Adaptation and evaluation of a monopolar electrosurgical triangle‐tip knife for transendoscopic ventriculocordectomy in healthy horses

• Published in: Veterinary surgery Vol. 48; no. 4; pp. 481 - 487
• Main Authors: Suarez‐Fuentes, David G., Tatarniuk, Dane M., Caston, Stephanie S., Bell, Chris D., Loinaz, Ricardo J., Hostetter, Jesse M.
• Format: Journal Article
• Language: English
• Published: United States Blackwell Publishing Ltd 01.05.2019
• Subjects: Collagen; Deposition; Endoscopy; Evaluation; Fibrosis; Histopathology; Horses; In vivo methods and tests; Inflammation; Instrumentation; Instruments; Medical personnel; Muscles; Population studies; Respiratory system; Respiratory tract; Semiconductor lasers; Surgery
• ISSN: 0161-3499; 1532-950X
• DOI: 10.1111/vsu.13154

Objective To evaluate the efficacy and safety of a transendoscopic monopolar electrosurgical triangle‐tip knife as instrumentation to perform unilateral ventriculocordectomy (VC) in healthy adult horses. Study design In vivo experimental study. Study population Nine horses donated for medical conditions unrelated to respiratory system. Methods The triangle‐tip knife was applied in contact fashion. Left VC was performed under standing sedation. Endoscopic images of the upper airway were graded for inflammation by 2 masked surgeons preoperatively and immediately, 24 hours and, in 2 cases, 7 and 14 days postoperatively. Four larynxes were examined for histological evidence of inflammation and collagen deposition at 24 hours (n = 2) and at 14 days (n = 2) after surgery. Results Ventriculocordectomy was successfully performed in all horses. Endoscopic evidence of inflammation was scored as normal (preoperatively), mild (immediately postoperatively), mild (24 hours postoperatively), mild (7 days postoperatively), and normal (14 days postoperatively). According to histopathology, inflammation of the surgical site and ventricularis muscle was generally increased (variable is common and is present in most high‐power fields) 24 hours and 14 days postoperatively. Fibrosis and collagen deposition also seemed increased at the surgical site 14 days postoperatively. Conclusion Ventriculocordectomy was successfully performed with an electrosurgical triangle‐tip knife and resulted in acceptable short‐term outcomes. Clinical significance The use of an electrosurgical triangle‐tip knife alternative instrumentation may be offer an alternative option to perform VC in practices when diode laser is not available or is cost prohibitive. Longer term evaluation of the VC site is required to determine the effect on rima glottic cross‐sectional area.