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1.
Vet Surg ; 53(3): 485-493, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-37997031

RESUMEN

OBJECTIVE: To evaluate the feasibility and limitations associated with a minimally invasive ultrasound-assisted cutting thread technique for tenotomy of the deep digital flexor tendon (DDFT) in horses. STUDY DESIGN: Ex vivo study. SAMPLE POPULATION: Twenty cadaveric forelimbs. METHODS: Forelimbs were placed on a jig to mimic a standing semiflexed position and the midmetacarpal region was prepared to perform tenotomy of the DDFT using a percutaneous technique with a cutting thread. For that purpose, the thread was placed percutaneously around the DDFT (first dorsally and then palmarly) with the aid of a curved 20 gauge spinal needle. Tendon palpation/manipulation and ultrasonographic assessment assisted thread placement. Procedure time and skin puncture size were recorded. Limbs were then dissected to evaluate the degree of DDFT transection and the presence of any iatrogenic lesions. RESULTS: The DDFT was completely transected in all cases. Minor lesions of the superficial digital flexor tendon were found in 11/20 limbs and considered clinically irrelevant. However, the neurovascular bundle was damaged in 6/20 limbs (four limbs had nerve damage and two limbs had a nerve and either a palmar artery or vein damaged). The skin puncture hole sizes ranged from undetectable to 5 mm long. The average duration of the procedure was 7 min and 38 s (range: 4 min 56 s to 10 min 19 s). CONCLUSION: A DDFT tenotomy can be performed reliably with a percutaneous cutting thread technique. However, refinement of the technique is required to minimize iatrogenic damage. CLINICAL SIGNIFICANCE: The reported technique allows a DDFT tenotomy to be performed in a minimally invasive manner and has the potential to be clinically applicable.


Asunto(s)
Enfermedades de los Caballos , Tenotomía , Humanos , Caballos , Animales , Tenotomía/veterinaria , Tendones/patología , Enfermedad Iatrogénica/veterinaria , Enfermedades de los Caballos/patología , Miembro Anterior/patología
2.
Vet Surg ; 53(2): 357-366, 2024 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-37463876

RESUMEN

OBJECTIVE: To report the use and feasibility of a self-locking resorbable loop device for cryptorchidectomy. STUDY DESIGN: Clinical prospective study. POPULATION: Twenty horses. METHODS: Horses suspected to have an abdominal testicle/s after admission work-up were enrolled. Horses were anesthetized in dorsal recumbency and a standard laparoscopic technique was performed. The looped device was inserted into the abdomen, glided around the testis/cord and tightened. Then, the spermatic cord was transected prior testis removal. Surgical procedure details and remarks, perioperative complications and total surgical time were recorded. Short- (>3 weeks) and long-term (>6 months) follow-ups were obtained by telephone questionnaire. RESULTS: Median total surgical time was 67 min (range: 43-189 min) and significantly shortened after the first four horses. The loop device was easily glided around 13/20 abdominal testes and required more time and technical skills around larger testes (≥3 years). Excellent intraoperative hemostasis was achieved in 17 horses. Three horses demonstrated mild intraoperative bleeding that required retightening, device replacement or adding a second device, respectively. Three horses developed mild postoperative hemoabdomen identified ultrasonographically and were successfully managed medically. Follow-up revealed no significant complications related to the procedure. One horse was euthanized for colic 4 months after surgery and one died of hemolytic shock 17 months postoperatively. CONCLUSION: This device represents another method to perform equine cryptorchidectomy that requires minimal training and laparoscopic expertise but demands knowledge of the device and application to prevent complications. CLINICAL SIGNIFICANCE: Laparoscopic cryptorchidectomy using this device is an alternative technique for horses <3 years.


Asunto(s)
Criptorquidismo , Enfermedades de los Caballos , Laparoscopía , Masculino , Caballos/cirugía , Animales , Criptorquidismo/cirugía , Criptorquidismo/veterinaria , Estudios Prospectivos , Enfermedades de los Caballos/cirugía , Orquiectomía/veterinaria , Orquiectomía/métodos , Laparoscopía/veterinaria , Laparoscopía/métodos
3.
Can Vet J ; 64(1): 25-30, 2023 01.
Artículo en Inglés | MEDLINE | ID: mdl-36593938

RESUMEN

Three client-owned horses diagnosed with obstructive ureteral stones were referred and treated in a minimally invasive manner by retrograde ureteroscopy in conjunction with electrohydraulic lithotripsy (EHL) or laser Holmium:YAG lithotripsy (HYL). For all 3 horses, additional tests revealed variable degrees of azotemia and ureteral obstruction. Ultrasound examination (2 horses) revealed a loss of cortico-medullary distinction consistent with a chronic nephropathy. Ultrasound-guided biopsy of the right kidney in 1 horse revealed moderate glomerulosclerosis and lymphoplasmacytic nephritis. A standing anesthesia with a coccygeal epidural was done for each horse. A perineal urethrotomy was performed in 2 horses before the urethrocystoscopy. One horse was treated with Holmium:YAG laser lithotripsy and 2 others were treated using a electrohydraulic lithotripsy probe. Each procedure was successful. The ureteroscopy was successfully performed and visualization was excellent. Fragmentation of stones seemed easier with the electrohydraulic lithotripsy probe. No complications, pain, or signs of discomfort after the procedure were noticed. All 3 horses were discharged from the hospital. Key clinical message: Obstructive ureteral stones in horses can be successfully treated in a minimally invasive manner by retrograde ureteroscopy accompanied by lithotripsy. This technique is safe, not painful and did not require general anesthesia. Electrohydraulic lithotripsy appeared superior for stone fragmentation.


Exérèse minimalement invasive de calculs urétéraux obstructifs par lithotritie intracorporelle chez le cheval : trois patients. Trois chevaux appartenant à des clients diagnostiqués avec des calculs urétéraux obstructifs ont été référés et traités de manière peu invasive par urétéroscopie rétrograde en conjonction avec une lithotripsie électrohydraulique (EHL) ou une lithotripsie au laser Holmium:YAG (HYL). Pour les trois chevaux, des tests supplémentaires ont révélé des degrés variables d'azotémie et d'obstruction urétérale. L'échographie (deux chevaux) a révélé une perte de distinction cortico-médullaire compatible avec une néphropathie chronique. La biopsie échoguidée du rein droit chez un cheval a révélé une glomérulosclérose modérée et une néphrite lymphoplasmocytaire. Une anesthésie debout avec une péridurale coccygienne était effectuée pour chaque cheval. Une urétrotomie périnéale a été réalisée chez deux chevaux avant l'urétrocystoscopie. Un cheval a été traité par lithotripsie au laser Holmium:YAG et deux autres ont été traités à l'aide d'une sonde de lithotripsie électrohydraulique. Chaque procédure a réussi. L'urétéroscopie a été réalisée avec succès et la visualisation était excellente. La fragmentation des calculs semblait plus facile avec la sonde de lithotripsie électrohydraulique. Aucune complication, douleur ou signe d'inconfort après la procédure n'a été remarqué. Les trois chevaux ont obtenu leur congé de l'hôpital.Message clinique clé :Les calculs urétéraux obstructifs chez les chevaux peuvent être traités avec succès de manière peu invasive par urétéroscopie rétrograde accompagnée de lithotripsie. Cette technique est sûre, non douloureuse et ne nécessite pas d'anesthésie générale. La lithotritie électrohydraulique est apparue supérieure pour la fragmentation des calculs.(Traduit par Dr Serge Messier).


Asunto(s)
Enfermedades de los Caballos , Litotripsia por Láser , Litotricia , Cálculos Ureterales , Caballos , Animales , Litotripsia por Láser/veterinaria , Holmio , Litotricia/veterinaria , Cálculos Ureterales/cirugía , Cálculos Ureterales/veterinaria , Ureteroscopía/veterinaria , Ureteroscopía/métodos , Resultado del Tratamiento , Enfermedades de los Caballos/cirugía
4.
Vet Surg ; 50(1): 29-37, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33074573

RESUMEN

OBJECTIVE: To describe the technique to perform diagnostic standing scapulohumeral joint needle arthroscopy with a 1.2-mm-diameter arthroscope in horses. STUDY DESIGN: Experimental study. ANIMALS: Eight thoracic limbs in phase 1 and six horses in phase 2. METHODS: In phase 1, the feasibility of the technique was evaluated by using a craniolateral arthroscopic approach. An evaluation of the visible structures of the scapulohumeral joint was performed with both a needle arthroscope and a 4-mm-diameter arthroscope. In phase 2, the technique was performed in six healthy sedated horses to validate the technique in live animals and to report any complications or limitations. RESULTS: In phase 1, joint evaluation was similar between arthroscopes and allowed complete evaluation of approximately the lateral half of the humeral head and the lateral glenoid rim. In phase 2, all joints were successfully accessed, and fluid extravasation was mild. Arthroscopic visualization was complete for the centrolateral aspect of the joint in all horses and either complete (3/6) or partial (3/6) for the craniolateral and caudolateral structures, respectively. The procedure was rapidly performed and well tolerated, and no postoperative complications occurred. CONCLUSION: The described technique was simple and allowed direct inspection of the scapulohumeral joint. Nonetheless, the standing nature of the technique prevents evaluation of the medial aspect of the humeral head and most of the glenoid cavity. CLINICAL SIGNIFICANCE: Needle arthroscopy of the scapulohumeral joint is feasible in horses and offers a diagnostic technique that may improve the surgeon's diagnostic ability for certain shoulder pathologies.


Asunto(s)
Artroscopía/veterinaria , Agujas/veterinaria , Articulación del Hombro/cirugía , Animales , Artroscopía/instrumentación , Artroscopía/métodos , Cadáver , Femenino , Caballos , Masculino
5.
Can Vet J ; 62(9): 975-981, 2021 09.
Artículo en Inglés | MEDLINE | ID: mdl-34475583

RESUMEN

This study investigated the pharmacokinetics of ceftiofur after intravenous regional limb perfusion (IVRLP). Six horses were involved in 3 IVRLP sessions. For each session, operators with varying clinical experience placed the tourniquet. A wide-rubber tourniquet was applied in the antebrachium as 2 g of ceftiofur in a total volume of 100 mL was injected into the cephalic vein. Plasma and metacarpophalangeal synovial fluid samples were obtained to evaluate perfusate leakage and synovial fluid concentrations of ceftiofur over 24 h. Overall, mean plasma concentrations were not significantly different before and after tourniquet removal. Mean synovial fluid ceftiofur concentrations were significantly higher 5 min and 8 h after tourniquet removal versus 24 h, after which values above the minimum inhibitory concentration (MIC) (1 µg/mL) were not detected. Concentrations above the MIC were detected in 72% and 50% of the horses at 5 min and 8 h, respectively. Overall, higher synovial fluid concentrations were obtained for the operator with the most recent clinical experience performing IVRLP.


Pharmacocinétique du ceftiofur dans l'articulation métacarpophalangienne après perfusion intraveineuse loco-régionale chez le cheval debout. Cette étude a examiné la pharmacocinétique du ceftiofur après perfusion intraveineuse loco-régionale des membres (PLR). Six chevaux ont participé à trois séances PLR. Pour chaque séance, un opérateur d'expérience clinique différente a placé le garrot. Un garrot large en caoutchouc a été appliqué dans l'avant-bras tandis que 2 g de ceftiofur dans un volume total de 100 mL ont été injectés dans la veine céphalique. Des échantillons de plasma et de liquide synovial métacarpophalangien ont été prélevés pour évaluer les fuites de perfusion et les concentrations de liquide synovial de ceftiofur au fil du temps. Dans l'ensemble, les concentrations plasmatiques moyennes n'étaient pas significativement différentes avant et après le retrait du garrot. Les concentrations moyennes de ceftiofur dans le liquide synovial étaient significativement plus élevées 5 min et 8 h après le retrait du garrot par rapport à 24 h, où les valeurs supérieures à la CMI (1 µg/mL) n'étaient pas détectées. Des concentrations supérieures à la CMI ont été détectées chez 72 % et 50 % des chevaux à 5 min et 8 h, respectivement. Des concentrations plus élevées de liquide synovial ont été obtenues pour l'opérateur avec une expérience clinique plus récente sur PLR.(Traduit par les auteurs).


Asunto(s)
Amicacina , Miembro Anterior , Animales , Antibacterianos , Cefalosporinas , Caballos , Articulación Metacarpofalángica , Perfusión/veterinaria , Líquido Sinovial
6.
Vet Surg ; 49 Suppl 1: O38-O44, 2020 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-31981365

RESUMEN

OBJECTIVE: To investigate the use of a needle arthroscope for diagnostic tenoscopy of the carpal sheath in standing horses. STUDY DESIGN: Experimental study. SAMPLE POPULATION: Six forelimbs for the cadaveric part of the study and six horses for the in vivo part of the study. METHODS: Six cadaveric limbs were used to perform carpal sheath tenoscopy with a 1.2-mm-diameter needle arthroscope (65 and 100 mm long), followed by tenoscopy with a 4-mm arthroscope through a standard proximolateral approach. Then, unilateral standing carpal sheath tenoscopy was performed in six healthy sedated horses with a 65-mm-long needle arthroscope. Limbs were maintained in flexion during the procedure by using a custom-made splint and base. Degree of tenoscopic evaluation, safety, horse tolerance, and complications were recorded. RESULTS: Visibility at the most distal aspect of the sheath was absent for the needle arthroscopes vs a standard arthroscope. The maneuverability with a 65-mm needle arthroscope was excellent and allowed exhaustive visualization of the proximal region of the carpal sheath in cadaveric limbs and standing horses (six of six). However, visualization of the intertendinous recess was partial in most horses (four of six) vs cadavers (complete in six of six) because of remaining flexor tendon tension in standing horses. No major complications were encountered. CONCLUSION: Standing carpal sheath tenoscopy allowed a safe and thorough evaluation of most structures in the proximal region of the sheath and offers an alternative diagnostic technique. CLINICAL SIGNIFICANCE: Horses with unrewarding results after traditional imaging or that require an accurate diagnosis before treatment may benefit from this alternative procedure.


Asunto(s)
Artroscopía/veterinaria , Miembro Anterior/cirugía , Caballos/cirugía , Tendones/cirugía , Animales , Artroscopios/veterinaria , Artroscopía/instrumentación , Artroscopía/métodos , Cadáver , Agujas/efectos adversos
7.
Vet Surg ; 49 Suppl 1: O60-O70, 2020 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-31228274

RESUMEN

OBJECTIVE: To describe the technique, experience, and limitations of using a 2-mm flexible endoscope to perform standing minimally invasive sinoscopy. STUDY DESIGN: In phases 1 and 2, we used cadaveric heads (ex vivo). In phase 3, we used unaffected horses (in vivo). ANIMALS: Five cadaveric equine skulls in phase 1 and 10 cadaveric equine skulls in phase 2. Six horses older than 5 years in phase 3. METHODS: In phase 1, the specimens were used to determine the suitability of the endoscope for sinoscopy and the ideal landmarks to approach the paranasal sinuses through minisinusotomies performed with a 14 gauge needle. In phase 2, a nonblinded evaluation of the visualization of the different sinus compartments was performed, and a score was attributed to each structure. Procedures were video recorded and compared with direct visualization of the sinuses after performing frontal and maxillary flaps. In phase 3, the technique was validated in healthy horses under sedation. RESULTS: The landmarks determined in phase 1 allowed a thorough exploration of the sinuses in phases 2 and 3. Sinoscopy findings were confirmed after direct visualization of the sinuses via frontal and maxillary bone flaps in phase 2. The procedure was well tolerated by all horses. CONCLUSION: Minimally invasive sinoscopy was readily performed without relevant complications in standing horses. A thorough evaluation of most sinus structures was obtained only using the frontal and the rostral maxillary portals. CLINICAL SIGNIFICANCE: Minimally invasive sinoscopy offers an alternative diagnostic tool to veterinarians. A specialized endoscope and appropriate training are required to perform this minimally invasive procedure.


Asunto(s)
Endoscopios/veterinaria , Caballos/cirugía , Procedimientos Quirúrgicos Mínimamente Invasivos/veterinaria , Senos Paranasales/cirugía , Cirugía Asistida por Video/veterinaria , Animales , Cadáver , Procedimientos Quirúrgicos Mínimamente Invasivos/métodos , Reproducibilidad de los Resultados , Cirugía Asistida por Video/instrumentación , Cirugía Asistida por Video/métodos
8.
Vet Surg ; 49(3): 445-454, 2020 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-31943288

RESUMEN

OBJECTIVE: To develop and assess a needle arthroscopic technique to diagnose conditions of the tarsocrural joint (TCj) in standing sedated horses. STUDY DESIGN: Experimental study. SAMPLE POPULATION: Six cadaveric hind limbs (phase 1) and six healthy horses (Phase 2). METHODS: In phase 1, each TCj was examined with a 1.2-mm-needle arthroscope. Suitability of the needle arthroscope and degree of joint visualization with traditional arthroscopic approaches were assessed. In phase 2, the feasibility of the procedure was assessed in six standing healthy horses. A custom-made splint and base were developed to maintain joint flexion during the procedure. RESULTS: Thorough evaluation of the dorsal intra-articular structures of the TCj via dorsomedial and dorsolateral approaches was possible in both phases. The procedure was feasible, quickly performed, and well tolerated by all horses. Complications consisted of moderate movement (2/6 horses) and hemarthrosis (3/6 horses). CONCLUSION: Diagnostic standing needle arthroscopy of the TCj allowed thorough evaluation of the dorsal aspect of the joint while avoiding the cost and risks associated with general anesthesia. Inadvertent puncture of the dorsomedial vasculature with the cannula and obturator led to significant hemarthrosis. CLINICAL IMPACT: Needle arthroscopy of the TCj offers an alternative diagnostic tool when traditional imaging techniques (radiography and ultrasonography) are unrewarding or nondiagnostic. The technique is conceived mainly for diagnostic purposes, but its use during short interventions warrants investigation.


Asunto(s)
Artroscopía/veterinaria , Sedación Consciente/veterinaria , Enfermedades de los Caballos/diagnóstico , Enfermedades de los Caballos/cirugía , Agujas , Animales , Artroscopía/normas , Sedación Consciente/normas , Caballos
9.
Vet Surg ; 49(5): 894-904, 2020 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-32333682

RESUMEN

OBJECTIVE: To develop a technique for standing diagnostic needle arthroscopy of the radiocarpal and middle carpal joints in standing sedated horses. STUDY DESIGN: Experimental study. ANIMALS: Six cadaveric forelimbs (phase 1) and six healthy horses (phase 2). METHODS: In phase 1, six cadaveric forelimbs were used to assess needle arthroscopic evaluation of both joints. Six healthy horses were subsequently enrolled in phase 2 to validate the procedure in live animals. The joint was maintained in flexion with a custom-made splint and base. RESULTS: In phase 1, needle arthroscopy allowed thorough evaluation of the dorsal and palmar recesses of both joints with traditional arthroscopic portals. In phase 2, joint evaluation was also thorough but only dorsal approaches were performed. All horses underwent radiocarpal joint arthroscopy, whereas the middle carpal joint was evaluated in only three of six horses because of limb movement. The technique was quickly performed and well tolerated by all horses. Complications included moderate movement, mild iatrogenic cartilage damage, and mild hemarthrosis. CONCLUSION: Standing needle arthroscopy allowed thorough evaluation of the dorsal aspect of both joints, although only three of six middle carpal joints were assessed because of movement limitations. CLINICAL SIGNIFICANCE: The proposed technique offers an alternative diagnostic tool for radiographically silent intra-articular lesions of the carpus while initially avoiding the cost and risks associated with general anesthesia. Arthroscopy of a single joint is recommended to minimize risks associated with movement during the procedure.


Asunto(s)
Artroscopía/veterinaria , Articulaciones del Carpo/cirugía , Miembro Anterior/cirugía , Caballos/cirugía , Agujas/veterinaria , Animales , Cadáver , Femenino , Masculino
10.
Can Vet J ; 61(10): 1101-1105, 2020 10.
Artículo en Inglés | MEDLINE | ID: mdl-33012827

RESUMEN

The objective of this study was to determine if abdominal elevation could induce radiographically visible widening of the interspinous spaces in the thoracolumbar region of standing sedated horses and facilitate the surgical approach to the region. Radiographs centered on T13 and T18 were taken while applying different degrees of tension on a wide strap placed under the abdomen of 7 healthy horses. Then, the interspinous spaces between T11 and L2 were measured following a standardized method. The interspinous spaces widen radiographically between T11 to L2, except for T18-L1. Thus, the reported technique could potentially facilitate the surgical approach for horses with impinging and overriding dorsal spinous processes.


Influence de l'élévation abdominale sur les mesures radiographiques des espaces intervertébraux thoraco-lombaires chez des chevaux asymptomatiques. L'objectif de la présente étude était de déterminer si l'élévation abdominale pouvait causer un élargissement radiographique visible des espaces intervertébraux dans la région thoraco-lombaire de chevaux sous sédation en position debout et faciliter l'approche chirurgicale de la région. Des radiographies centrées sur T13 et T18 furent prises tout en appliquant différents degrés de tension sur une large courroie placée sous l'abdomen de sept chevaux en santé. Puis, les espaces intervertébraux entre T11 et L2 furent mesurés en suivant une méthode standardisée. Les espaces intervertébraux s'élargissaient radiographiquement entre T11 à L2, sauf pour T18­L1. Ainsi, la technique radiographique rapportée ici pourrait potentiellement faciliter l'approche chirurgicale chez des chevaux avec empiètement et chevauchement des apophyses épineuses.(Traduit par Dr Serge Messier).


Asunto(s)
Vértebras Lumbares , Vértebras Torácicas , Abdomen , Animales , Caballos , Vértebras Lumbares/diagnóstico por imagen , Vértebras Lumbares/cirugía , Radiografía , Vértebras Torácicas/diagnóstico por imagen , Vértebras Torácicas/cirugía
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