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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.
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...
Non-invasive scalp recording of electroencephalograms and evoked potentials in unanesthetized horses using a 12-channel active electrode array. Despite the long history of the horse-human bond, our understanding of the brain and mind of horses remains limited due to the lack of methods to investigate their brain functions. This study introduces a novel methodology for completely non-invasive, multi-channel recording of electroencephalography (EEG) and evoked potentials in awake horses to examine equine auditory cortical processing. The new approach utilizes specially designed brush-shaped active electrodes that facilitate stable signal acquisition through the hair coat by penetrating electrode pins and integrated pre-amplifiers. A 12-...
Caudal vena cava isolation using ablation index-guided radiofrequency catheter ablation (CARTO™ 3) to treat sustained atrial tachycardia in horses. Myocardial sleeves of the caudal vena cava are the predilection site for atrial tachycardia (AT) in horses. Caudal vena cava isolation guided by the ablation index, a lesion quality marker incorporating power, duration and contact force, might improve outcome. Objective: Describe the feasibility and outcome of caudal vena cava isolation using ablation index-guided radiofrequency catheter ablation (RFCA) to treat AT in horses. Methods: Ten horses with sustained AT. Methods: Records from 10 horses with sustained AT treated by three-dimensional electro-anatomical mapping and ablation index-guided...
Fenestration of the maxillary septal bulla using different surgical approaches and endoscopy systems in horses: An ex vivo study. Sinusitis is common in horses. Sinoscopy is used for visualization of sinus cavities and can be used for diagnostic and therapeutic purposes. In this surgical procedure, a larger chamber is created and communication with other sinus compartments facilitated. To compare the applicability of different surgical approaches and rigid endoscopy systems for sinus inspection and fenestration of the maxillary septal bulla, and to examine the impact of different lens angles on the effectiveness of the procedure. Six chemically preserved cadaveric equine heads were used. Frontal and caudal maxillary port...
Influence of the Vertek aiming device on the surgical accuracy of computer-assisted drilling of the equine distal sesamoid bone-An experimental cadaveric study. To determine the effect of the Vertek aiming device (VAD) on the surgical accuracy of navigated drilling of the distal sesamoid bone (DSB). Methods: Experimental cadaveric study. Methods: A total of 30 paired equine cadaveric limbs from 15 horses. Methods: Each specimen was placed in a purpose-built frame (PBF). Preoperative cone beam computed tomography (CBCT) images were acquired with an imaging unit coupled with a surgical navigation system. In the DSB of each specimen, a 4.5 mm glide hole and a 3.2 mm thread hole were drilled under navigation guidance, to simulate drilling for the repa...
Lesion size index-guided radiofrequency catheter ablation using an impedance-based three-dimensional mapping system to treat sustained atrial tachycardia in a horse. Sustained atrial tachycardia at an atrial rate of 191/min on the surface ECG was detected in a 6-year-old Warmblood mare. The vectorcardiogram obtained from a 12-lead ECG suggested a caudo-dorsal right atrial origin of the arrhythmia. Impedance-based three-dimensional electro-anatomical mapping, using the EnSite™ Precision Cardiac Mapping System revealed a clockwise macro-reentry around a line of conduction block in the caudomedial right atrium. Ten radiofrequency applications were applied to isolate the caudal vena cava myocardial sleeves at a power of 35 W and mean contact force of 14 ...
Technique description and outcome evaluation of Thoroughbred racehorses following soft palate thermocautery performed under standing sedation. Palatal dysfunction (PD), which encompasses palatal instability (PI) and intermittent dorsal displacement of the soft palate, is the most common performance-limiting upper respiratory tract obstruction in young Thoroughbred racehorses. Soft palate thermocautery (SPT) performed under general anaesthesia is a routinely performed procedure for PD in some countries, but the procedure for and outcome of SPT performed under standing sedation has not been published. (1) To describe a technique for SPT performed under standing sedation; and (2) to assess post-operative performance in horses compared t...
Treatment of a urethral stricture by image-guided placement of a custom-made absorbable stent in a standing, sedated horse. A 10-year-old Irish Sport Horse gelding developed complications from a general anesthesia resulting in sling support and recurrent urinary catheterization. The horse subsequently presented signs of dysuria and pollakiuria, was diagnosed with sabulous cystitis, and developed a urethral stricture from the repeated catheterizations, which was confirmed on urethroscopy. Clinical signs persisted despite conservative management with topical corticosteroids and urethral bougienage with balloon dilators. An image-guided approach was used to treat the stricture with a custom-made polydioxanone stent pl...
Surgical Management of Equine Neoplasia. Equine neoplasia poses challenges in surgical management owing to their diverse locations and potential for aggressive behavior. Surgical interventions aim for complete excision while minimizing cosmetic and functional impairments. Techniques such as laser ablation and electrochemotherapy offer minimally invasive options for accessible tumors. For deeper or larger masses, surgical excision with adequate margins remains the gold standard. Preoperative biopsy and imaging guides surgical planning, ensuring complete tumor removal while preserving vital structures. Close adherence to a strict surgi...
Effect of breed, obturator type and surgical experience on tenoscopic portal creation into the digital flexor tendon sheath in horses. To determine the influence of breed (cob [CB] and non-cob [NC]), obturator type and surgical experience on the number of attempts, time taken and iatrogenic damage (ID) created when entering the digital flexor tendon sheath (DFTS) tenoscopically. Methods: Prospective experimental cadaveric study. Methods: A total of 104 cadaver limbs. Methods: An equal number of randomly selected CB and NC limbs were operated using a conical obturator (OB) or a switching stick (SS) by one boarded (BS) and one resident surgeon (RS). Skin measurements, number of attempts and time taken to enter the DFTS were rec...
Development of an ultrasound-guided radiofrequency ablation technique in the equine cadaveric distal limb: histological findings and potential for treating chronic lameness. Radiofrequency (RF) relieves chronic pain in humans, but it is unexplored in horses affected by chronic lameness. This study aims to describe the technique and the histological effects of ultrasound (US)-guided radiofrequency ablation (RFA) of palmar digital nerves (PDNs) in horse's fetlock and pastern, . Unassigned: After assessing the US anatomy of lateral and medial PDNs in fetlock and pastern ( = 10 horses; 20 forelimbs), US-guided RFA was performed on these sites in cadaveric forelimbs ( = 10) applying four different settings with increasing invasiveness ( = 40 total treatmen...
