“Surgeons can move many combinations of skin, bone, and muscle from one location to another.”
Intricate precision and skill are required to perform microvascular surgery, the practice of connecting tiny, fragile blood vessels to one another. Physicians have used the technique in humans for years, and veterinary surgeon Dr. Heidi Phillips is determined to bring the same level of care to animals.
“The practice has become mainstream in human medicine,” explains Dr. Phillips, who practices at the University of Illinois Veterinary Teaching Hospital in Urbana. “Surgeons can move many combinations of skin, bone, and muscle from one location to another.” The tissue that is moved, called composite tissue, is disconnected from its original blood supply and reconnected to arteries and veins in the new location.
Dr. Phillips adds that the technique, which involves using fine-tipped instruments, miniscule needles and suture that is as thin as human hair, is useful when transplanting organs and when damaged tissue needs to be replaced.
For example, say a pet has a cancerous tumor in its mouth that must be removed. Some of the jaw bone adjacent to the tumor may need to be removed to ensure that all the cancerous tissue is gone. If the tumor is large, the amount of jaw structure that must be removed may be so great that the pet will experience difficulty eating and drinking.
“It’s possible to replace lost bone of the jaw with a similar piece of healthy live bone from elsewhere in the animal’s body. When the blood supply to the area is connected to the vessels feeding the new bone, it can receive nutrients to grow and connect with the original jaw bone, similar to the way two broken pieces from the same bone heal by reconnecting to one another.”
You may wonder where exactly on the body a pet might have bones to spare for such a procedure. It turns out there are some bone segments and non-weight-bearing bones, such as the ribs and portions of the ulna, that can be relocated.
Dr. Phillips has become an authority in the field of veterinary microsurgery thanks to extensive experience performing kidney transplants in cats and dogs at the University of Pennsylvania as well as from specialty training she received working side-by-side with microsurgeons at the Cleveland Clinic in Ohio and Columbia University in New York City.
She recently joined the University of Illinois College of Veterinary Medicine as an assistant professor of surgery and, as a microsurgeon, she hopes to develop methods of helping animals with her special skill.
“Sometimes a pet might have a tumor or injury that is so extensive that conventional veterinary surgery does not offer a reasonable reconstructive option,” explained Dr. Phillips. “As our experience develops, I hope to offer those animals a chance at recovery and a longer life.”
Dr. Phillips uses a valuable operating microscope to see the vessels, just millimeters in diameter, that she manipulates during surgery, but she says “for a surgeon, the most important instruments are one’s hands.”
The fine motor skill necessary to perform microvascular surgery takes a lot of practice and, as with any muscle-dependent talent, long periods of inactivity can have a negative effect. For this reason, Dr. Phillips recently traveled to Columbia University to practice with other microsurgeons. And in the fall, Dr. Phillips hopes to ensure that her muscles stay well trained by working with resident physicians at the University of Illinois-Chicago medical school.
And, until Dr. Phillips can validate microsurgical options for veterinary patients, she’s looking for a local reconstructive surgeon from human medicine who might enjoy collaborating with her when she needs the extra help.
“I am always keeping my eye out for that perfect person: someone who loves animals and who will feel as rewarded as I am by helping pets and the people who love them. I’m optimistic that I’ll meet someone soon.”
By Holly Richards