Minimally Invasive Surgery
We are constantly pushing our skills to provide better surgical outcomes with less pain, less surgical trauma, less anesthetic time, and quicker return to function. Minimally invasive orthopedics allows us to achieve many of these goals with advanced imaging technology and related procedures.
Arthroscopic surgery has been performed in equine and human surgery for nearly 20 years. It has only been in the last few years that instrumentation has become available to allow small animal surgeons to enter joints arthroscopically. We have been performing arthroscopy on the elbow and shoulder joints at Vetcision for several years. Our equipment consists of a combination of the best Stryker, Linvatec, and Storz arthroscopy systems which include a 3 chip video camera and a complement of arthroscopes, power, and hand instruments. We also have a Sony image storage and retrieval system to document our images.
In small animal arthroscopy we have become proficient at exploring and treating intra-articular conditions of the elbow and shoulder joint. We have not concentrated on cruciate repairs in the stifle joint since we feel the best current treatment is the Tibial Plateau Leveling Osteotomy (TPLO) technique. OCD lesions of the stifle, while rare, can be easily treated with arthroscopy.
Laparoscopic surgery is being performed at Vetcision predominately for liver biopsies and prophylactic gastropexies. Laparoscopic surgeries allow abdominal surgery to be performed on patients with typically only 3 small nicks in the skin. A ridged laparoscopic telescope, attached to a camera, is inserted through a cannula through a nick in the skin while instruments are inserted through cannulas at other sites through the abdomen. The surgeon uses these cannulas (portals) to insert long handled instruments working inside the abdominal cavity which is inflated with CO2 gas.
Thoracoscopic surgery is being performed at Vetcision for lung biopsies, some lung lobectomies, and pericardectomies. Thoracoscopic surgery allows the surgeon to work in the chest cavity. Typically 3 cannulas (portals) are placed in the chest to allow a surgeon to work inside the chest with long instruments. The huge benefit of thoracoscopic surgery is the minimal postoperative pain, and early return to full function after the procedure. This is in comparison to an open chest approach that leaves the patient uncomfortable for several weeks.
Rhinoscopy surgery is being performed at Vetcision by the medicine department. The procedure is used to look and sample deep into the nose for masses, infectious prcesses and foreign bodies. A small diameter ridged telescope, attached to a camera, is able to be guided all the way to the very back of the nasal cavity.
Cystoscopy uses flexible or ridged scopes to look into the urethra and urinary bladder in female dogs and cats, and small male dogs. Samples of fluid and tissue can be taken at all sights. Developmental abnormalities can also be diagnosed, and sometimes treated with the minimally invasive approach.
As the only veterinary facility in New England to have a C-arm (intra-operative fluoroscopy unit), Vetcision can offer a hole host of new techniques for your pet. The C-arm is like having X-ray vision during surgery, allowing us to perform certain fracture repairs through small skin incisions, removing metallic implants from healed fractures, and recently removing a sewing needle from the neck of a dog with a tiny incision. The C-arm is also useful for myelograms, evaluating swallowing with barium, and in performing portograms, pyelograms, and other moving die studies. The C-arm allows us to use a new cannulated screw system for certain types of fractures. A fracture is first reduced with external manipulation or percutaneous pointed bone clamps. These are normally fractures like sacro-iliac luxations, condylar fractures, or other fractures that are repaired with 1 or 2 screws. A k-wire is then placed perfectly across the fracture line using C-arm visualization. The special cannulated self drilling, self tapping titanium screw is then slid down the k-wire. The implant is then screwed into the bone following the k-wire to compress the fracture site. The k-wire is then removed. The C-arm also allows us to more quickly and accurately apply external skeletal fixators. Using positive profile transcortical pins we can place linear external skeletal fixators including Kirshner, Securos, Imex standard and Imex SKF systems, as well as, Imex circular fixators with linear and angular motors. These techniques have recently allowed us to stabilize fractures very close to joints that would have previuosly required trans-articular fixators which would compromise the joint.