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What is laparoscopy? You may have heard this term in the human medical field or you may have undergone a laparoscopic surgery yourself. It is a non-invasive surgical technique that we are able to utilize for a variety of surgeries on dogs and cats. Typically with a laparoscopic procedure, 2 very small incisions (about ½ inch each) are made to gain entrance into the abdomen. Into one of the incisions a surgical video scope (laparoscope) is placed so that the contents of the abdomen can be visualized without fully opening the pet! Through the other incision, surgical instruments can be introduced internally to perform a variety of different procedures. This is an exciting frontier in veterinary surgery, which will likely change how veterinarians have traditionally approached surgical cases.
There are numerous advantages to laparoscopic surgery over the more traditional open surgical procedures. Because laparoscopy utilizes very small incisions to gain access to the abdomen and there is little disturbance to any of the other abdominal structures, healing times and post-surgical pain are greatly reduced. Also, with a closed laparoscopic procedure, there is less of an opportunity for air-borne bacteria to contaminate the surgical field. Due to the magnification that the laparoscope offers, as well as being able to access otherwise obscured areas in the abdomen, better overall visualization is afforded. Often, laparoscopic procedures are actually quicker than open procedures and this allows for less time under anesthesia, and the safety of our patients is always our #1 priority.
What procedures can be done with a laparoscope? Great question. The short answer is that the laparoscope can be used whenever a pet's internal abdominal organs need to be accessed. We offer a variety of procedures in which the laparoscope may be employed. Below is a short list of some of our more commonly utilized laparoscopic capabilities. This is by no means completely inclusive. In fact, this list seems be growing all the time.
Ovariectomy (removal of the ovaries). One of the most frequent opportunities that we have to utilize laparoscopy is when performing ovariectomies (OVE) in female dogs and cats. For many years the spay procedure entailed removal of both ovaries as well as the uterus (OVH). However, research has repeatedly shown that there is no risk for heat cycles, pregnancy, or uterine infections once the ovaries have been completely removed. In short, it is not necessary to remove the uterus. The ovariectomy procedure has been the standard of care in Europe for decades. Because we are only removing the ovaries for this procedure (OVE), it has become possible for us to utilize laparoscopy as a minimally invasive surgical approach. This will lead to a more rapid return to normal activity for dogs undergoing this procedure.
Gastropexy. Anyone who has ever had a dog that experienced Gastric Dilatation and Volvulus (GDV; commonly referred to as bloat) can attest to just how terrible of a disaster this can be. GDV is when the stomach flips and rotates on its own axis. The stomach is filled with gas-producing bacteria that are constantly in a fermenting process. Because the stomach has now twisted on itself, there is no outlet for the accumulating gas. Without quick surgical treatment, death is imminent. Deep-chested larger dogs are more prone to GDV than others. It is typically recommended for those dogs with these select body types to undergo prophylactic gastropexies (often at the same time as a spay/neuter procedure). A gastropexy involves surgically attaching the outer layers of the stomach to the muscle layers of the internal body wall. This attachment will prevent the possibility of the stomach unexpectedly flipping. Laparoscopic gastropexy is a non-invasive procedure that can prevent one of the scariest emergencies that a pet owner could ever encounter.
Biopsy and Exploration. Sometimes making a complete diagnosis goes all the way down to the cellular level. It is often necessary to obtain small biopsies of the internal abdominal organs to attain this information. We are able to biopsy nearly any structure that lies within the abdomen via laparoscope. This includes (but is not limited to): the liver, intestines, pancreas, spleen, lymph nodes, kidneys, stomach, and bladder. On occasion when x-rays and/or ultrasound are not sufficient in supplying an accurate picture of what is happening internally, it might be necessary to physically visualize the inside of the body cavity to get an accurate depiction. A laparoscopic exploratory surgery is a non-invasive way to provide answers and possibly solutions when there is an illness that has eluded detection by other means of diagnostic imaging.
Cystoscopy. In some cases, it is possible to scope the bladder to obtain biopsies, provide a more accurate internal bladder evaluation, as well as to potentially remove accumulated bladder stones.
Rhinoscopy. Access and visualization of the nasal passages may be in order to biopsy tissue, provide a more thorough examination for the purposes of nasal disease, or remove potentially inhaled foreign objects.
Otoscopy. The ear canals and ear drums of dogs and cats can be incredibly hard to visualize completely, especially if there is inflammation and/or infection. Sometimes otoscopy may be helpful for magnification, removal of foreign debris/objects, biopsies, as well as deep flushes to help resolve ear infections.
Equipment: We are pleased to offer our patients and our clients surgical instrumentation that is likely to be found in only the highest quality human surgical facilities.
Our newly acquired Covidien Force Triad® is a state-of-the-art energy source that we utilize for cutting and coagulation purposes. This newly emerged radiofrequency technology is equipped with tissue-sensing capabilities. This allows for precision vessel coagulation. This is truly next generational veterinary surgical instrumentation. Rest assured that we are using the best technology out there!