What is a Diplomate?
The term "ACVS Diplomate" refers to a veterinarian who has been board certified in veterinary surgery. Only veterinarians who have successfully completed the certification requirements of the ACVS are Diplomates of the American College of Veterinary Surgeons and have earned the right to be called specialists in veterinary surgery.
Laparoscopy is a technique to perform surgery through small incisions (about 1cm each) using a specialized camera and instruments. A long, narrow and rigid camera called a laparoscope is placed through a small incision to view inside the body. The image is transmitted to a camera for the surgeon to view on a monitor.
Long-handled surgical instruments that are specifically designed for laparoscopy are passed through separate cannulae (tubular portals placed through other small incisions) to assist in surgery (Figure 1). Some procedures in horses are performed using a combination of laparoscopy and a larger incision that the surgeon can put their hand through. This is referred to as hand-assisted laparoscopy.
Gastrointestinal Tract:
- Adhesions (scar tissue within the abdomen) (Figure 2)
- Tears in the mesentery (the tissue holding the intestines together)
- Rectal tears
- Colopexy or nephrosplenic space ablation ̶ chronic colic caused by colon displacements
- Hernias (inguinal hernias or body wall hernias)
- Umbilical remnant resection ̶ removing an infected umbilicus in foals
Urogenital Tract:
- Ovariectomy - Removal of one or both ovaries to treat tumors or for behavior modification
- Cryptorchid castration - Remove undescended testicle(s) laparoscopically. (Movie 1)
- Bladder stone removal by hand-assisted laparoscopy
- Ruptured bladder repair (foals)
- Nephrectomy - Removal of a kidney by hand-assisted laparoscopy
Chest:
Laparoscopy of the chest is called thoracoscopy
- Take biopsies or see abnormal areas of lung (for diagnostic purposes)
- Treat abscesses associated with pleuropneumonia
- Remove scar tissue
Exploratory and Diagnostic Procedures:
Aids in diagnosis of chronic, intermittent colic
Perform biopsies or cultures of organs or other tissue
View organs or intra-abdominal masses
Alternate Procedures/Techniques:
Many of the procedures listed above can be performed by traditional surgical techniques; however, some cannot, and others typically require much larger incisions than those used with laparoscopy. Most traditional methods are performed under general anesthesia. Please consult an ACVS board-certified veterinary surgeon about specific conditions and the pros and cons of laparoscopy vs. traditional surgery.
- Smaller incisions vs. traditional techniques
- Better visualization (in some cases)
- Easier post-operative wound care
- Less lay-up time and scaring (in some cases)
- Some procedures can be done in the standing, sedated horse
- Not all surgeries can be done with laparoscopy
- Requires specialized equipment and training for the veterinary surgeon
- In some cases it may be used to diagnose the problem, but the problem cannot be fixed without making a larger incision or performing standard open surgery
