This is something we hear a lot about these days and has been held up as the future of surgery in both human and veterinary medicine for some time. What is it?
Essentially it is the art of performing internal surgical procedures using endoscopy. Generally these are rigid endoscopes where light and images are transmitted via glass tubes and fibre glass to video screens allowing magnification and producing extremely high quality images. Adding hollow “ports” and inflating the body with sterile carbon dioxide permits the entry of long thin surgical instruments and, hence, the ability to operate under direct visualisation. What are the advantages?
The main difference is that much smaller incisions are required. For example in a bitch spay we will use two 5mm single suture incisions rather than make a long wound to allow entry of the hands.
It also allows the surgery to be carried out “in place”. Again using a bitch spay as an example the ovaries are located and removed from their normal position. In classic open surgery the ovaries are removed once their ligaments have been stretched to allow them to pulled out of the body to be ligated and removed.
The net effect therefore is to produce less trauma, less bruising and therefore much less pain. Oh, and minimal wound care after the surgery! What can we do with this?
At the moment our main surgery is to perform laparoscopic bitch spays. In these we only remove the ovaries (unlike traditional spays where the womb is removed too- this is of no consequence to your pet as all the clinical evidence shows there is no advantage in removing the uterus unless it is diseased (eg a pyometra)). Heat cautery is used rather than suture material to stop any bleeding. This is much more efficient and we see little or no bleeding in laparoscopic spays. The main thing is the post-operative recovery where the lack of pain afterwards – they look amazing! In fact, there can be a problem keeping them still post-operatively but as they don’t have long incisions, that doesn’t matter either!
Minimally invasive surgery is also used to perform exploratory surgery where bizarrely the endoscope gives much better visualisation through a 5mm hole than you get with the usual bodylength incision. In addition it is really easy to take biopsies of internal organs if we are worried about tumours or liver failure- and because there is no long incision to suture, these surgeries are very quick and simple with no post-operative pain problems.
The disadvantages? The equipment is expensive! Our set up has cost over £35,000 which is why we do have to charge an extra £150 on top of a normal bitch spay price to do this laparoscopically. Then again, when you see the results we think you’ll agree it’s well worth the difference! If you are interested in your pet having a laparoscopic spay, please call us at the clinic on 01264 729165.