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What's New
Endoscopic Surgery
New Preventative Treatment for Hip Displaysia
Laser Surgery
Now Done At Lake Geneva Animal Hospital
Endoscopic Surgery
The use of small cameras to
perform diagnostics and surgery has been the standard of care for 10 to 15 years
in human medicine and is now available for animals also! Arthroscopic (most
commonly knee, shoulder, and elbow joints), laproscopic (abdomen such as gall
bladder removal in people), and thorascopic (chest and lung) surgery are all now
possible at Lake Geneva Animal Hospital.
Benefits
- Small incisions – Usually ¼ to ½ inch
-
Less Pain – Small incisions are less painful and heal easier
-
Better Visualization – Images are magnified and projected onto a monitor for
easier viewing. Angled optics allow for looking around corners and into
crevices that may not be visualized with traditional surgery.
-
“A picture is worth a thousand words” – Seeing structures like the liver or
kidney allow biopsies to be taken from specific areas of interest that may not
be visualized on x-ray or ultrasound.
Common Indications for Endoscopic Surgery
- OCD (Cartilage Flap) of the shoulder,
elbow, or knee (stifle).
- Biceps Tendonitis
- Gastropexy in breeds likely to bloat (deep-chested
breeds such as Great Danes, Dobermans, Rottweilers, Labradors, Retrievers,
etc.). Prophylactic gastropexy (permanently suturing the stomach to the body
wall) is used to prevent gastric volvulus; a life threatening condition where
the stomach rotates on itself leading to bloating and death within hours.
- Bladder evaluation for urinary problems,
persistent infections or removal of stones.
- Lung Mass Removal
- Biopsies – Liver, Kidney, Pancreatic, etc.
- Cancer Staging –Staging of cancer to
determine treatment options – Many cancers are very treatable with surgery or
other modalities. Veterinarians and owners often do not want to put an animal
through a major surgery to remove a cancerous growth if the cancer has spread to
other regions. Spread often indicates the need for chemotherapy or radiation.
It may also mean that the surgery will not extend the animal’s quality of life.
Those animals can be checked first with the endoscope through a very small
incision to determine if major surgery will be helpful and/or get biopsies for a
definitive diagnosis. This avoids a potentially long recovery from major
surgery allowing the animal to go home quickly.
“Cowboy” had his stomach tied down to
prevent twisting (GDV)
Bloat
Lake Geneva Animal Hospital is
now performing a new revolutionary treatment for hip dysplasia called a juvenile
pubic symphsiodesis. This procedure is much less invasive and much less painful
than traditional hip surgery.
The procedure involves fusing a
growth plate in the lower pelvis (the belly side) slowing growth here and
allowing normal growth at the dorsal growth plate (the top side). The effect is
to move the hip socket out and over the ball of the hip creating a better
fitting joint. Studies indicate a very significant reduction in hip arthritis
at three years of age in dogs that have had the procedure (80% of dogs with hip dysplasia
had arthritis at three years without surgery compared to 20% of the
dogs who had surgery). Recovery is rapid and most dogs go home the same
day without noticeable lameness or pain.
Age is important and the procedure must be
done prior to 22 weeks of age with best results if done by 18 weeks. In
order to find these dogs by such a young age, we are now neutering and spaying
dogs at 16 to 18 weeks. While under anesthesia, the dog’s hips are
palpated for signs of laxity and the procedure c an
be performed if indicated.
"Rug" shortly
after surgery
Laser Surgery
Now Done At Lake Geneva Animal Hospital
Advantages
- No bleeding
- the laser cauterizes as it
cuts.
- Less Pain - the nerves are sealed as
they are cut so no raw nerve endings. Thus, there is much less pain.
- Sterile - Any organisms (bacteria,
viruses, etc.) are vaporized by the laser. Plus, the laser never touches the
surface as it cuts resulting in less selling.
- Precise - the beam can be directed to
exact spots and the power adjusted to vary the depth of cut. This allows very
precise cuts. Also, because of a feature called super-pulse on this laser,
there is minimal thermal damage to surrounding tissue. The heat produced by the
super-pulse laser does not spread to other tissues and to surrounding tissue.
This is not the case with all lasers. Some do not have the super-pulse feature
or use a different form of laser energy (diode lasers for example) and result in
significant tissue damage not apparent at the time of surgery. This can lead to
healing problems and even sloughing of tissue days after surgery. The
carbon-dioxide, super-pulse laser that we employ eliminates these issues.
Disadvantages
- These are few but the laser is not used in all
surgeries. Because of the lack of bleeding and swelling, incisions can take
slightly longer to fully heal (14-21 days versus 10-14 days with a scalpel).
Though this is not noticeable for most surgeries, we do not use the laser when
it is essential for rapid healing (such as intestinal surgery). The doctor will
determine if laser surgery is a good option for each case.
Cost
Use of the laser add anywhere from $35 (spays, neuters) to $150 (large mass
removals or toenail lasing).
Procedures that benefit
from laser surgery
- Declaws - The procedure used to be very
painful for the cats. Now, the cats usually are walking and playing the next
day. Even older or heavy cats can now be done humanely. Because of the
significant reduction in the post-operative pain level for this procedure, the
use of the laser is mandatory. We no longer do declaws without the laser.
- Short-Nosed Animals -
Pugs, Pekinese,
Bulldogs, Persian cats, etc - Animals with "pushed in noses" commonly have "Brachyocephalic
Syndrome". They breathe loudly, snore, and often times do not exercise much.
Though this is a "normal conformation" for these breeds, it is not healthy. The
nostrils are typically just slits rather than open holes, and the soft palate is
too long. The result is noisy breathing, snoring, and decreased exercise. Over
time, the continual vacuum created by these problems causes the larynx (voice
box) and trachea (windpipe) to collapse further limiting air movement. Once
this happens, the dog begins to cough and breathe even harder. There is no
treatment at this stage of disease. Now, laser surgery can be done, prior
to permanent damage, to open the nostrils and reduce the soft palate. This
alleviates much of the noisy breathing and the effort required. The animals can
move air more easily and can live a more normal life lessening the chance of
tracheal collapse later in life. After very promising results with the first
patients, we are recommending this procedure on many of these pushed-in-face
dogs.
- Mass removal - Small masses (warts) are
often vaporized away with just a local anesthetic. Larger masses are removed
with less bleeding and cleaner edges since there is no scalpel to possibly drag
tumor cells to new areas when cutting.
- Toe Nails -
Animals with "Long Quicks"
can have the nailbed lasered back. The laser is used to cauterize and seal the
nailbed back very close to the toe with minimal post-operative bleeding or
pain. The nail will still need to be trimmed but the quick is now much
shorter. General anesthesia is required.
- Spays/Neuters
- the majority of the
post-operative pain comes from the incision. Since the laser seals the nerves,
it is much less painful.
- Many, many more...
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