Through the use of VETMED’s state of the art equipment, new Karl Storz Endoscopy tower, and a Covidien Force Triad™ vessel sealer, the VETMED team of specialists are capable of offering a number of extended, minimally invasive diagnostic and therapeutic procedures. One benefit of minimally invasive surgery (MIS) is the incredible magnification and lighting provided, which can make the view better than that of open surgery. MIS also greatly reduces the pain and inflammation compared to open surgery due to the use of multiple, small access points or natural orifices. By decreasing the size of the approach, we can decrease the time in hospital, recovery, and rehabilitation compared to traditional surgery.
Our goal is to perform the needed diagnostic and therapeutic procedures with minimal morbidity and recovery time; however, we may need to convert to an open approach if visualization is inadequate, adhesions limit visualization, lesions are too large for removal, or complications occur in which the patient cannot ventilate adequately or require open surgery for resolution.
Below is a list of the minimally invasive services available at VETMED:
Examination of joints using a rigid endoscope, access ports, and irrigation is a specialized orthopedic procedure that can be diagnostic and therapeutic. The joint surfaces, cartilage, and ligaments can be evaluated. Abnormalities, particularly cartilage fragments, can be removed without the need of a traditional arthrotomy. The most commonly evaluated and treated joints are the shoulder, elbow, and stifle.
A rigid endoscope protected by a sheath is used evaluate the lower urinary tract and to allow access for instrumentation to sample and treat lower urinary tract disorders. The most common indications are recurrent urinary tract infections and incontinence. Samples can be taken for biopsy and culture, and a laser can be introduced to divide abnormal tissue between an intramural ureter and urethra in dogs with ectopic ureter. Very small stones may be flushed from the tract, and occasionally a basket catheter can be used to remove stones. Cystoscopy can be used as an aid for stent placement, and on occasion can be used to debulk mass lesions.
Introducing an endoscope through small, trans-abdominal ports and insufflation with CO2, which allows the cavity to be examined and operated. Common diagnostic procedures include sampling for biopsy, culture, and metal analysis in cases of liver disease. The kidney, lymph nodes, and pancreas can also be sampled laparoscopically. Therapeutic interventions include ovariectomy, ovariohysterectomy, cryptorchid castration, prophylactic gastropexy, cystoscopic-assisted stone retrieval, selected foreign body removal, adrenalectomy, and cholecystectomy. Very early pyometra surgery may be possible in some cases, and the approach for jejunostomy tube placement is minimized via laparoscopy.
Examination of the external and middle ear can be done in cases of recurrent otitis in combination with CT scanning. The external ear can be evaluated with the patient awake or mildly sedated to diagnose foreign bodies, cerumenoliths, mass lesions, and strictures. Abnormalities of the tympanic membrane can be evaluated if the ear canal is open and not filled with cerumen or exudates. Deep ear cleaning and evaluation of the middle ear require general anesthesia. Deep ear cleaning is highly useful for removing accumulation of cerumen or exudate, making topical therapy more effective. Video-otoscopic deep ear cleaning is done with great magnification and lighting, which decreases the risk of iatrogenic trauma, and the instrumentation associated with the endoscope makes the procedure more efficient than the traditional approach. The middle ear can be evaluated, and precise myringotomy and aspiration or irrigation can be done. Cleaning of the middle ear is possible with otoscopy, and some mass lesions can be debulked with instruments passed beside the endoscope or down the working channel, which may be appropriate for benign lesions such as inflammatory polyps.
Examination of the nose, nasal turbinates, nasopharynx, and in some cases the frontal sinuses is an often used diagnostic procedure. Sampling can be properly targeted via endoscopic visualization to the lesion and can be done with larger instruments to increase the likelihood of obtaining a diagnosis and not just sampling the surrounding inflammation or secondarily infected areas. The technique is therapeutic in cases of foreign bodies, which can be removed with instrumentation beside the endoscope or down an endoscopic channel.
Examination and treatment of conditions of the chest cavity greatly reduces the pain and inflammation associated with opening the chest or sternum, both of which require significant retraction, which causes stretching of the junctions with the spine and sternum. Atelectasis improves visualization and allows for diagnostic sampling for histopathology and culture and for some treatments including pericardectomy, partial or complete lung lobectomy, lymph node or mass biopsy, thoracic duct ligation, treatment of PRAA, and in selected cases, mass removal. The recovery time is greatly reduced due to the minimal approach for port placement and avoidance of rib or sterna retraction.
To refer a patient to VETMED or to learn more about our extensive services, please call (602)697-4694.
Minimally Invasive Procedures
Laparoscopic procedures include:
- hepatic, pancreatic and lymph node biopsy
- prophylactic gastropexy
- jejunostomy tube placement
- cryptorchid castration
- cystoscopic stone removal
- foreign body removal
- and more.
Thoracoscopic procedures include:
- partial or complete lung lobectomy
- persistent right aortic arch
- thoracic duct ligation
- and more.
About Dr. Radlinsky:
MaryAnn Radlinsky, DVM, MS, DACVS
Dr. Radlinsky received her DVM at Cornell University, and completed an internship in Small Animal Surgery at Texas A&M, along with her residency in Small Animal Surgery at Texas A&M. She is a board-certified diplomate of the American College of Veterinary Surgeons. her clinical interests include soft tissue surgery, laryngeal paralysis, chylothorax, laparoscopy and thoracoscopy, minimally invasive diagnostic and therapeutic procedures of the respiratory & urinary tracts, and ear.
She is a recipient of the Norden Distinguished Teacher Award, and in her free time, she enjoys riding her horse, scuba diving, the beach, and South African wildlife conservation.
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