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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.
A novel strategy of mesenchymal stem cells delivery in the uterus of mares with endometrosis. Mesenchymal stem cells (MSCs), because of their immunomodulation and trophic activities, in addition to their capacity to regenerate damaged tissues, have potential for treatment of many diseases. The success of stem cell therapies depends, in part, on the method of cell delivery, which should provide wide cell distribution and homing in to injured sites. The objective of the present study was to developing a novel strategy for delivery of MSCs into the uterus of mares with endometrosis (degenerative alteration of uterine glands and surrounding stroma). Endometrosis was confirmed in all mares ...
A review of equine laparoscopy. Minimally invasive surgery in the human was first identified in mid 900's. The procedure as is more commonly practiced now was first reported in 1912. There have been many advances and new techniques developed in the past 100 years. Equine laparoscopy, was first reported in the 1970's, and similarly has undergone much transformation in the last 40 years. It is now considered the standard of care in many surgical techniques such as cryptorchidectomy, ovariectomy, nephrosplenic space ablation, standing abdominal exploratory, and many other reproductive surgeries. This manuscript describes the hi...
Minimally invasive repair of a calcaneus fracture in a Standardbred foal. A 4-month-old Standardbred colt was examined because of a fractured right calcaneus of 8 days' duration with increased distraction of the fracture fragment evident on sequential radiographs. Results: The foal was severely lame with diffuse periarticular tarsal swelling. Radiographically, a complete, displaced long oblique fracture of the right calcaneal body was evident. Because the fracture gap was increasing with time and lameness remained severe, despite medical management, surgical repair was recommended. Results: The foal was anesthetized, and minimally invasive fracture reduction and int...
Removal of a nasogastric tube fragment from the stomach of a standing horse. An 82-cm fragment of nasogastric tube was removed from the stomach of an adult horse under standing sedation by use of an endoscope and electrocautery snare. This is the first report of successful non-surgical removal of a nasogastric tube fragment from the stomach of a horse. Un fragment de 82 cm d’un tube naso-gastrique a été enlevé de l’estomac d’un cheval adulte sous sédation se tenant debout en utilisant un endoscope et une anse de galvanocautérisation. Il s’agit du premier rapport de l’enlèvement non chirurgical d’un fragment de tube naso-gastrique de l’estomac d’u...
A controlled study evaluating a novel surgical treatment for kissing spines in standing sedated horses. To compare the results of a novel minimally invasive surgical technique with intralesional corticosteroid medication, as treatment for overriding dorsal spinous processes (ORDSP) in horses. Methods: Retrospective controlled clinical case series. Methods: Horses (n = 68) with ORDSP. Methods: ORDSP was diagnosed based on history, clinical, and radiographic examination. All narrowed spaces were treated. Horses undergoing medical treatment had methylprednisolone acetate injected directly in the affected space under radiographic control. Surgical cases had interspinous ligament desmotomy (ISLD) usi...
Laparoscopic-assisted colpotomy for ovariectomy in the mare. To describe a technique for ovariectomy through a colpotomy using a chain écraseur with laparoscopic guidance and report outcome in 4 mares. Methods: Case series. Methods: After insertion of a laparoscope into the abdomen through the left flank, colpotomy was performed to allow introduction of an écraseur into the caudal aspect of the abdomen. Grasping and removal of the ovary and evaluation of the pedicle was observed via the laparoscope. The laparoscope was then inserted in the right flank for right ovariectomy. The colpotomy was closed in a continuous suture pattern using laparoscopic or ...
Arthroscopic approach to the subextensorius recess of the lateral femorotibial joint of the foal. To (1) develop an arthroscopic approach to the subextensorius recess of the lateral femorotibial (LFT) joint in foals and (2) report its use in foals with LFT joint sepsis. Methods: (1) Anatomic study and (2) retrospective case series. Methods: (1) Cadaveric hind limbs (n = 32 foals) to delineate the anatomy of the subextensorius recess; 13 foal limbs for cadaver surgery to assess the approach to the subextensorius recess; and (2) foals (n = 8) with LFT joint sepsis. Methods: (1) The LFT joint was distended and examined ultrasonographically. Dissection was used to document periarticular landma...
[Diagnostic assessment of peritoneal fluid cytology in horses with abdominal neoplasia]. To evaluate the diagnostic value of peritoneal fluid (PF) cytology for clinical diagnosis of abdominal neoplasia in horses. Methods: Ten horses with histopathologically confirmed abdominal neoplasia, in which a PF analysis was performed, were included in this retrospective study. PF was analyzed for total protein concentration and a nucleated cell count was performed. Using cytological criteria of malignancy, the PF samples were evaluated regarding their probability of malignancy. Results: Cytologic classification of cells according to criteria of malignancy allowed a positive cytologic diagno...
Equine laparoscopy: equipment and basic principles. Laparoscopic techniques for veterinary surgery are growing in popularity for the same reason the use of minimally invasive procedures has increased tremendously in human surgery. Compared with open surgery, the benefits of laparoscopic surgery include smaller incisions, reduced postoperative morbidity and pain, shorter hospitalization, a more rapid return to normal activities, and, in some instances, superior access. Laparoscopic surgery is different from open surgery in equipment/instrumentation and psychomotor skills. This first article in a series on equine laparoscopic surgery introduces t...
Use of a laparoscopic retrieval device for urolith removal through a perineal urethrotomy. To report the use of a laparoscopic retrieval device for removal of uroliths via a perineal urethrotomy. Methods: Case report. Methods: A 12-year-old Konenklijk Warmbloed Paardenstamboek Nederland (KWPN) gelding and a 15-year-old Holsteiner gelding. Methods: Perineal urethrotomy was performed on 2 standing sedated geldings and the urolith was removed using a laparoscopic retrieval device. Results: In both cases, uroliths were removed successfully with no short- or long-term complications. The larger of the 2 uroliths measured 6 cm in length and 4.6 cm in width. Conclusions: Removal of a urolit...
Laparoscopic cryptorchidectomy and ovariectomy in standing horses using the EnSeal® tissue-sealing device. In the present series of cases, 8 laparoscopic cryptorchidectomies and 4 laparoscopic ovariectomies were carried out in sedated standing horses. Sedation involved a lesser anaesthesiological risk than does general anaesthesia. As compared to laparotomic exposure, the minimally invasive laparoscopic intervention provided better visualisation, shorter operative time and faster recovery. The blood vessels supplying the testes and ovaries and the suspensory ligaments of the organs were sealed and cut with EnSeal®, an adaptive bipolar electrosurgical blood vessel- and tissue-sealing device. The cl...
Laparoscopic-assisted cystotomy and cystostomy for treatment of cystic calculus in a gelding. To report laparoscopic-assisted cystotomy and inguinal cystostomy for treating bladder urolithiasis in a gelding. Methods: Clinical report. Methods: Twelve-year-old Appaloosa gelding. Methods: A laparoscopic approach was used to locate and grasp the bladder, which was exteriorized through an enlarged instrument portal for cystotomy to remove the calculus. During withdrawal, the calculus fragmented into multiple pieces. To avoid urethral occlusion and facilitate elimination of these fragments, an inguinal cystostomy was created. The seromuscular layer of the bladder was circumferentially secure...
Trans-arterial coil embolization of the internal carotid artery in standing horses. To develop transarterial coil embolization (TACE) for occlusion of the internal carotid artery (ICA), in normal standing horses, and to evaluate it use for prevention of hemorrhage in horses with guttural pouch mycosis (GPM). Methods: Prospective study. Methods: Normal horses (n = 8) and 5 with GPM. Methods: Horses had TACE of the ICA in standing position under fluoroscopic guidance. Four normal horses were euthanatized 2 weeks after TACE for morphologic assessment and 4 were followed for 6 months. The 5 clinically affected horses were evaluated for long-term (10-12 months) success rate and co...
Unilateral and bilateral laparoscopic ovariectomy in 157 mares: a retrospective multicenter study. To evaluate surgical techniques, perioperative complications and outcome of laparoscopic surgery for unilateral and bilateral ovariectomy in mares. Methods: Retrospective multicenter case series. Methods: Mares (n = 157). Methods: Indications for surgery were neutering, fertility problems, elimination of hormone-related abnormal behavior, ovarian tumors as well as nonregressive ovarian hematomas or cysts. Ovariectomy (n = 206) were performed by a standard laparoscopic procedure in 157 standing sedated mares. Dissection and hemostasis were achieved by using either (1) a linear stapling device, ...
Comparison of transvaginal natural orifice transluminal endoscopic surgery (NOTES®) and laparoscopy for elective bilateral ovariectomy in standing mares. To compare surgical trauma, perioperative pain, surgical time, and complication rate in mares undergoing standing bilateral ovariectomy by natural orifice transluminal endoscopic surgery (NOTES) or laparoscopy. Methods: Experimental study. Methods: Healthy mares (n = 12). Methods: Ovariectomy was performed with a vessel-sealing device by transvaginal NOTES (n = 6) using a flexible endoscope and specialized instruments or by bilateral flank laparoscopy (n = 6). Preoperative and postoperative complete blood count (CBC), plasma fibrinogen concentration, serum amyloid A concentration, peritoneal n...
Use of a suprapatellar pouch portal and laparoscopic cannula for removal of debris or loose fragments following arthroscopy of the femoropatellar joint of 168 horses (245 joints). To validate the safety of a suprapatellar pouch (SPP), approach to the femoropatellar joint (FPJ), and describe use of a laparoscopic cannula to remove debris or loose bodies. Methods: Retrospective case series Methods: Horses (n = 168) with osteochondritis dissecans (OCD) of the FPJ. Methods: Arthroscopy was performed on 245 FPJ with OCD. Two subpatellar portals were created, 1 axial and 1 abaxial to the lateral patellar ligament. Additionally, a SPP egress portal for lavage, was created 2 cm proximal to the most palpable dorsolateral eminence of the patellar base. A 10-mm laparoscopic cannul...
Standing ovariectomy in mares using a transvaginal natural orifice transluminal endoscopic surgery (NOTES®) approach. To develop and assess the feasibility of standing transvaginal Natural Orifice Transluminal Endoscopic Surgery (NOTES®) ovariectomy in the mare. Methods: Descriptive study. Methods: Mares (n=10). Methods: The technique was developed in 6 mares and then evaluated in a short-term study in 4 mares. Abdominal access was developed using controlled access vaginal cannula placement under endoscopic guidance. With viewing provided by a flexible endoscope, hemostasis, and transection of ovarian pedicles was performed using a customized bipolar vessel-sealing device. The ovaries were retrieved and the ...
Characterization of adipose-derived equine and canine mesenchymal stem cells after incubation in agarose-hydrogel. Adult stem cells are of particular interest for the therapeutic approach in the field of regenerative medicine. Due to their ease of harvest, adipose-derived mesenchymal stem cells (ASCs) are an attractive stem cell source that has become increasingly popular. Critical aspects of applied cell therapies are the circumstances of transport from the laboratory towards the site of operation and cell delivery into the desired area. With regard to these issues, agarose-hydrogel was analyzed as a cell carrier matrix of equine and canine ASCs in vitro, which can be used for minimally invasive applicati...
Lumbar ligamentum flavum hematoma treated with endoscopy. Hematoma of the ligamentum flavum is a rare cause of neural compression, for which treatment has consisted of excising the hematoma via open surgical approaches, including total laminectomy or bilateral partial laminectomy. This article presents the first report of a microscope-assisted endoscopic decompression to resect a hematoma of the ligamentum flavum.A 52-year-old man presented with back and leg pain, as well as difficulty initiating micturation. Magnetic resonance imaging demonstrated an epidural mass at L5/S1 that was continuous with the facet joint. Visualization was obtained via an e...
Assessment of a bone biopsy technique for measuring tiludronate in horses: a preliminary study. This study assessed the feasibility of measuring tiludronate in horses using a minimally invasive bone biopsy technique. Eight horses were treated with intravenous (IV) tiludronate [1 mg/kg bodyweight (BW)], either once (n = 4) or twice, 28 d apart (n = 4). The horses that were treated once were euthanized on days 1, 43, 57, or 92 and those that were treated twice, were euthanized on days 112, 154, 194, or 364. Bone samples were taken bilaterally from each horse at 4 sites: the third metacarpal bone (MCIII), the 13th rib (R13), the tuber coxae (TC), and the cuboid bone (CB). Test samples were ...
Evaluation of a minimally invasive arthrodesis technique for the carpometacarpal joint in horses. To evaluate a minimally invasive technique for arthrodesis of the carpometacarpal (CMC) joint in horses. Methods: Experimental study. Methods: Healthy horses (n=6). Methods: A 5.5 mm, 3-drill tract arthrodesis technique was evaluated in 1 randomly selected CMC joint in each of 6 normal horses. Peak vertical ground reaction force (GRF) values were recorded before surgery and at 6, 8, and 12 months thereafter. Radiographic and clinical lameness scores were assigned at regular intervals until 12 months after surgery when the horses were euthanatized. Gross and histologic examinations were perfo...
Assessment of body fat in the pony: part II. Validation of the deuterium oxide dilution technique for the measurement of body fat. Excessive accumulations or depletions of body fat have been associated with increased morbidity and mortality in horses and ponies. An objective, minimally-invasive method to accurately quantify body fat in living animals is required to aid nutritional management and define welfare/performance limits. Objective: To compare deuterium oxide (D(2) O) dilution-derived estimates of total body water (TBW) and body fat with values obtained by 'gold standard' proximate analysis and cadaver dissection. Objective: D(2) O dilution offers a valid method for the determination of TBW and body fat in equids....
Evaluation of ethyl alcohol for use in a minimally invasive technique for equine proximal interphalangeal joint arthrodesis. To determine whether intra-articular 70% ethyl alcohol alone (IAEA) or in combination with 2 percutaneously placed transarticular lag screws (EA-TLS) would result in arthrodesis of the equine proximal interphalangeal (PIP) joint. Methods: Experimental. Methods: Healthy horses (n=6), aged 1.5-3 years, free of lameness, diagonally paired front and hind PIP joints. Methods: Six milliliters 70% ethyl alcohol was injected into randomly selected diagonally paired front and hind PIP joints. Thirty days later, 2 parallel 5.5 mm cortical screws were inserted in lag fashion across the hind PIP joints an...
Standing hand-assisted laparoscopic ovariectomy in 65 mares. To review the efficacy and safety of unilateral ovariectomy by use of a standing hand-assisted laparoscopic approach and evaluate the effect of ovary size on posttransection hemorrhage after application of a linear stapling device. Methods: Case series. Methods: Horses (n=65) aged 2-20 years. Methods: Medical records of mares that had ovariectomy performed by use of a standing hand-assisted laparoscopic approach were reviewed. Data retrieved were signalment, ovary removed (left, right), ovarian size, ovarian pathology, intraoperative and postoperative complications, and length of hospitalizati...
Hand-assisted laparoscopic removal of a nephroblastoma in a horse. A 3-year-old Thoroughbred was presented for evaluation of hematuria post exercise. On physical examination, an enlarged kidney was identified, as well as serum biochemical abnormalities such as an elevated creatine kinase (CK) and hypoalbuminemia. The kidney was removed laparoscopically and a nephroblastoma was identified. Un Thoroughbred âgé de 3 ans est présenté pour évaluation de l’hématurie après l’effort. À l’examen physique, un rein enflé est identifié ainsi que des anomalies biochimiques sériques comme une créatine kinase (CK) élevée et l’hypoalbuminémie. Le rein...
Arthroscopic treatment of fractures of the lateral malleolus of the tibia: 26 cases. A minimally invasive arthroscopic technique for removal of fractures of the lateral malleolus of the tibia is considered to be beneficial but data to this effect are required. Objective: Arthroscopic removal of fractures of the lateral malleolus of the tibia is technically feasible, provides a comprehensive evaluation of the tarsocrural joint and enables removal of remote comminuted fragments and disrupted short collateral ligaments. The technique is associated with low patient morbidity, requires only short periods of hospitalisation and affords a good prognosis to affected horses. Methods: T...
Laparoscopic techniques for investigating the equine oviduct. The diagnostic and therapeutic options for oviduct disorders in the mare are limited. The current best techniques require exploratory surgery under general anaesthesia or flank laparotomy. Objective: The orthograde flushing of the oviduct for diagnostic or therapeutic options is possible using laparoscopic techniques in the standing sedated mare. Methods: Development of a laparoscopic technique for catheterisation of the infundibulum and flushing of the oviduct (sterile methylene blue solution) in the standing sedated mare was examined in 2 experiments. The first involved a transvaginal laparo...
