Patients, Students Benefit from New Approaches in Small Animal Surgery
by Jennifer Stone

With the addition of new surgical equipment and a patented surgical procedure, the quality and scope of the small animal surgery services at the Veterinary Teaching Hospital will expand, according to Dr. Dianne Dunning. The changes will also make learning easier for veterinary students.

One change is offering a procedure called tibial plateau leveling osteotomy (TPLO). This procedure, developed for the treatment and prevention of cranial cruciate rupture, differs dramatically from traditional treatments. Traditionally the ruptured cranial cruciate ligament was replaced with an
artificial ligament.

New equipment makes it possible for surgeries to be viewed by many people as well as recorded for future instruction.

This new surgery is based on the theory that cranial cruciate ruptures arise because one bone in the major joint of the forelimb rests on the inclined surface of another bone and therefore tends to slip forward and tear the ligament. The surgery involves leveling this incline and changing the mechanics of the joint so that the animal bears weight on a flat surface, not a slippery slope. The procedure is designed to not only correct the torn ligament but also prevent reoccurrence of the problem.

“This procedure is patented, which means a short course must be taken in order to be approved to perform it,” says Dr. Ann Johnson, chief of the small animal surgery section, who completed the training. Dr. Dunning, who joined the small animal surgery section last year, is also learning the procedure.

The small animal surgery section will soon be acquiring equipment to perform arthroscopy.

“Soon we will be able to look inside knees, elbows and tarsi without having to open the joint completely,” says Dr. Dunning. Minimally invasive surgery will cause less pain to the patient, reduce chances of infection, and speed recovery time considerably.

Dr. Dominique Griffon, another surgeon who came to Illinois last year, has been instrumental in acquiring the new equipment.

“The overall configuration of equipment is a tower that has several different instruments and functions,” she explains.

The most basic component of the tower is a scope that has a camera and a powerful light source. This scope is inserted into a small hole in the skin. “This instrument is what allows us to see inside the cavity that we are working on,” says Dr. Griffon.

In addition, a shaver allows the removal of defective cartilage and other tissue, and a radio ablator allows the coagulation and shrinkage of tissue for ease of removal. The ablator can also be used to tighten loose joints. A pump sends fluid under pressure into the joint to make room to see and move around. For abdominal surgeries a CO₂ gas pump, called an insuflator, is used to inflate the abdomen. The new equipment brings advances in teaching, too.

“In the past the only people who were able to view a surgery were those few people who could crowd around the surgery table. Even then the view was not always good,” says Dr. Johnson. “Now because of the scoping equipment that we have, an entire procedure can be seen very easily as it is projected on a monitor. In addition, we are installing cameras into the lights so that whatever the surgery lamp is pointing at can be projected onto a monitor.”

This means that an entire surgery can be viewed by many students and can even be recorded for use in future instruction.