arthroscopic methods for the fetlock. Additionally, to evaluate and present a retrospective case series. Methods: Ex vivo and retrospective clinical study. Methods: A total of 25 fetlocks in 23 horses. Methods: A direct approach to the distal pouch of the palmar/plantar recess of the fetlock was developed on five cadaveric limbs. Arthroscopic anatomy and landmarks were examined. The approach was clinical...
Garcia-Collao MR, Curtiss AL, Hogan PM.To describe the outcomes of arthroscopic debridement of third carpal bone (C3) incomplete slab fractures (ISF) in racehorses. Methods: Retrospective case study. Methods: Horses undergoing arthroscopic debridement of ISF of C3. Methods: The medical records of horses surgically treated for ISF of C3 were reviewed. Age, sex, breed, limb, fracture configuration, preoperative radiographs, arthroscopic findings, postoperative intraarticular therapies, and exercise recommendations were recorded. Racing performance was obtained from online databases. Univariable analyses were used to determine associa...
Sanchez-Arjona R, Lopez Cruz C, Hague BA, Jayawickrama J, Kamm JL.To evaluate the outcomes of diode laser-facilitated (DLF) ankylosis using different surgical techniques to treat distal tarsal osteoarthritis (OA) in horses. Methods: Retrospective cohort study. Methods: A total of 64 client-owned horses with distal tarsal OA treated with DLF ankylosis between 2011 and 2021 in a referral hospital were included. Methods: DLF ankylosis techniques included: intra-articular diode laser (L), diode laser with periarticular drilling (L + D) and diode laser with cuboidal bone fenestration (L + F). Horses requiring a second surgery formed a fourth group (T). Ou...
Agrícola R, Ribeiro G, Borges J, Carvalho L, Roquet I, Carvalho LM, Prazeres J.Duodenal pathologies are underreported in equine medicine, probably not due to little occurrence, but due to the limitations of current diagnostic techniques. The aim of this report is to describe a novel duodenoscopic approach, that allows a complete visualization of a region inaccessible via standard techniques. Gastroduodenoscopy was performed in a clinical setting in 60 adult horses referred to us due to complaints suspected to be related to gastroduodenal diseases. The initial steps of the procedure were performed using previously published techniques. Once the video-endoscope reached the...
Wenzel CJ, Mochal-King CA, Eddy AL, Bowser JE, Wills RW, Jumper WI, Claude A, Swiderski CE.The aim of this retrospective clinical study was to assess surgical duration and surgical and post-operative complications associated with Video-Assisted Thoracoscopic Surgery (VATS) and lung biopsy in horses with severe Equine Pasture Asthma (EPA) and paired control horses. Twelve horses (6 EPA-affected, 6 control) were sex, age and breed matched. Twenty-four thoracic surgeries were performed. Surgery of each matched pair (EPA-affected and healthy) was performed during asthma exacerbation (summer) and remission (winter). Surgical times were shorter with uncomplicated thoracoscopy (85 min) and...
Bourassi S, Jack H, Florczyk A.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...
Carvalho BVL, de Souza MCN, Avanza MFB, Teixeira RBC, Silva JRB, da Silva Cardoso T, Novais LGES, de Oliveira Monteiro FD, Viana RB, Monteiro BM....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 ...
Mählmann K, Lischer CJ.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 ...
Aimonetti E, Genton M, Lischer CJ, Rossignol F.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...
Hodgson E, Romano TR, Stewart A, Bond S, Wise J.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 24-98 days. Methods: Prospective interventional study. Capsules were attached to the glandular g...
Cerullo A, Scilimati N, Di Nicola MR, Colla L, Mazza S, Bertoletti A, Nannarone S, Gialletti R.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...
Dillmann JB, Dos Santos TS, Dos Santos RC, Monteiro SG.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...
Amari M, Brioschi FA, Auletta L, Ravasio G.Radiofrequency ablation (RFA) and pulsed radiofrequency (PRF) are non-pharmacological techniques employed in humans for chronic pain, but their veterinary application is unexplored. This pilot study evaluated clinical effects of RFA and PRF in twenty-four horses with chronic distal forelimb lameness. Ultrasound-guided RFA (N = 8; 60-90 °C, 2-8 min) or PRF (N = 16; 42 °C; 12 min) was applied to palmar digital nerves. Lameness was scored (American Association of Equine Practitioners scale) at baseline and monthly for six months (T1-T6). At T2, partial- and non-responders in both groups receive...
Muñoz AM, Cribb N.Minimally invasive laparoscopic surgical techniques are desirable in horses and other equids. A new approach called "modified single incision laparoscopic surgery (SILS) for equine cryptorchidectomy" is described, along with the postoperative outcomes of 10 equids. A SILS Port device (Covidien) was placed a 30- to 40-millimeter incision in combination with 1 or 2 15-millimeter para-inguinal incisions to exteriorize the intra-abdominal testicles. Ten animals, 2 bilateral abdominal cryptorchid horses and 8 unilateral abdominal cryptorchid equids, underwent cryptorchidectomy using the SILS tech...
Marques GF, Moorman VJ, Ellis KL, Perlini M, Edwards VL.To describe the long-term outcome of a horse that underwent a standing, ultrasound-guided, minimally invasive, biceps brachii tenotomy. Methods: Case report. Methods: A 17-year-old Tennessee Walking Horse gelding. Methods: The horse had a chronic, severe, lameness localized to the left shoulder region. Diagnostic imaging revealed fractures of the intermediate and lesser tubercles of the left humerus, biceps brachii (BB) tendinopathy, and bicipital bursitis. Conservative management was attempted, but lack of improvement prompted surgical intervention. An ultrasound-guided, minimally invasive, B...
Freeman DE, Smith B, Bauck AG, Denagamage T, Moyer EK, Chanutin S.To develop a modified stapled (MS) jejunocecostomy (JC) in healthy horses. Methods: In vivo experimental study. Methods: Six healthy adult horses underwent ventral midline celiotomy, a jejunal resection, and an MS. Methods: Time to complete anastomosis and anastomotic length at necropsy were recorded. Horses were assessed by physical examination every 6 h for 5 days after surgery, then once daily until euthanasia at 7 days. A group of seven horses that had a stapled side-to-side JC and were euthanized 28 days postoperatively was used as an historical control (SS). Results: All MS horse...
Nocera I, Moroni R, Fanelli D, Rota A, Di Franco C, Ungari C, Puccinelli C, Gandini M, Giusto G, Vannozzi I.Over the years, various diagnostic and surgical techniques have been developed to recognise and treat cryptorchidism in equid. This study retrospectively analysed cases of cryptorchidism referred to two centres between 2012 and 2025. Clinical data collected included species, breed, age, gender, location of retained testis, diagnostic approach, anaesthesia plan and surgical treatment, perioperative medical treatment, intra-operative complications and outcomes. A total of 37 clinical cases were included, 1/37 was a donkey and 1/37 was an intersex female. Most of the horses were three years old a...
Gernhardt J, Böttcher P, Eule JC, Mählmann K, Müller E, Lischer CJ.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. ...
Miguel EL, Carneiro MFL, Griffo ALC, Baatsch Nascimento F, Dória RGS, Corrêa RR, Celeghini ECC.Vaginal varicosities in mares are rarely reported, although considered relatively common. Clinical recognition can be challenging, especially during early pregnancy, due to the intermittent nature of the bleeding. This report aims to describe the diagnostic approach, clinical evolution, and treatment of a case of vaginal varicosity in a pregnant mare, emphasizing a practical and minimally invasive method. A 9-year-old Brazilian Sport Horse mare with intermittent vaginal hemorrhage underwent clinical evaluation, showing no abnormalities. Vaginoscopy with a rigid endoscope revealed varicose vein...
Racine J, Ungermann A, Blatter M, von Plato G, Rijkenhuizen ABM.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...
Lepage H, de Chaisemartin C, Spadaro Rosselo A, Leroy H, Lepage O.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...
Willems T, Dias ABM, Dedecker L, Matamalas SS, De Lange L, de Beauregard T.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...
de Chaisemartin C, Belluco S, Nottrott K.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...
Nelson BB, Easley JT.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...
Beggan CP, Panizzi L, Oliver LJ.To measure microsphere recovery following needle-through-and-through lavage (NTAT) of the metacarpo-/metatarsophalangeal joint (fetlock) and digital flexor tendon sheath (DFTS) compared to endoscopic lavage (EL). Methods: Ex vivo experimental study. Methods: Adult equine cadavers immediately following euthanasia (n = 10). Methods: Colored 15 μm microspheres (2 million) were injected into fetlock joints and DFTS. Synovial structures were assigned to NTAT or EL groups. Each lavage was performed using 5 L of 0.9% NaCl, sequentially collecting egress fluid for microsphere quantification. Re...
Wood AD, Parker RA.To describe a tenoscopically guided technique for desmotomy of the proximal digital annular ligament (PDAL). Methods: Ex vivo study and clinical case series. Methods: A total of 10 normal cadaver equine hindlimbs and five clinical cases of PDAL desmitis. Methods: The digital flexor tendon sheath (DFTS) was approached via a lateral basisesamoid portal and a palmar/plantar annular ligament (PAL) desmotomy was performed to improve maneuverability in the DFTS. Additional proximolateral and distal midline instrument portals were created to facilitate transection of the proximolateral attachment, th...
García-López JM.Intrathecal and intrasynovial tendon and ligament injuries can result in extrusion of tendon/ligament fibers, granuloma, and adhesion formation that not only impairs healing of the original injury but can create new injuries that negatively affect adequate healing and return to athletic work. In these cases, endoscopic evaluation and debridement, not only of the lesion, but also any other secondary injury present, can enhance the healing of the tendon or ligament and improve the athletic prognosis. Careful planning of the approach, positioning, instrumentation, and thorough knowledge of the an...