Basic HTML Version
WINTER 2014 ISSUE
LASER SURGERY
Technological advances have allowed the
development of a new generation of digital
diagnostic instruments, such as x-ray units,
ultrasound machines and endoscopes. These
are both highly portable and also able to
provide images of stunning quality. This has
allowed many procedures that in the past
could only be carried out at a clinic or
hospital to be performed at home on
the yard.
High tech' treatment modalities are also now
in frequent use and include, for example,
shockwave therapy and surgical lasers.
The use of surgical lasers is a good example
of how the advances in knowledge and
equipment have been harnessed to provide
a significant improvement in the way in which
we treat an age old problem, in this case
sarcoids and melanomas (Figures 3 and 4).
Sarcoids are the most common skin tumour
affecting equines and are often difficult to
treat due to their unpredictable nature,
varying response to traditional therapies
and tendency to recur. Equally melanomas
under the tail and between the legs are a
frustratingly common occurrence in ageing
grey horses.
A surgical laser is a specialised piece of
equipment that can cut through skin and
other soft tissues, just like a normal surgical
blade, but since the emitted energy also
results in heat, small blood vessels are sealed
immediately. The laser therefore cuts and
vaporises tissue, with minimal bleeding. This
is particularly useful when operating on skin
tumours, where there is an increased risk
of spreading the tumour via the blood or
lymphatic system. As the laser vaporises the
cells it cuts, any potential cancerous cells are
also killed, thereby reducing the chance of
tumour cells contaminating the surrounding
healthy tissues. Once the sarcoid is removed
the underlying area can be crosshatched
with the laser to vaporise any remaining
cancerous cells.
The laser has distinct advantages over other
treatment methods such as the application of
creams as these often have to be reapplied
on numerous occasions. Laser therapy
however removes the offending tissue in one
session. It also has the benefits of rapid
healing times, good cosmetic results, minimal
complications and most importantly good
success rates with a low recurrence rate.
Despite all of its advantages some sarcoids,
depending on the type and position, are still
best treated by more traditional methods or
a combination of the laser with other options.
A general anaesthetic is sometimes required
for the laser removal of sarcoids but many
other cases can be treated under standing
sedation with the area desensitised by local
anaesthetic only. Early intervention when the
offending lesions are small provides the
best rates of success combined with low
recurrence rates.
In Summary
Advances in technology
have provided significant
benefits in the way in which
we monitor, diagnose and
treat our equine patients.
Figure 3: Melanoma before Laser surgery
Figure 4: Melanoma after Laser surgery
EQUINE MATTERS
20