Laparoscopy in the horse: comparative keyhole surgery.

This research article is about the development and application of laparoscopy in horses, specifically in cryptorchid operations (removal of undescended testes), comparing it to the usage in human medicine and its evolution over the years.

History of Laparoscopy

• Described as keyhole surgery, laparoscopy’s technical development wasn’t perfected until the early 20th century.
• The first use of a laparoscope was demonstrated on a dog by Georg Kelling, and its use was later extended to humans.
• Laparoscopy was primarily used for diagnostic purposes, such as offering a direct view for liver biopsies, and then further extended to gynaecology for sterilisation.

Technological Enhancements and their Impact

• The first computer chip camera in 1985 marked a significant turning point in laparoscopy. It allowed surgeons to view the operative field on a television screen and left their hands free to manage instruments inside the patient’s body.
• A surge in the use of these techniques was led by factors such as public demand for minimal access surgery and financial considerations like equipment manufacturers and surgeons.
• Applications of laparoscopy have spread to diagnosing abdominal pain, appendicectomy, staging laparoscopy for upper GI malignancies, and surgery for inguinal hernia, hiatus hernia, and colonic cancer.

Use in Paediatric Urology and Horses

• In paediatric urology, laparoscopic orchidopexy for patients with nonpalpable testes is highly successful. It is recommended to be performed before the age of 2 in humans to allow normal function of the testicles.
• In horses, laparoscope was first used in 1970 to study ovulation sites and anatomy of reproductive organs.
• Since that time, diagnostic laparoscopy has been used to detect abdominal diseases in horses, enabling a biopsy of liver, kidney, and spleen under direct visual control.

Therapeutic Applications for Equine Laparoscopy

• In 1991, Fischer demonstrated therapeutic applications of equine laparoscopy including cryptorchid castration, ovariectomy and aspiration of intra-abdominal abscesses.
• The testes or ovaries were exteriorised from the abdomen for removal, and the laparoscope was used to identify target organs and facilitate administration of local anaesthetic.
• Cryptorchidectomies and ovariectomies performed outside the body were regarded as laparoscopic-assisted open procedures.
• By 1992, Fischer reported use of laparoscopy in horizontally placed horses under general anaesthesia for cryptorchidectomy using a combo of laparoscopic and open technique.
• In 1993, use of internal laparoscopic instruments to perform laparoscopic ovariectomy in standing horses was reported by Palmer.