A selection of educational media has been kindly provided from the case notes of Dr Eugene Lin.
We hope to raise awareness of the enhanced clarity, safety and precision achieved via laparoscopy and endoscopy. All media is credited to Dr Eugene Lin. All rights reserved.
Traditionally bladder, urethra, ureter and kidney uroliths (stones) are removed via incisions into the respective organs to extract the uroliths. At The Animal Ark Centre for Minimally Invasive Surgery, we are now able to blast larger uroliths into smaller fragments using Holmium:YAG laser. The process is called laser lithotripsy. The fragments are then physically removed or simply urinated out. Below is a video of the treatment procedure of urethral and bladder stones in a male 9 kg dog, all accomplished without a single incision.
Some smaller uroliths are simply pulled out of the urethra with the help of a urethrocystoscope and a tiny forceps.
Urethrocystoscopy enable us to thoroughly examine the urethral lumen and bladder wall. In the case below, a single solitary lesion on the bladder wall (less than 1mm in size) was discovered during laser lithotripsy of bladder stones. The mass was subsequently biopsied and unfortunately it turned out to be a malignant bladder cancer called Transitional Cell Carcinoma. We will start the dog on medications and subsequently follow up with laser ablation of the tumour cells.
Urethrocystoscopy enables us to have an unimpaired view of the urethral and bladder lumen as we insert the scopy from the urethra to the bladder.
Laparoscopic ovariectomy (spaying) is performed through small incisions (3mm - 5mm) into the abdomen and then inserting special long and slander instrument into the abdominal cavity. In this case the right ovary of a dog is carefully separated from its attachments with a Ligasure device and then removed from the body.
Esophageal stricture is relatively common in chronic vomiting animals, especially cats. In this case the cat has been vomiting for months and was finally referred to The Animal Ark when it could not swallow anything (not even water) for a few days. An esophagoscopy revealed an esophageal stricture and the lumen was only 2mm at its narrowest! The video shows the esophageal stricture before and after balloon dilatation.
Gall bladder stone is occasionally encountered in animals. The stones prevent bile from draining out of the gall bladder. Cholecystoscopy is a minimally invasive procedure that involves inserting a 2.7mm rigid telescope into the gall bladder to remove the obstructing stones. If the gall bladder itself is diseased, a laparoscopic cholecystectomy is indicated.
Esophagoscopy enables us to remove almost all foreign bodies from the oesophagus. Traditionally if an object is tightly lodged in the esophagus, a major surgery which involves cutting open the chest and then the esophagus to retrieve the foreign body is required. With esophagoscopy, the object is simply pull out of the esophagus without the need for any incision.
Internal organs biopsy normally requires a large incision into the respective body cavities in order to harvest a small quantity of tissues for accurate histopathology. At The Animal Ark Veterinary Centre, these biopsies are carried out laparoscopically through two 3mm or 5mm incisions. The following video is a recording of a laparoscopic liver biopsy.
Chronic ear problem warrants an in-depth look into the ear channel. Otoscopic examination allows just that. On many occasions the cause of the chronic ear infection is a growth in the ear canal (as in the case below) or a foreign body (e.g. grass seed, dead insects).
Traditional hand-held otoscopes can only view parts of this membrane and have limited cleaning access. Deep Ear Otoscopy allows full cleaning of all areas leading up to the eardrum, with important functions such as pressure washing, fluid suction and grasping of infected material. If there is pus in the middle ear, the ear drum can be surgically opened and the scope further advanced into the middle ear for thorough cleaning.
Ear canal after thorough cleaning - chronic ear infection resulting in narrowing of the deep ear canal.