By Lauren Lamb, DVM
Laparoscopic surgery is a form of minimally invasive surgery that can be performed on a horse. Minimally invasive surgery is performed through small skin incisions (1/2 to 3/4 of an inch). These skin incisions are called laparoscopic surgical portals. Most surgeries require three to five surgical portals.
The number of portals depends on the type of surgery being performed. A long specialize camera is placed through one of the laparoscopic portals. The camera is connected to a monitor, which will project the image seen within the horse’s body.
Specialized long instruments are placed through the other skin incisions and the surgical procedure is performed under direct observation with the laparoscopic camera. Traditional laparoscopic surgery is performed without the surgeon placing a hand within the horse’s body.
There are several advantages of laparoscopic surgery versus traditional surgical techniques. With laparoscopic surgery, the skin incisions are a fraction of the size compared to traditional surgical techniques. Small incisions result in lower incisional complication rates, such as incisional infection or dehiscence (when the surgical incision falls apart).
The small skin incision also results in a much faster return to training and performance. Frequently the time a horse is out of training following a laparoscopic surgery is reduced by 50 to 70 percent compared to traditional surgical techniques.
Another advantage of laparoscopic surgery is the ability to avoid general anesthesia. Most laparoscopic surgeries are performed with the horse standing and sedated in a set of stocks. Local anesthetics, such as lidocaine, are used to block the skin at the location for the surgical portals. Lidocaine will also be used to desensitize the organ within the body on which the surgical procedure is being performed.
A third advantage of laparoscopic surgery is the ability to clearly and directly visualize the anatomical structure being operated on. Laparoscopic surgery in the horse was developed to assist surgeons when performing surgery on structures within the chest or abdomen that cannot be seen directly with a traditional surgical approach.
Prior to the development of laparoscopic surgery, these procedures were performed under poor visualization or extreme tension on the tissue. Laparoscopic surgery allows direct visualization of the tissue being operated on and allows the surgical procedure to be performed under little to no tension on the tissue.
Despite all the great advantages of laparoscopic surgery, there are several disadvantages. The first being the cost of the equipment needed to perform laparoscopic surgery. The long-specialized camera and surgical instruments are expensive, which results in the cost of laparoscopic surgery potentially being more expensive than traditional therapy.
Read the January issue to learn more!