Recent advances in soft tissue minimally invasive surgery

Abstract

Advancements in soft tissue minimally invasive surgery have been rapid and comprehensive since its inception in human medicine approximately 25 years ago. From its origins in traditional laparoscopy, followed rapidly by video‐assisted thoracoscopic surgery, minimally invasive surgery in human medicine has evolved through a number of different platforms that now include single‐port approach devices, robotic surgery as well as natural orifice transluminal endosurgery. Whilst some of these remain beyond the reach of veterinary medicine for now, largely because of technical challenges and the prohibitive costs of some single‐use disposable components, veterinary minimally invasive surgery is advancing rapidly allowing our small animal patients to benefit from some of the many documented advantages that a minimally invasive approach affords the patient.

A comparison of the rates of postoperative complications between dogs undergoing laparoscopic and open ovariectomy

“…Laparoscopic surgery is becoming increasingly popular in veterinary practice (Mayhew ). The benefits of laparoscopy are now well‐established and include a reduction in postoperative pain and surgical stress following laparoscopic ovariohysterectomy compared to open surgery (Davidson et al .…”

“…There is a relative paucity of information regarding any impact of the approach utilised on the incidence of postoperative complication for any given surgery. Only a small number of reports compare minimally invasive to open surgical approaches (Mayhew ). One previous study (Mayhew et al .…”

Evaluation of pet owner preferences for operative sterilization techniques in female dogs within the veterinary community

“…Similarly, within veterinary medicine, SP procedures, including OVE, using single incision laparoscopic devices (SILS; Covidien‐Medtronic, Salem, Massachusetts) have been described. Using these devices for the OVE technique enables easy insertion and reinsertion of the port during surgery, allowing rapid re‐establishment of a pneumoperitoneum and obviating the requirement for a transabdominal suspension suture for ovary retraction . Another minimally invasive approach, natural orifice transluminal endoscopic surgery (NOTES), emerged in the mid‐2000s as an alternative operative approach for OVE in dogs .…”

“…Minimally invasive procedures typically cost both the client and the surgical practice more because of the specialized equipment and advanced training required to perform operations proficiently . Newer approaches are still developing and being refined and, as such, may be viewed with caution among both clients and veterinarians.…”

Facilitation of Soft Tissue Surgery

“…With advances in these procedures and the improvement of minimally invasive stapling and vascular sealing instrumentation, vascular structures can be occluded confidently and diseased tissues can be removed safely. 41 Most endoscopic stapling instruments have an articulating head and use staple cartridges that simultaneously place 6 rows of staples. An embedded cutting blade incises through the middle of the stapled line, leaving 3 rows of staples on each side and providing a seal to each sides of the excised tissues.…”