Tenoscopic-guided resection of the manica flexoria utilizing radiofrequency energy. A proof of concept study.
Authors: Barton Charlotte K, Nelson Brad B, Winther Taylor M, Maker Tristan C, Goodrich Laurie R
Journal: Veterinary surgery : VS
Summary
# Editorial Summary: Tenoscopic Radiofrequency Resection of the Manica Flexoria A torn manica flexoria—the fan-like fascia binding the flexor tendons in the carpal canal—presents a surgical dilemma: conventional sharp dissection risks collateral damage to adjacent vital structures in a confined space. Researchers developed and validated a tenoscopic technique using radiofrequency energy to resect the manica flexoria, testing it in 18 cadaver limbs followed by 8 in vivo procedures in live horses. Complete resection was achieved in all cases, with mean surgical time of 26–31 minutes and high-quality outcomes: dissection scoring averaged 14.3–14.8 out of 15 (where 15 represents optimal resection with zero collateral injury), whilst histological analysis and live/dead staining showed intact tissue architecture and minimal tenocyte death despite radiofrequency exposure. For practitioners managing manica flexoria lesions, this proof-of-concept offers a technically controlled alternative to traditional instrumentation, potentially reducing the risk of inadvertent damage to the digital flexor tendons and associated structures during the resection procedure.
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Practical Takeaways
- •Radiofrequency-guided resection offers a safer alternative to sharp instrumentation for removing torn manica flexoria, reducing risk of accidental damage to adjacent deep digital flexor tendon and other soft tissues
- •Procedure takes approximately 26-31 minutes and achieves complete, symmetric resection with excellent precision based on tissue scoring
- •This minimally invasive tenoscopic approach may reduce complications and improve healing compared to traditional surgical resection methods
Key Findings
- •Radiofrequency-guided tenoscopic resection of the manica flexoria achieved 100% success rate (18/18 ex vivo, 8/8 in vivo) with mean surgical time of 30.6 minutes ex vivo and 26.1 minutes in vivo
- •Tissue damage scores were excellent in both ex vivo (14.3/15) and in vivo (14.8/15) procedures, indicating minimal iatrogenic injury to surrounding structures
- •Histological analysis and live/dead staining showed minimal cell death and preserved tissue architecture following radiofrequency exposure