Minimally Invasive Surgery: Laparoscopy and Thoracoscopy

Minimally invasive surgery (MIS) allows diagnostic and/or therapeutic surgical procedures to be performed using very small incisions through which a camera and instruments are placed inside body cavities. We can visualise a magnified high quality image of the interior of these body cavities and joints using a highresolution monitor. Video-assisted surgery (VAS) is a surgical modality halfway between open conventional surgery and MIS, which combines the magnification and better visualisation offered by using the camera system, but uses larger incisions than in true MIS to facilitate the surgery, but smaller incisions than in conventional open surgery. In humans, the development of minimally invasive surgery (MIS) has revolutionised surgery over the past 25 years. A large number of " open " conventional surgeries can now be performed using a minimal approach, which has application in several disciplines. MIS is widely used for diagnosis and treatment for abdominal (laparoscopic) and thoracic (thoracoscopic) procedures. In veterinary medicine we are now able to offer pets many of the advantages of MIS and VAS that exist today in human medicine. Compared with traditional open surgery, MIS/VAS offers several advantages including decreased pain, better visualisation (due to the magnified high-resolution images produced), reduced risk of dehiscence and postoperative wound complications, as well as shorter hospitalisation times. In older and debilitated animals MIS is also likely to reduce other post-surgical complications. The benefits for the patients are often reinforced for the owner when they are able to see a much smaller surgical wound and scar compared to the larger incisions and scars produced by open surgery. Although not all procedures can be performed using laparoscopic or thoracoscopic techniques, the list of operations that we can perform in this way is continuously growing. Laparoscopy: This technique allows exploration of the abdominal structures using small portals (between 5-12 mm); diagnostics and treatment can be offered for a large number of abdominal pathologies. Procedures that can be performed using laparoscopy or video-assisted laparoscopy: 1. Exploratory laparoscopy and biopsies: Gastrointestinal tract, liver, spleen, pancreas, kidney, prostate, lymph nodes, abdominal masses in dogs and cats. 2. Ovariectomy/ovariohysterectomy in dogs. For routine sterilisation (spay) or reproductive tract neoplasia or ovarian remnant syndrome. 3. Uterus colpopexy and bladder colposuspension in dogs-for treatment of urinary incontinence in spayed female dogs (intrinsic sphincter dysfunction) and as treatment of " intra-pelvic bladder ". 4. Cryptorchidectomy in dogs/cats-removal of retained abdominal testicle(s). 5. Cystotomy in dogs/cats-for removal of …