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1.
A technique was developed for subtotal prostatectomy in dogs with the neodymium:yttrium-aluminum-garnet (Nd:YAG) laser. In six normal dogs, full-thickness necrosis of the prostate occurred if the central-lateral region within 5 mm of the urethra was photoablated at 60 watts for 1 second. Moderate to superficial necrosis occurred when the prostate within 5 mm of the urethra was photoablated at 35 watts for 2 seconds or 60 watts for 0.5 second. At necropsy, leakage of the urethra occurred in two dogs at sites treated at 60 watts for 1 second. In a clinical study, complications associated with subtotal prostatectomy with the Nd:YAG laser (n = 6) were compared with complications associated with prostatic drainage (n = 6) in dogs with prostatic disease. Intraoperative death (2/6 dogs) and nocturnal incontinence (4/4 surviving dogs) occurred with subtotal prostatectomy. Uncontrolled prostatic infection (2/6 dogs) occurred with prostatic drainage and resulted in the death of one dog on day 11. Four of five dogs surviving prostatic drainage developed recurrent urinary tract infection.  相似文献   

2.
OBJECTIVE: To describe a technique of contact neodymium:yttrium-aluminum-garnet (Nd:YAG) laser-assisted excision of progressive ethmoid hematoma (PEH) in horses, to determine the recurrence rate of clinical signs of PEH in horses with follow-up time of a minimum of 12 months, and to compare this result with reported results achieved by using conventional techniques. DESIGN: Retrospective study. ANIMALS: 21 horses with 26 PEH. PROCEDURE: Medical records of all horses with PEH treated by Nd:YAG laser excision from December 1986 through August 1996 were analyzed. Twenty-one horses underwent unilateral (18 surgeries) or bilateral (14) frontonasal bone flap with excision of the mass, using an Nd:YAG laser. One horse with bilateral PEH underwent a unilateral bone flap twice, 1 year apart. RESULTS: 1 horse died. Four of 20 horses with followup times of 12 months or longer had recurrence of PEH. The PEH recurrence rate was 20% (5/25 PEH). Three of 6 horses with bilateral lesions had recurrence of PEH. Recurrence rate for horses that had bilateral PEH (3/6 horses) was greater than for horses with unilateral PEH (1/14 horses). CLINICAL IMPLICATIONS: Treatment of PEH by Nd:YAG laser excision through a frontonasal bone flap results in a recurrence rate comparable with that reported for conventional techniques. Horses with bilateral lesions are more likely to have a recurrence of PEH.  相似文献   

3.
OBJECTIVE: To determine effects of cyclophotocoagulation via administration of 100 J with a neodymium:yttrium aluminum garnet (Nd:YAG) laser on corneal touch threshold (CTT), intraocular pressure (IOP), aqueous tear production, and corneal nerve morphology in eyes of dogs. ANIMALS: 15 dogs. PROCEDURE: Noncontact Nd:YAG laser was transsclerally applied (10 applications; 25 W for 0.1 seconds for each application to each of 4 quadrants) to the ciliary body of the left eye of 15 dogs; the right eye was the control eye. Corneal integrity, CTT, tear production as measured by the Schirmer tear test (STT), and IOP were evaluated for 14 days following laser treatment. On day 14, dogs were euthanatized, eyes harvested, and corneas stained with gold chloride. Major nerve bundles were analyzed by use of a drawing tube attached to a light microscope, and maximum diameters were measured by use of image analysis software. RESULTS: All laser-treated eyes had significantly higher CTT values, compared with control eyes. Six of 15 laser-treated eyes developed ulcerative keratitis. On most days, IOP was significantly lower in laser-treated eyes in both morning and evening. Laser-treated eyes had a significant decrease of approximately 1 nerve bundle/corneal quadrant. Values for STT or nerve bundle diameters did not differ significantly. CONCLUSIONS AND CLINICAL RELEVANCE: Administration of 100 J with a Nd:YAG laser effectively reduced IOP while increasing CTT and caused a significant decrease in number, but not diameter, of major corneal nerve bundles. Nerve damage and corneal hypoesthesia are etiologic factors in ulcerative keratitis following Nd:YAG cyclophotocoagulation.  相似文献   

4.
OBJECTIVE: To report an neodymium:yttrium-aluminum garnet (Nd:YAG) laser-assisted modified Forssell's surgical technique and outcome for treatment of cribbing (crib-biting) in horses. STUDY DESIGN: Retrospective clinical study. ANIMALS: Ten adult horses with stereotypic cribbing behavior. METHODS: Data were obtained from medical records and telephone conversations with owners, trainers, and veterinarians. Surgical technique involved an approximately 34-cm ventral median skin incision starting rostral to the larynx and extending caudally. A 10-cm section of the ventral branch of the spinal accessory nerve was removed, using an Nd:YAG laser at 25 W and continuous pulse with a contact, sculpted-fiber tip. After neurectomy, approximately 34-cm sections of the paired omohyoideus and sternothyrohyoideus muscles were removed starting 2 cm rostral to the ventral aspect of the larynx, at the basihyoid bone, using the Nd:YAG laser. RESULTS: Median horse age was 7 years (range, 1 to 11 years). Median surgical time was 90 minutes (range, 75 to 130 minutes). Long-term outcome (range, 7 to 72 months) was available for all horses. None of the horses had cribbing behavior after surgery, and all returned to their previous use. Four horses had complications (two of which were unrelated to the surgical site), but all recovered fully. CONCLUSION: The successful outcome we obtained is better than reported previously using a modified Forssell's technique. CLINICAL RELEVANCE: Surgical treatment for cribbing by Nd: YAG laser-assisted myectomy and neurectomy resulted in an excellent prognosis for resolution of the stereotypical behavior with minimal complications.  相似文献   

5.
OBJECTIVE: To develop a technique for neodymium:yttrium-aluminum-garnet (Nd:YAG) laser ventriculocordectomy in standing horses and document healing in horses undergoing laser ventriculocordectomy. ANIMALS: 6 horses between 2 and 32 years old. PROCEDURE: Under endoscopic guidance, the left laryngeal ventricle was everted with grasping forceps and excised with an Nd:YAG laser, using 60 watts of power in a noncontact fashion (6,403 to 9,197 Joules). Following removal of the ventricle, the vocal cord was photoablated. Horses were examined endoscopically 2, 7, 14, 21, 30, and 47 days after ventriculocordectomy, and 1 horse was euthanatized on each of these days. At necropsy, the larynx was removed intact and examined grossly. Samples were collected for histologic examination of the ventriculocordectomy site. RESULTS: Endoscopic examination revealed granulation tissue by day 7, the start of epithelialization by day 21, and healing by day 47. At necropsy, 4 horses were found to have a small amount of ventricular mucosa remaining dorsally and 1 additional horse was found to have a mucocele. Granulation tissue was identified grossly and histologically in the horses euthanatized between 7 and 30 days after surgery. Incipient reepithelialization was evident histologically on day 14, and complete reepithelialization of the surgery site was evident by day 47. CONCLUSION AND CLINICAL RELEVANCE: Results suggest that ventriculocordectomy can safely be performed with an Nd:YAG laser in standing horses.  相似文献   

6.
OBJECTIVE: To describe a technique for endoscope-assisted disruption and removal of urinary calculi using a holmium:YAG laser in sedated, standing horses. STUDY DESIGN: Retrospective study. ANIMALS: Six horses with urinary calculi. METHODS: A holmium:YAG laser was used to disrupt naturally occurring urinary calculi in horses (4 geldings, 1 stallion, 1 mare). Ischial urethrotomy was performed in male horses to provide a portal for the endoscope and laser fiber. Calculus fragments were removed by a combination of lavage, transendoscopic basket snare removal, forceps, and digital manipulation. Ischial urethrotomies healed by second intention. Follow-up was obtained by recheck examination and telephone interview of owners. RESULTS: No major operative or postoperative complications occurred. Two calculi (1 stallion and 1 mare) were fragmented by a combination of laser ablation and manual disruption with a lithotrite. Postoperative dysuria occurred in the mare, but resolved after 1 month. Mean (+/- SD) follow-up was 306 +/- 149 days; no other complications were reported. CONCLUSIONS: Calcium carbonate urinary calculi (up to 15 cm in diameter) in horses can be effectively fragmented with a holmium:YAG laser. It is not known if this technique would be completely effective for larger calculi or extremely dense calculi. CLINICAL RELEVANCE: Calculus disruption by an endoscopically assisted holmium:YAG laser offers a minimally invasive method that can be performed in standing horses and that minimizes patient risk.  相似文献   

7.
Objective— To investigate and compare technique, surgical time, and complications of canine laparoscopic ovariectomy using Nd:YAG surgical laser and Remorgida bipolar electrosurgery forceps.
Study Design— Randomized, prospective clinical trial.
Animals— Female dogs (n=40) for elective ovariectomy.
Methods— Dogs had bilateral ovariectomy with one ovary randomly assigned to removal by use of Nd:YAG surgical laser with a 600 μm optical fiber in contact mode and the other ovary to removal by use of a Remorgida forceps (featuring bipolar electrocoagulation with simultaneous sharp resection). Duration of predetermined surgery intervals and complications were compared between techniques. Additionally, the effects of several intraoperative variables on surgical time were evaluated.
Results— Ovariectomy by use of Remorgida forceps required significantly less time than laser ovariectomy but intraoperative hemorrhage was not reduced. Surgical time was significantly increased in obese dogs, depending on the amount of fat in the ovarian ligament. Intraoperative hemorrhage had no significant influence on surgical time.
Conclusion— Both ovariectomy techniques were effective but the Remorgida forceps can be used as a relatively inexpensive, stand-alone device that decreases surgical time compared with Nd:YAG laser ovariectomy.
Clinical Relevance— Novel techniques, such as laser and combined bipolar electrosurgical and cutting forceps aim to reduce surgery duration, complication rates and recovery time in laparoscopic surgery.  相似文献   

8.
The neodymium:yttrium aluminum garnet laser (Nd:YAG) produces an intense amount of irradiation when set at 100 W of total power output. The irradiation is easily transmitted through small quartz glass fibers that can be passed through the biopsy channel of most endoscopes. Noncontact or free fiber applications of lasers employ high-power outputs, whereas contact applications of laser energy are restricted to low-wattage output of the laser. Horses periodically develop a benign lesion referred to as a progressive ethmoid hematoma (PEH) that may fill the paranasal sinuses and can break through the ventral floor into the nasal passage. When this lesion originates from the nasal ethmoid turbinates, it can be removed by transendoscopic Nd:YAG laser photoablation. In the sinus form of PEH, the lesion first requires surgical removal, after which remnants are transendoscopically irradiated using laser technique. At NCSU College of Veterinary Medicine between 1986 and 1996, 41 horses received standing noncontact Nd:YAG laser treatment for PEH. In 70% of the cases, the treatment was successful in removing the entire lesion and/or eliminating any postsurgical remains or recurrences.  相似文献   

9.
There are clearly a number of applications for which flexible endoscopic laser surgery has become the state of the art in equine surgery, and the Nd:YAG laser seems to be the most versatile instrument for this type of surgery. Nevertheless, it is critical to understand the advantages and disadvantages of each laser technique. For example, the Nd:YAG laser used in a noncontact fashion seems to be superior when ablation of tissue is required such as treatment of upper airway masses. Conversely, contact Nd:YAG laser techniques have proven themselves to be superior when more precise cutting is advantageous such as treatment of epiglottic entrapment. Ultimately, it seems that a range of lasers is necessary to ensure selection of the most appropriate technique, adding significantly to the expense of equipment but improving the outcome for a range of equine diseases.  相似文献   

10.
Transendoscopic neodymium:yttrium-aluminum-garnet (Nd:YAG) laser was used to treat 12 standing horses with epiglottic entrapment (EE) or dorsal displacement of the soft palate (DDSP), or both. In four horses, transendoscopic laser staphylectomy was performed. The most common presenting complaints were respiratory stridor, cough, and exercise intolerance. Ten horses with EE healed without epiglottic complications; in one horse, partial adhesion of the aryepiglottic fold to one side of the epiglottis was corrected surgically through a laryngotomy incision. One horse with DDSP had no further signs, one continued to have continual DDSP, and two had induced DDSP. Transendoscopic Nd:YAG laser proved to be a feasible means of correcting EE and selected cases of DDSP.  相似文献   

11.
OBJECTIVE: To compare use of neodymium:yttrium aluminum garnet (Nd:YAG) surgical laser and bipolar electrocoagulation (BEC) for laparoscopic ovariectomy (OVE) in dogs. STUDY DESIGN: Prospective clinical trial. ANIMALS: Female dogs (n=72). METHODS: Laparoscopic OVE by Nd:YAG laser (600 microm optical fiber, contact mode) in 36 dogs was compared with laparoscopic OVE by bipolar electro-coagulating grasping forceps. Dogs were paired (laser, electrocoagulation) matched for breed, age, body weight, obesity, and number of heat cycles. Duration of predetermined surgery times and total surgical time were compared between groups. Occurrence of intra- and postoperative complications and their effect on surgical duration were evaluated. RESULTS: Laser surgery resulted in a higher incidence of intraoperative mesovarial bleeding (12 times; 9 dogs) compared with electrosurgery (4 times; 3 dogs). Use of laser caused a 2 minute delay for transection of the left ovary compared with electrosurgery. Postoperative complication rates and convalescence were similar for both groups. CONCLUSIONS: BEC reduced surgical time and intraoperative mesovarial bleeding compared with laser resection. CLINICAL RELEVANCE: Although the laser was effective for laparoscopic OVE, bipolar electrosurgical laparoscopic OVE remained the method of choice.  相似文献   

12.
Endoscopic tracheal lavage cytology was evaluated before and 24 hours after standing transendoscopic laser surgery of the upper airway in 18 horses (9 patients undergoing Neodymium:yttrium aluminum garnet [Nd:YAG] surgery and 9 non-patient horses undergoing argon surgery). Paired endoscopic tracheal lavages taken 24 hours apart were evaluated in six control horses to determine if the lavage technique influenced the cytology. After 24 hours, no inflammation was noted in three, mild inflammation was noted in six and suppurative inflammation in four surgically treated horses. Five of the surgically treated horses underwent general anesthesia prior to baseline tracheal lavage and had evidence of inflammation in pre-laser lavage samples; this made it difficult to assess the true incidence of laser-induced inflammation in horses in this report. Five of six control horses had a normal tracheal lavage at 24 hours. Six normal adult horses had baseline tracheal mucous clearance rates determined using scintigraphy followed one week later by tracheal mucous clearance rates two hours after either standing transendoscopic Nd:YAG ventriculectomy or standing transendoscopic argon cauterization of a 2 × 2 cm area of dorsal pharynx. The horses were left in pasture for three weeks, followed by a second baseline and post-laser tracheal mucous clearance rate using the opposite laser technique. There was no significant difference between the first and second baseline measurements. The order of laser treatments had no effect on the results obtained. There was no significant difference between the baseline tracheal mucous clearance rates (mean 1.65 ± 0.65 cm/min) and tracheal mucous clearance rates post-laser surgery (mean 1.62 ± 1.21 cm/min). Neither laser technique altered tracheal mucous clearance rates significantly (argon mean 1.57 ± 0.59 cm/min and Nd:YAG mean 1.67 ± .68 cm/min.  相似文献   

13.
Effects of neodymium:yttrium aluminum garnet (Nd:YAG) laser irradiation on equine endometrium were evaluated In vitro and in six mares with endometrial cysts. The Nd:YAG laser was applied to six endometrial sites, in each of five uterine specimens, with power densities of 5659 to 33,954 J/cm2. Depth of tissue ablation was measured and graded on histologic sections of the tissue lesions. Power density had a significant effect on the depth of tissue ablation (p < .001). Grade 3 lesions (full-thickness ablation of the endometrium) were created with energy densities of 16,977 to 33,954 J/cm2. Six mares had endometrial cysts treated by photoablation. Two of the four mares that were reproductively sound but barren, despite appropriate breeding, produced foals after treatment. One mare remained reproductively unsound after treatment, and another mare that was treated postpartum was bred successfully.  相似文献   

14.
Contact neodymium:yttrium aluminum garnet (Nd:YAG) laser transscleral cyclophotocoagulation (TSCP) was performed on 23 eyes of 16 horses for treatment of glaucoma. The mean highest preoperative IOP was 51 ± 17 mmHg. Follow-up evaluation was available for 19 eyes 1 day after surgery, 14 eyes from 1 to 2 weeks, 16 eyes from 4 to 6 weeks, 9 eyes from 12 to 16 weeks, and 10 eyes greater than 20 weeks after laser treatment. The mean intraocular pressure (IOP) the day following surgery was 34 ± 13 mmHg. The mean IOP for each follow-up period was: one to two weeks postoperative, 23 ± 9 mmHg; four to six weeks, 24 ± 7 mmHg; 12–16 weeks, 28 ± 10 mmHg; and  20 weeks, 22 ± 9 mmHg. IOP measurements were significantly different from pretreatment values for all follow-up intervals except for weeks 12–16 ( P < 0.05). Treatment success was defined as maintenance of IOP < 30 mmHg. Treatment success was achieved in 93%, 88%, 78%, and 70% of the treated eyes at the 1–2 weeks, 4–6 weeks, 12–16 weeks, and the  20 weeks re-evaluation, respectively. No significant difference was found between the number of eyes visual at presentation (52.2%) and visual at 20 weeks (60%). The most common laser complications were conjunctival hyperemia (21.7%) and corneal ulcers (13.0%). Results of this study indicate that Nd:YAG TSCP is an effective method of controlling IOP and preserving vision in horses with glaucoma. An effective Nd:YAG laser protocol for TSCP in the equine glaucomatous eye is a power setting of 11 W, duration of 0.4 s, applied 5 mm posterior to the limbus at 60 sites, resulting in a total energy dose of 264 J.  相似文献   

15.
Unilateral uveitis with pupillary occlusion and secondary glaucoma was treated with neodymium:YAG laser iridotomy and iridencleisis in an aphakic 2-year-old male Miniature Schnuauzer. The dog presented 4 months after bilateral phacoemulsification with a complaint of blepharospasm of the left eye. Examination revealed anterior uveitis with pupillary occlusion and iris bombé. A slit-lamp mounted Q-switched Nd:YAG laser was used to create a central iridotomy to deepen the anterior chamber and an iridencleisis was performed to recreate a pupil. The eye remained visual and normotensive over a 6-month follow-up period.  相似文献   

16.
A vaginal septum was diagnosed in an English bulldog bitch during routine estrous cycle staging. The septum extended 16 cm from the vestibulo-vaginal junction to just caudal to the cervix. The septum was removed by two applications of an Nd:YAG laser via a flexible fiberoptic endoscope. Complete healing occurred over a 5-week period and was uneventful. The bitch was bred and subsequently delivered four puppies vaginally. Transendoscopic laser ablation provided a noninvasive approach to surgically remove a vaginal septum in the dog.  相似文献   

17.
A 15-year-old, pregnant Dutch Warmblood mare was exhibiting intermittent hemorrhage secondary to a large vestibulovaginal varicosity. The vessel was reduced with transendoscopic Nd:YAG laser photocoagulation. This technique is minimally invasive compared with traditional surgical ligation, and significantly decreases the risk of severe hemorrhage, especially with advancing pregnancy. One laser treatment resulted in complete reduction in vessel size and allowed the pregnancy to continue to term without incident or further vaginal hemorrhage.  相似文献   

18.
Holmium:yttrium-aluminum-garnet (Ho:YAG) laser lithotripsy was attempted in a mare and a gelding with calculi in the urinary bladder. The procedure was unsuccessful in producing adequate fragmentation of the calculi. In the gelding, pulsed dye laser lithotripsy was subsequently used to fragment the urolith. Manual removal of the urolith via the urethra was performed in the mare.  相似文献   

19.
Transendoscopic Laser Treatment of Guttural Pouch Tympanites in Eight Foals   总被引：1，自引：0，他引：1  
Guttural pouch tympanites was diagnosed in eight foals with respiratory stridor and tympanic swelling in the parotid region. Three foals were treated by transendoscopic neodymium:yttrium aluminum garnet (Nd:YAG) laser fenestration of the median septum between the guttural pouches. One foal died of pneumonia, and the other two foals recovered completely, although the fenestration later closed in one foal. Five foals were treated by creating a salpingopharyngeal fistula using transendoscopic laser irradiation: complete resolution of the tympanites occurred. Transendoscopic laser surgery in standing foals may be a reasonable alternative to conventional surgery and general anesthesia for correction of guttural pouch tympanites.  相似文献   

20.
An 8‐year‐old Warmblood gelding was referred for evaluation of headshaking to the Clinic for Horses, University of Veterinary Medicine Hannover. Based on clinical signs and computed tomography – as well as magnetic resonance imaging – findings, otitis media was diagnosed. Medical treatment including trimethoprim potentiated sulfadimethoxine and meloxicam for 3 weeks did not result in cessation of clinical signs. Therefore, the tympanic cavity was opened transendoscopically using an Nd:YAG‐laser via the guttural pouch according to surgical procedures in human and small animal medicine, leading to a considerable improvement of clinical signs.  相似文献   

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