Augmenting Veterinary Minimally Invasive Surgery: Evidence-based Review of Foundational and Novel Devices and Technology.

Veterinary minimally invasive surgery continues to grow as a specialty. With increasing experience in this field, comes improved accessibility as well as progressive complexity of procedures performed. Advancement in technology has been both a response to the growth and a necessary driver of continued refinement of this field. Innovative research leading to advancements in surgical equipment has led to the development of novel image acquisition platforms, cannulas, smoke evacuation systems, antifog devices, instrumentation, and ligating/hemostatic devices. These innovations will be reviewed and potential clinical applications are discussed.

Looking to the Future; Veterinary Robotic Surgery.

This article details the rise of surgical robots in the human surgical sphere as well as their use in veterinary medicine. Sections will describe in detail the equipment required for these procedures and the advantages and disadvantages of their use. Specific attention is given to the articulated instrumentation, which affords psychomotor benefits not only for surgical precision but also for surgeon ergonomics. A discussion of the possible indications and current use of robotics in veterinary medicine and the challenges to integrating robotics is also provided.

Update on Surgical Principles and Equipment.

The diversity implicit in exotic animal surgery requires a tailored approach to optimize successful outcomes. Outlined is information on patient preparation, instrumentation, hemostatic techniques, and magnification as it pertains to the exotic animal. Application of topical antiseptic solutions and judicious removal of pelage and feathers will decrease bacterial load during patient preparation. The use of specific barrier protection ensures proper aseptic technique and enables optimal patient monitoring. Magnification combined with a focal light source enhances visual acuity, allowing for better use of delicate instrumentation and identification of anatomic structures.

Facilitation of soft tissue surgery: surgical staplers and vessel sealing devices.

Recent advances and acceptance of various medical devices have clearly helped in the efficiency, simplicity, and effectiveness of veterinary surgery. The goals of surgery include efficient methods and minimal surgical times, delicate tissue handling techniques, confidence with tissue reconstruction, and minimizing contamination, leakage and complications. Mechanical means of suturing, cutting, and hemostasis assist with accomplishing these goals. Most recently, stapling instrumentation and vascular sealing devices have become common instruments on all levels of surgery because of their ease of use and increase in surgical efficiency.

Current concepts in hepatobiliary surgery.

The most common hepatic procedures performed in companion animals are liver biopsies and partial hepatectomies. Surgery of the biliary tract most often involves the gallbladder, although surgical intervention of the bile duct may also be performed. Hepatobiliary surgery is often challenging, being performed in patients with significant systemic illness and associated with potentially life-threatening complications. An in-depth understanding of the regional anatomy, use of a team concept for patient management, particularly for patients undergoing partial hepatectomy surgery, and provision of intensive perioperative monitoring and support helps minimize complications and maximize outcome.

Current concepts in oncologic surgery in small animals.

Surgical oncology is experiencing rapid transition in veterinary medicine. Mast cell tumors and soft tissue sarcomas are two of the most common neoplasms in small animal patients. Clinicians should be familiar with the need for staging and the procedures involved in treating patients with these tumors. Clinicians should be comfortable with available adjuvant therapies and when to use them in certain patients.

Current concepts in congenital portosystemic shunts.

Congenital portosystemic shunts (CPSS) are vascular abnormalities that allow portal blood to bypass the liver and join systemic circulation. Laboratory and imaging studies are performed preoperatively to diagnose CPSS and hopefully identify an anatomic location of the shunt. CPSS can be found in different locations in both small and large breed dogs. Most CPSS are best managed surgically. The goal of surgical management of CPSS is to slowly redirect blood from the shunting vessel through the portal vasculature while avoiding portal hypertension. Many surgical management methods are available, including open and less invasive procedures, such as laparoscopy and embolization.

Assessing the need for future veterinary surgeons.

While some in the profession are concerned about a possible 'overproduction' of vets, others argue that more might be needed to help meet current and future challenges. A debate at this year's BVA Congress tackled the question of how many vets are required, while considering how their unique skills might be more widely applied. Manuela Herrera reports.

Picturing the pain of animal others: rationalising form, function and suffering in veterinary orthopaedics.

Advances in veterinary orthopaedics are assessed on their ability to improve the function and wellbeing of animal patients. And yet historically veterinarians have struggled to bridge the divide between an animal's physicality and its interior experience of its function in clinical settings. For much of the twentieth century, most practitioners were agnostic to the possibility of animal mentation and its implications for suffering. This attitude has changed as veterinarians adapted to technological innovations and the emergence of a clientele who claimed to understand and relate to the subjective experiences of their animals. While visualising technologies and human analogies have shaped the nuts and bolts of veterinary orthopaedic practices, an emerging awareness of the inability of radiographic images to apprehend or correlate to a patient's experience of their function reliably has required veterinarians to place a greater emphasis on the owner's knowledge of the "selves" inhabiting their animals. Rather than simply basing clinical judgments on the "look" of their patients, the indeterminacy in the connection between form and function has compelled veterinarians to put questions regarding particular human-animal relationships near the centre of their practices, not least in orthopaedic surgery.

Update on veterinary cataract surgery.

PURPOSE OF REVIEW: The purpose of this review is not to specifically discuss the techniques of veterinary cataract surgery, but rather to emphasize some of the differences between the veterinary and human cataract patients, procedures and outcomes. RECENT FINDINGS: In general, veterinary cataract surgery has more similarities than differences when compared to its human counterpart. This is especially true when comparing pediatric cataract patients. Veterinary cataract surgery has changed dramatically in recent years with regards to surgical technique, ocular pharmacology, viscoelastic devices, phacoemulsification, and the most recent advancement, intraocular lens implantation for dogs, cats, and horses. SUMMARY: It is hoped that the exchange of information between the human and veterinary specialties can be of benefit to both groups as we all work to improve outcomes and resolve complications.