Adaptation and evaluation of a monopolar electrosurgical triangle-tip knife for transendoscopic ventriculocordectomy in healthy horses.
Authors: Suarez-Fuentes David G, Tatarniuk Dane M, Caston Stephanie S, Bell Chris D, Loinaz Ricardo J, Hostetter Jesse M
Journal: Veterinary surgery : VS
Summary
# Editorial Summary: Monopolar Electrosurgical Knife for Ventriculocordectomy in Horses Recurrent laryngeal neuropathy (RLN) remains a significant cause of exercise-induced upper airway obstruction in horses, and whilst diode laser ventriculocordectomy is the gold standard surgical approach, cost and equipment accessibility limit its availability in many practices. Suarez-Fuentes and colleagues evaluated a novel monopolar electrosurgical triangle-tip knife as an alternative instrument for performing unilateral ventriculocordectomy in nine healthy adult horses under standing sedation, examining both endoscopic and histological evidence of tissue trauma across multiple timepoints. The procedure was successfully completed in all cases, with endoscopic inflammation grading minimal (mild at immediate and 24-hour postoperative assessments) and resolved to normal by day 14; histopathological analysis revealed variable but generally increased inflammation at 24 hours and 14 days, alongside evidence of fibrosis and collagen deposition by the later timepoint. Whilst these short-term safety and efficacy data are promising for practitioners in resource-limited settings, the authors appropriately highlight that longer-term evaluation is necessary to determine whether this technique achieves comparable rima glottica patency to laser approaches and whether the fibrosis observed histologically translates to clinically acceptable functional outcomes during work.
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Practical Takeaways
- •The electrosurgical triangle-tip knife offers a viable alternative to diode laser for performing ventriculocordectomy when laser equipment is unavailable or cost-prohibitive
- •Short-term endoscopic healing appears acceptable with mild inflammation resolving within 14 days, though histological inflammation persists
- •Long-term clinical outcomes and effect on rima glottic opening require further evaluation before recommending this technique as equivalent to laser-based approaches
Key Findings
- •Ventriculocordectomy was successfully completed in all 9 horses using the monopolar electrosurgical triangle-tip knife technique
- •Endoscopic inflammation grading showed mild inflammation immediately and at 24 hours postoperatively, returning to normal by 14 days
- •Histopathology revealed increased inflammation in the surgical site and ventricularis muscle at both 24 hours and 14 days postoperatively
- •Fibrosis and collagen deposition were increased at the surgical site by 14 days postoperatively