Can we Use Endoscopic Surgery in Abdominal and Thoracic Tumors?

Thoracic and abdominal oncologic diseases that demand surgical intervention often are associated with significant iatrogenic trauma and discomfort. Minimally invasive access to the abdominal or thoracic cavity for endoscopic exploration and observation of intracavitary tissues, biopsy of abnormal structures, or intracavitary surgical procedures, also referred to as video-assisted thoracic surgery (VATS), has several advantages over conventional open procedures. There is very limited information of the use of endoscopic surgery in cats.

Minimally invasive techniques gain popularity in human and veterinary medicine but procedures are often ill-described and anecdotal. The expectation is that these procedures are applicable to dogs and cats and will decrease the morbidity associated with open surgery significantly using these techniques.

The techniques decrease pain after certain surgical procedures and allow owners to make a well-informed decision about what surgical procedure is the right one.

Thoracotomy/laparotomy is associated with considerable intra- and postoperative pain, discomfort, and convalescence period, which are clearly reduced in humans and in dogs when using an endoscopic approach. Other advantages are the magnified and detailed view of intracavitary tissues and the increased access to deep areas, which actually allows a more extensive and complete exposure of the thoracic cavity compared to open approaches. The number of applications of endoscopic surgery in dogs is rapidly increasing and endoscopically performed procedures such as the creation of a pericardial window or partial pericardectomy, or thoracic duct ligation are becoming the standard of care nowadays in several specialized institutions. Until recently, however, the same was true for feline laparoscopic procedures, and there is no convincing reason not to assume that the same advantages of minimally invasive thoracic procedures apply to cats as they do to humans (including neonates of < 1 kg body weight) and dogs. Furthermore, the number of available endoscopic procedures in both dogs and cats is merely related to the surgeon’s experience and skills and the willingness and creativity to convert these into an expanding range of VATS procedures. Companion animal minimally invasive surgery lags behind on its human counterpart, which is primarily related to the associated costs of investment in equipment and surgical training. Nevertheless, considering the recent but revolutionary history of minimally invasive surgery in humans, both canine and feline minimally invasive surgery are expected to be increasingly applied in the near future. Moreover, the same advantages of minimally invasive surgery that have been described for humans are increasingly reported in veterinary patients. As with laparoscopy, the smaller body size of cats compared to dogs requires dedicated equipment and skills, which may more often result in veterinary surgeons initially investing in minimally invasive surgery in canines rather than felines. The basic surgical principles of laparoscopic surgery also apply to thoracoscopic surgery.  [...]