The world of veterinary medicine is full of scientific words and phrases, not commonly used in day-to-day life. Normally, when we speak to clients, we can explain what we mean so that everyone has an understanding of the situation and there is no confusion. However, you may come across certain language on a vet’s website which might not be clear. Laparoscopic surgery is often one of those phrases seen when advertising which services a vets can offer. But what does laparoscopic surgery actually mean and why should you pay attention to it?
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A (very) brief history lesson
A lot of medical language originates from Latin or other ancient languages. The word ‘laparoscopy’ comes from the ancient Greek ‘lapára’ meaning ‘flank’ or ‘side’, and ‘skopéō’ meaning ‘to see’. Laparoscopic surgery is otherwise known as keyhole surgery, specifically of the abdomen, and was first performed at the turn of the last century, in 1901.
What is it and how does it differ from traditional surgery?
Laparoscopic surgery is becoming incredibly common in human medicine and many pet owners have had experience of it either for themselves or for someone they know. The procedure involves making very small incisions into the abdominal cavity to allow special cameras and surgical instruments to be inserted, which are then controlled by the surgeon as they view the images on a large screen. It is likened to playing video games and it’s not uncommon for those surgeons who spent substantial chunks of their childhood in front of the latest console, to be quicker to pick up the skills and techniques required when training on laparoscopic equipment than those of us who didn’t!
So, what procedures can be done ‘laparoscopically’?
In a veterinary setting, the most common use of laparoscopy is in neutering, particularly for spays. Traditional spaying involves opening the abdomen by making a midline incision of at least a couple of inches in length and performing a full ovariohysterectomy – removing both ovaries and the uterus, then tying off the blood vessels with sutures. The wound is usually closed with skin sutures and the dog needs to be kept quiet for around 10-14 days, until the stitches are removed.
In the laparoscopic spay, two or three small (less than 1cm) abdominal incisions are made through which the instruments are inserted, and if the uterus and ovaries look healthy, only the ovaries are usually removed. The blood vessels are sealed by electrocautery before each ovary is extracted through the same holes used to operate the instruments.
Other common laparoscopic surgeries include
- cryptorchid castration
- taking biopsies from abdominal organs
- abdominal exploration, for example, to look for a tumour
More complex procedures include
- gastropexy (fixing the stomach to the body wall to prevent a bloat and torsion)
- colopexy (fixing the colon to the body wall)
- cystopexy (fixing the bladder to the body wall)
- removal of abnormal or cancerous organs such as the spleen, gall bladder or adrenal glands
What are the pros and cons of laparoscopic surgery?
Pros:
- Small incisions
- Rapid healing time
- More comfortable in recovery vs open abdominal procedures
- Able to ‘get back to normal’ quicker
- Minimally invasive
- Lower morbidity
- The equipment can be used for a number of procedures, including joint surgery, obtaining biopsies, and abdominal surgery.
Cons:
- Requires extra staff training
- Requires expensive equipment
- Greater expense to the client
- Often need to convert to an ‘open’ procedure if complications arise.
- Surgeons are not able to physically feel the tissues to make clinical assessments.
As with any advances in veterinary medicine, the benefits to the animal should be the driving force. This is certainly the case with laparoscopic surgery and many owners whose pets have experienced a laparoscopic procedure would agree that in most cases, the animals appear almost back to normal by the following day. Although we shouldn’t always extrapolate from human medicine, human surgical patients will nearly always report having a much faster and less painful recovery from laparoscopic surgery than those that undergo ‘open’ surgery and, if they had the choice, most would choose this method.
The majority of veterinary practices that offer laparoscopic surgery will offer it as an option alongside more traditional methods. It’s always worth speaking to the practice team to discuss whether laparoscopy is the right way forward for you and your pet but in many cases, your pet may well feel the benefits of this more modern technique.