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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.
Outcome of arthroscopic debridement for the treatment of incomplete third carpal bone slab fractures in racehorses. 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...
Efficacy of needle and endoscopic lavage on the recuperation of microspheres from the adult equine metacarpo-/metatarsophalangeal joint and digital flexor tendon sheath. 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...
Diagnosis and Minimally Invasive Surgical Treatment for Enhancing Intrathecal/Intrasynovial Tendon Injuries. 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...
Navigated minimally invasive puncture of the trigeminal cistern in horses-a cadaveric study in preparation for a controlled rhizotomy. Trigeminal-mediated headshaking is a neuropathic disorder in horses, characterized by signs of regional pain similar to trigeminal neuralgia in humans. The injection of glycerol into the trigeminal cistern to ablate pain-conducting nerve fibers within the trigeminal ganglion -known as glycerol rhizotomy- is a well-established treatment in human medicine. This study compares two approaches to the equine trigeminal cistern using a navigation system for guiding needle placement, a previously described ventral and a newly developed transmandibular lateral approach. The surgical accuracy and risk o...
Direct arthroscopic approach to the distal pouch of the palmar/plantar recess of the metacarpophalangeal/metatarsophalangeal joint in horses. 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...
Internal fixation of a fractured cranial articular process of the sixth cervical vertebra by means of computer-assisted surgery in a Warmblood gelding. To describe the repair of a fractured cranial articular process (AP) of the sixth cervical vertebra (C6) with cortex screws placed in lag fashion using computer-assisted surgery. Methods: A 12-year-old Swiss Warmblood gelding. Methods: Case report. Methods: The gelding was presented with neck pain and ataxia after a fall. A fracture of the right cranial AP of C6 was identified on radiographs. The fracture was repaired by internal fixation with two 4.5 mm cortex screws of 58 and 48 mm length placed in lag fashion using computer-assisted surgery. Results: During general anesthesia, it was su...
The Suitability of Dried Blood Spot Sampling for Pharmacokinetic Studies in Veterinary Medicine. 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...
Racing and sales performance in Thoroughbred yearlings after carpal osteochondral fragment removal. While radiographically evident carpal osteochondral fragments (COF) in Thoroughbred yearlings impair sales, their impact on future racing performance has been minimally investigated. Objective: To assess the impact of COF on Thoroughbred yearling sales and racing performance, and whether these are improved by arthroscopic removal. We hypothesised that surgical removal of COF improves Thoroughbred yearling sales and racing performance. Methods: Retrospective observational. Methods: Using clinical records from years 2015-2018, 46 Thoroughbred yearlings with COF were identified and allocated to a...
Accuracy of computer-assisted drilling of equine cervical vertebral bodies using a purpose-built cervical frame-An experimental cadaveric study. To assess the accuracy of computer-assisted surgery (CAS) of equine cervical vertebrae using a purpose-built cervical frame (CF) for neck stabilization. Methods: Experimental cadaveric study. Methods: Six whole fresh equine cadavers. Methods: Cadavers were positioned in dorsal recumbency with the neck extended within the CF. A cone-beam computed tomography (CBCT)-based surgical navigation system with optical tracking was used. A ventral approach exposed cervical vertebrae C3-C5. In each cadaver, 12 drill corridors were prepared with the patient tracker on the CF (position CF), followed by 12 c...
INJECTION OF THE INSERTION OF THE COLLARAL LIGAMENT OF THE DISTAL INTERPHALANGEAL JOINT IN STANDING HORSES USING THE PALMAR RADIOGRAPHIC-GUIDED APPROACH. Injury to the collateral ligament (CL) of the distal interphalangeal joint (DIPJ) is recognized as a source of lameness in horses. Intralesional injection has been advocated to increase return to performance. This study was a proof-of-concept study in standing horses to evaluate success of a palmar radiographic-guided approach for injecting insertions of the DIPJ CLs previously described in cadaver limbs. Horses were sedated, nerve blocked, and placed on wooden blocks with the limb to be injected staggered approximately 20cm cranially to the other limb. The DIPJ CL insertion was injected, usin...
Oral Extraction and Nasal Retrieval of a Fragmented Maxillary Fourth Premolar Tooth in a Horse Using Endoscopic Guidance: A Case Report. This case report presents the removal of the left maxillary fourth premolar tooth (208) which had a chronic complicated crown root fracture in a 9-year-old Warmblood mare. Following a 14-month history of malodorous nasal discharge, clinical and radiographic examination allowed the diagnosis of a comminuted crown root fracture of 208 and oronasal fistula. Some root fragments inaccessible for oral extraction were subsequently removed using a transnasal approach through the existing oronasal fistulous tract using bronchoesophageal forceps under endoscopic guidance. The oronasal fistula was surgic...
Molograph 4.0: A demonstration of a non-invasive, automated system for evaluating aspects of the masticatory process in the horse. 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...
Novel Intracardiac Ultrasound Images Developed on a Cardiac Ultrasound Simulator and Validated in Live Horses. Ultrasonographic guidance of catheter-based interventions in horses is based primarily on transthoracic echocardiography (TTE). Intracardiac echocardiography (ICE) has the potential to provide detailed imaging of specific cardiac regions. Insight and training in echocardiographic guidance can be acquired using an echocardiography simulator. Objective: Use an echocardiography simulator for horses to determine specific ICE views for catheter-based interventions and validate these in live horses. Methods: Six adult healthy experimental horses. Methods: Observational study. An echocardiographic ph...
A dorsal ultrasound-guided approach to perineural injection of the sixth and seventh cervical spinal nerves in horses is accurate and does not result in epidural placement. To determine the accuracy of a dorsal ultrasound-guided approach for perineural injection of the sixth and seventh cervical spinal nerves (CSNs) with the use of a clinically relevant volume of injectate (2 mL). We hypothesized that the majority of injections would result in identification of contrast solution in the intervertebral foramen (IVF) on CT and corresponding methylene blue dye staining of the CSN on postmortem evaluation, and distribution of injectate into the epidural space would not occur. Unassigned: 7 horses donated to the University of Pennsylvania New Bolton Center for euthanas...
Gross anatomy, computed tomographic contrast tenography, and needle endoscopy of the equine medial digital flexor tendon sheath. To investigate the computed tomography (CT) and gross anatomy of the equine medial digital flexor tendon sheath (MDFTS), and the endoscopic anatomy and approach to the MDFTS. Methods: Ex vivo experimental study and one clinical case. Methods: Twelve clinically normal cadaveric hindlimbs. Methods: Dissection, native and contrast CT scans were conducted to evaluate the anatomy of the MDFTS. Based on these findings, the portal locations for the endoscopic approaches were determined. Six hindlimbs were used in the pilot phase and another six limbs were selected for the main study. Endoscopic image...
Description of a Modified Two-Step Omphalectomy Technique Using the LigaSure™ Device to Remove the Whole Extrahepatic Umbilical Vein: A Case Series Study in Equine and Donkey Foals. Umbilical disorders are common in equids, although scarce information is available in donkeys compared to horses. Foals with these disturbances have high morbidity and mortality rates. The conventional omphalectomy technique does not remove the whole umbilical vein, which can lead to infection in the remnant vein or even liver abscess. At the moment, if the whole umbilical vein needs to be removed, a longer ventral midline incision must be performed, which is linked with several complications. This retrospective case series study focused on a modified two-step omphalectomy using the LigaSureTM...
Real-time ancillary diagnostics for intraoperative assessment of intestinal viability in horses-looking for answers across species. Clinical intestinal viability assessment is associated with significant limitations, and there is an undisputable need for ancillary diagnostics during colic surgery. Human and companion animal surgeons struggle with similar intraoperative issues, yet there is little exchange between specialists. Therefore, this narrative review aimed to create an overview of real-time ancillary diagnostics with the potential for intraoperative intestinal viability assessment in horses. Most real-time ancillary diagnostics can be classified as either tissue perfusion or oxygenation assessments. Intestinal perf...
Comparison of a dorsolateral approach and a dorsomedial approach to access the medial malleolus of the distal tibia in horses. To determine the utility of a dorsolateral arthroscopic approach to the tarsocrural joint (TCJ) to examine and surgically access the medial malleolus (MM) and compare this to the standard dorsomedial approach to the MM. Methods: Experimental cadaver study. Methods: Six pelvic limbs from four adult horses. Methods: Arthroscopic examination of the dorsal aspect of the TCJ was performed followed by the dorsomedial and dorsolateral surgical approaches to the MM, in randomized order on cadaver limbs (n = 6). The dorsomedial approach involved placing the arthroscope and instrument in the dorsome...
Transvaginal Follicle Aspiration in Mares: A Description of Different Techniques and Comparison of Results Across Different OPU Clinics. This retrospective clinical study describes different techniques for transvaginal follicle aspiration in mares and compares results from 5 different commercial ovum pick-up (OPU) clinics in which the same operator aspirated mares using different systems and equipment: Clinic 1 (n = 42 mares, two-operator OPU technique, double-lumen-echogenic-tip needle, and manual syringe-assisted flushing of follicles), Clinic 2 (n = 28 mares, single-operator-OPU-technique, double-lumen-echogenic-tip needle, infusion pump controlled by foot-pedal for follicle flushing), Clinic 3 (n = 18 mares, sin...
Intranasal Dental Repulsion of a Displaced Cheek Tooth in an Arabian Filly. This case report documents an unusual cheek tooth (CT) displacement in a 3-year-old Arabian filly. The horse was referred to the clinic for loss of appetite and right-sided facial deformity. At admission, an oral inspection was performed, followed by a dental radiographic examination. The radiographs showed a very oblique vertical angulation (135°) of the CT 106 compared to the other premolars (107 and 108 CTs) (40°). In consideration of the clinical and radiographic findings, surgical extraction of the 106 CT was indicated. Due to the unique positioning of the displaced tooth, traditional e...
Tenoscopic-guided resection of the manica flexoria utilizing radiofrequency energy. A proof of concept study. To develop and optimize a tenoscopic technique for resection of the manica flexoria utilizing a radiofrequency probe. Methods: Experimental study. Methods: Eighteen cadaver limbs and two experimental horses. Methods: Tenoscopic-guided resection of the manica flexoria using radiofrequency energy proceeded sequentially by transection of the medial, lateral and proximal borders. The technique was performed in ex vivo limbs and then in vivo to replicate clinical scenarios. Time to complete resection of the manica flexoria (mean ± SD) and complications was recorded. Limbs were dissected and sc...
Needle tenoscopy of the digital flexor tendon sheath in a standing equine cadaver model using a novel approach and guided palmar/plantar annular ligament desmotomy. (1) To evaluate the feasibility of needle tenoscopy of the digital flexor tendon sheath (DFTS) using basisesamoid (BS) and proximolateral (PL) approaches in a standing equine cadaver model. (2) To report visualization of intrathecal DFTS anatomy via both approaches. (3) To determine the efficacy of needle scope-guided palmar/plantar annular ligament (PAL) desmotomy. (4) To report any iatrogenic damage associated with the procedure. Methods: Ex vivo experimental. Methods: Ten equine cadaver limbs. Methods: Limbs were placed in a Kimzey leg-saver splint and needle tenoscopy was performed using t...
Laparoscopic Inguinal Hernioplasty with a Polyether Ether Ketone Anchoring Device in Intact Male Horses Does Not Compromise Testicular Perfusion, Sperm Production or Motility Characteristics. A new surgical technique using a polyether ether ketone (PEEK) anchoring device for testicle-sparing laparoscopic inguinal hernioplasty in stallions was described in 2023 and is known as the PEEK harpoon technique (PHT). In breeding stallions, it is essential that the surgery is effective in preventing inguinal hernia but also that it does not impair the testicular function. This study aims to evaluate whether the PHT may affect testicular function. To achieve that, changes in the testicular blood flow, sperm production and motility characteristics were assessed 28 days after use of the PHT. S...
Complications associated with equine transvaginal ultrasound-guided follicle aspiration: Practitioner survey and field results. Transvaginal ultrasound-guided follicle aspiration (TVA) is being performed commonly in clinical equine practice. There is limited information in the literature about the type and incidence of complications related to TVA. We conducted a survey (Study 1), completed by 23 practicing veterinarians, soliciting information about the types and incidence of minor and major complications and of fatalities they had experienced associated with performance of TVA. In Study 2, data from a large clinical practice in which six veterinarians performed over 14,000 TVAs over a period of 7 years was reviewed t...
Effect of equine transvaginal follicle aspiration on serum concentrations of acute phase proteins and their utility in diagnosis of ovarian abscess. Transvaginal ultrasound-guided follicle aspiration (TVA) is being performed frequently in equine practice, to recover oocytes for in vitro embryo production via intracytoplasmic sperm injection. While complications from TVA are rare, one of the most prevalent major complications is formation of an ovarian abscess, which can result in the necessity for euthanasia. The acute-phase serum proteins, fibrinogen and serum amyloid A (SAA), are markers of inflammation that might be of use in diagnosis of ovarian abscess. However, no information is available on the effect of standard TVA on these acute ...
Ultrasound-guided celiac plexus block increases intestinal motility in normal horses. To describe a technique for ultrasound-guided celiac plexus block in horses and characterize its effect on intestinal motility in healthy horses. Methods: This study was conducted from January 2022 through June 2022. In phase 1 (dye study), an ultrasound-guided technique was optimized, and dye deposition around the celiac plexus branches was evaluated via postmortem dissection in 6 horses. In phase 2 (experimental study), 6 healthy horses were fasted and sedated with 0.6 mg/kg xylazine, IV (experiment 1). After a washout period, the ultrasound-guided celiac plexus block with lidocaine 1% (1.3 ...
Arthroscopic Removal of Traumatic Fractures of the Proximal Medial Trochlear Ridge of the Talus: A Retrospective Analysis of 18 Horses. The objectives of this study were (1) to evaluate the need for flexed radiographs of the proximal medial trochlear ridge (PMTR) after trauma involving medial tarsus; (2) to evaluate outcome following arthroscopic removal of traumatic osteochondral fragments (TOCF) resulting from direct injury to PMTR. Methods: Records of patients with wounds to the medial tarsus were searched and those with TOCF of the PMTR included. Patient history, fracture etiology, preoperative diagnostics, and intraoperative findings were documented. Postoperative performance data were collected using Thoroughbred R...
A novel placement method of a calibration-free pH capsule for continuous wireless measurement of intragastric pH in horses. Current methods to measure intragastric pH in horses have limitations. A wireless capsule has been designed for continuous esophageal pH monitoring in humans. Objective: To (1) determine the feasibility and describe the methodology of measuring intragastric pH wirelessly in horses; and (2) determine attachment duration of the capsules. Methods: Eleven healthy adult horses. Methods: Capsules were attached to squamous and glandular gastric mucosa under gastroscopic guidance, using suture loops and 1 to 4 hemostasis clips. pH was continuously recorded using a wireless recorder in both fed and fas...
Alcohol-based antisepsis without the use of chlorhexidine for arthroscopy in horses. Alcohol-based antisepsis has shown experimentally to be as effective as 4% chlorhexidine gluconate (CHG) at reducing bacterial counts (colony forming units; CFU) on equine skin. Our objectives were to determine the immediate and post-surgical reduction in CFU/mL on equine skin prepared with CHG-based or 70% isopropyl alcohol (IPA)-based (without CHG) protocols in a clinical setting with arthroscopic surgery. Our hypotheses were that the logCFU/mL reduction would not significantly differ between protocols immediately after preparation or at the end of surgery. Six horses underwent a 40 min bila...
How to perform a transtracheal aspirate in horses for diagnosis of lower respiratory tract disease. To describe indications for and demonstrate the technique to perform a transtracheal aspirate in horses. Transtracheal aspirate is indicated to collect samples for cytology and bacteriologic culture in cases of suspected pneumonia or other lower respiratory tract disease. Methods: 1 healthy university-owned horse was used for demonstration purposes. Images of clinical case samples from the University of Illinois Veterinary Teaching Hospital are shown. Methods: The horse is restrained and sedated with detomidine or xylazine to facilitate restraint and butorphanol to minimize coughing. The ventr...
