Minimally Invasive Surgery

The surgery service at VSH is proud to be a local leader in the field of minimally invasive surgery (MIS). Minimally invasive surgery has been recognized as the standard of care for many conditions in humans for over a decade and its use for our veterinary patients is rapidly growing. Our surgeons have extensive training and experience in a variety of surgical techniques, which can be used in the diagnosis and treatment of many orthopedic (arthroscopy), abdominal (laparoscopy) and thoracic (thoracoscopy) conditions.

Minimally invasive surgery involves the use of a camera and instruments inserted through small incisions in order to visualize and treat conditions within joints or body cavities. Minimally invasive procedures may be performed entirely within the body or, in some circumstances, can be used together with a smaller open approach. These combined approaches, known as “arthroscopic, laparoscopic or thoracoscopic-assisted surgery,” retain many of the advantages of MIS without compromising the surgeon’s ability to complete the procedure. 

Arthroscopy

Arthroscopy is routinely used in the treatment of many common orthopedic conditions in animals.  Our state of the art equipment allows for excellent visualization of joints and soft tissues, allowing our surgeons to more precisely identify and treat problems while eliminating the need for a more invasive approach in many cases. 

Orthopedic conditions commonly treated with arthroscopy include: 

  • Elbow dysplasia (medial coronoid disease, ununited anconeal process, osteochondritis dessicans)
  • Shoulder osteochondrosis, osteochondritis dessicans and instability
  • Cruciate ligament disease and meniscal injury
  • Arthroscopy can also be used to evaluate and flush infected joints, obtain joint capsule biopsies, document repair of fractures involving the joint surface and as a complementary diagnostic tool when radiographs, CT or MRI images fail to explain the cause of a problem.
      CT and arthroscopic images of a fragmented medial coronoid process of the ulna.


Laparoscopy/Thoracoscopy

Laparoscopy and thoracoscopy are minimally invasive surgical techniques in which abdominal or thoracic surgeries are performed through small (1.0 cm or less) incisions. These techniques can be used in place of or as an adjunct to (modified) traditional open procedures for a variety of conditions. Typically between one and four incisions are made through which the camera and instruments are introduced into the abdomen or thorax. Magnified images of the internal organs are visible on a high definition monitor.

Laparoscopic procedures commonly performed at VSH include:

  • Abdominal exploration and biopsy of the liver, pancreas, kidneys, and lymph nodes
  • Ovariectomy (spay) and cryptorchid testicle removal
  • Removal of bladder stones
  • Adrenalectomy (adrenal mass removal)
  • Cholecystectomy (gall bladder removal)
  • Gastropexy (tacking the stomach to the body wall)
  • Laparoscopic-assisted intestinal biopsy
      Completed laparoscopic gastropexy                          Laparoscopic adrenalectomy (removal of adrenal gland)

 

Thoracoscopic procedures performed at VSH include:

  • Thoracic exploration and biopsy of the lung, lymph nodes or lining of the chest wall
  • Pericardectomy (removal of sac around the heart)
  • Lung lobe removal
  • Treatment of pyothorax (infection) within the chest cavity
  • Treatment of chylothorax (lymph fluid)
  • Thymoma or lymph node excision/biopsy
      Thymoma removal                                                    Tumor dissection between aorta and pulmonary artery

 

There are a number of important advantages of minimally invasive surgery over traditional open procedures including improved visualization, decreased recovery time, decreased pain, and in many cases decreased complication rates.

There are limitations to what is possible with minimally invasive techniques and these techniques many not be appropriate in some circumstances. During your initial appointment, your surgeon will discuss whether these techniques are right for your pet as well as any potential advantages and disadvantages of incorporating them into your pet’s treatment plan. We currently offer minimally invasive surgery at our Cary and Durham hospitals.