ISSN 2398-2977      

Laser surgery: transendoscopic

pequis

Introduction

  • Transendoscopic surgery provides a safe, reliable and minimally invasive surgical method for surgical treatment of some equine upper respiratory tract (URT) conditions.
  • The Nd:YAG laser Laser surgery: overview is usually used transendoscopically, transmitted through a 2.1 m long, flexible fiber introduced via the biopsy channel of most fiberoptic or videoendoscopes.
  • When activated, the fiber tip emits a red aiming beam produced by a coaxially aligned milliwatt helium:neon laser.
  • Diode lasers are considerably less expensive than Nd:YAG systems and are generally small and portable Laser surgery: diode laser unit.
  • CO2 lasers developed for transendoscopic use require the use of fragile waveguides that can fit through the biopsy channel.

Uses

Advantages

  • Most transendoscopic surgery can be performed in standing sedated Anesthesia: standing chemical restraint horse - no requirement for general anesthesia Anesthesia: general - overview.
  • For peri-laryngeal surgery, additional advantage of no skin wound, eg laryngotomy or similar as is required for access to laryngeal structures using conventional open surgical techniques.
  • Ability to coagulate blood vessels of various sizes (depends on type of laser being used).  
  • Photovaporization of tissues.
  • Excision/incision of tissues with minimal zone of tissue injury.
  • Reduced post-operative pain and swelling.
  • A continuous sterile incision is created (intense heat).
  • Can be used down an endoscope, arthroscope or laparoscope to perform minimally invasive surgery.

Disadvantages

Requirements

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Preparation

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Procedure

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Aftercare

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Outcomes

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Prognosis

  • Depends on lesion, but generally good for most.

Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Compston P C, Turner T, Wylie C E & Payne R J (2016) Laser surgery as a treatment for histologically confirmed sarcoids in the horse. Equine Vet J 48 (4), 451-456 PubMed.
  • Caspers M K, Bell C D & Tatarniuk D M (2021) Transendoscopic ventriculocordectomy using monopolar electrosurgical instrumentation for conjunctive treatment of laryngeal hemiplegia in horses: 24 Cases (2017-2019). Front Vet Sci 8, 628410 PubMed.
  • Claffey E F & Ducharme N G (2020) Equine Nasal Endoscopy: Treating Bullae Disease and Sinus Disease. Vet Clin North Am Equine Pract 36 (3), 659-669 PubMed.
  • Beste K J, Ortved K F, Rossignol F & Ducharme N G (2020) Transendoscopic correction of epiglottic entrapment with a silicone-covered laser guide and diode laser in 29 horses. Vet Surg 49 (1), 131-137 PubMed.
  • Koskinen M J, Virtala A K & McNally T (2020) Racing performance of National Hunt thoroughbred racehorses after treatment of palatal dysfunction with a laryngeal tie-forward procedure and thermocautery of the soft palate with or without aryepiglottic folds resection. Vet Surg 49 (1), 114-123 PubMed.
  • Suarez-Fuentes D G, Tatarniuk D M, Caston S S et al (2019) Adaptation and evaluation of a monopolar electrosurgical triangle-tip knife for transendoscopic ventriculocordectomy in healthy horses. Vet Surg 48 (4), 481-487 PubMed.
  • Barakzai S Z, Wells J, Parkin T D H & Cramp P (2019) Overground endoscopic findings and respiratory sound analysis in horses with recurrent laryngeal neuropathy after unilateral laser ventriculocordectomy. Equine Vet J 51 (2), 185-191 PubMed.
  • Koch D W, Easley J T, Nelson B B et al (2018) Comparison of two techniques for transpharyngeal endoscopic auditory tube diverticulotomy in the horse. J Vet Sci 19 (6), 835-839 PubMed.
  • Schumacher J et al (1998) Transendoscopic chemical ablation of progressive ethmoidal hematomas in standing horses. Vet Surg 27 (3), 175-181 PubMed.
  • Tulleners E (1996) Instrumentation and techniques in transendoscopic upper respiratory tract laser surgery. Vet Clin North Am Equine Pract 12 (2), 373-395 PubMed.
  • Tate L P et al (1995) Transendoscopic laser treatment of guttural pouch tympanites in eight foals. Vet Surg 24 (5), 367-372 PubMed.
  • Charlton C & Tulleners E (1991) Transendoscopic contact neodymium-yttrium aluminum garnet laser excision of tracheal lesions in two horses. JAVMA 199 (2), 241-143 PubMed.

Other sources of information

  • Hawkins J F (2019) Lasers in Veterinary Surgery. In: Equine Surgery. 5th edn. Eds: Auer J & Stick J. Saunders, USA. pp 238-255.

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