Equis ISSN 2398-2977

Laser surgery: transendoscopic

Contributor(s): Safia Barakzai

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 chanel 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 are currently being developed for transendoscopic use.

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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Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • 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.
  • Tetens J et al (1994) Transendoscopic contact neodymium-yttrium aluminum granet laser treatment of tympany of the auditory tube diverticulum in two foals. JAVMA 204 (12), 1927-1929 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.
  • Palmer S E (1991) Standing laser surgery of the head and neck. Vet Clin North Am Equine Pract (3), 549-569 PubMed.
  • Tulleners E P (1991) Use of transendoscopic contact neodymium-yttrium aluminum garnet laser to drain dorsal epiglottic abscesses in two horses. JAVMA 198 (10), 1765-1767 PubMed.
  • Tulleners E P (1991) Evaluation of peroral transendoscopic contact neodymium-yttrium aluminum grante laser and snare excision of subepiglottic cysts in horses. JAVMA 198 (9), 1631-1635 PubMed.
  • Tate L P (1991) Application of lasers in equine upper respiratory surgery. Vet Clin North Am Equine Pract (1), 165-195 PubMed.
  • Tulleners E P (1991) Correlation of performance with endoscopic and radiographic assessment of epiglottic hypoplasia in racehorses with epiglottic entrapment corrected by use of contact neodymium-yttrium aluminum garnet laser. JAVMA 198 (4), 621-626 PubMed.
  • Tate L P et al (1990) Transendoscopic Nd-YAG laser surgery for treatment of epiglottal entrapment and dorsal displacement of the soft palate in the horse. Vet Surg 19 (5), 356-363 PubMed.


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