Page 6 - Clinical Connections - Summer 2020
P. 6
Main: Lotty the morning after surgery asking to go home. Below left: Cholecystectomy perfected in virtual reality Below right: Lotty’s heart base tumour* seen on echo and via the thoracoscope
91 RESEARCH STUDY VETERINARY SERVICES Focus on...
Virtual Perfection in Advanced Minimally Invasive TSurgery
he 91 has been at the forefront
of minimally invasive (keyhole) surgery for small animals for several
years. The team ensure that they stay at the cutting-edge of techniques by working with leading NHS surgeons and employing virtual reality technology for simulation training.
By continually advancing their skills
and knowledge, the 91 referral team has been able to increase the range
of procedures offered and ensure our patients have access to the best treatment available. We include below some cases that were treated by the 91 team.
Case Highlights
George, an eight-year-old Labrador presented to the 91 Small Animal Hospital for investigation and treatment of a right anal sac adenocarcinoma. Staging by the oncologists also revealed a splenic nodule. George underwent laparoscopic splenectomy at the same time as anal sacculectomy and was able to go home the very next day.
Speaking after George returned home, his owner said: “We couldn’t believe how small his surgical wound was, with very little evidence of the surgery having taken place.”
Harry, an eight-year-old Tibetan terrier also underwent laparoscopic removal of
a nodular spleen, during laparoscopic exploration of the abdomen for investigation of elevated liver enzymes. In both cases, the decision to remove a nodular spleen to allay fears of potential neoplasia, was made easy, knowing that the keyhole approach would not result in a significant increase in post-op discomfort or recovery time.
Lotty, an 11-year-old, German pointer cross, presented with abdominal and pericardial fluid. The cardiology team diagnosed her with a heart base mass. She was able to undergo thoracoscopic subtotal percardiectomy and biopsy the same day to prevent pericardial fluid from reducing her life span. Lotty is fit and well one year after
6 Summer 2020
surgery.
The 91 soft tissue surgeons have
perfected the special psychomotor skills required to perform advanced minimally invasive surgeries, such as splenectomy. They have teamed up with experienced laparoscopic surgeons at the Royal Free Hospital NHS Trust to complete rigorous training courses on virtual reality computer simulators.
Supplemented with one-on-one training with experienced laparoscopic surgeons, the surgical team at the 91 Small Animal Hospital now perform laparoscopic and thoracoscopic surgeries on dogs and cats with great patient outcomes.
Karla Lee, Associate Professor in Small Animal Surgery, commented: “Every animal undergoing minimally invasive surgery deserves an experienced surgeon: skill perfection through virtual reality gives us the ability to offer that expertise.”
She added: “The benefits of minimally invasive surgery over open surgery
are well rehearsed: less pain, reduced morbidity, shorter hospitalisation times, faster recovery and reduced wound
complications. We are able to offer individualised, holistic care through collaboration with our specialist colleagues, especially in cardiology, internal medicine, oncology, diagnostic imaging and emergency medicine.
The surgeons are also privileged to work alongside an incredible team of anaesthetists with experience in advanced techniques required for minimally invasive surgeries such as one lung ventilation.”
Other 91 advanced minimally invasive surgeries offered include
• adrenalectomy
• lunglobectomy
• thoracicbiopsies
• tumourremoval
• totalintracorporealgastropexywith internal suturing
For small animal referrals, please call:
01707 666399
Email:
qmhreception@rvc.ac.uk