SURGERY

ORTHOPAEDIC SURGERY

Arthroscopy

The most common orthopaedic procedure performed in the hospital is arthroscopic surgery (keyhole surgery of joints). Arthroscopy has revolutionised both diagnosis and treatment of common conditions affecting equine joints and the technology is now also commonly used to examine and treat tendon injuries within tendon sheaths and bursae. Arthroscopy is also our first line treatment for infected joints, tendon sheaths and bursae. This technique has returned a vastly improved survival rate of horses (now approximately 90%). Arthroscopy is also commonly used to guide repair of fractures within joints, allowing surgery to be performed in a minimally invasive manner.

Fracture Repair

Fracture repair in the horse is now commonly performed, and with recent advances in implant technology more and more complex fractures are being repaired. Our case load includes an high proportion of fracture patients and the hospital is fully equipped to accommodate these high risk orthopaedic patients, with AO/ASIF instrument kits, specialised assisted recovery systems (for helping horses recover from surgery) and the highest levels of surgical expertise.

SOFT TISSUE SURGERY

Colic Surgery

Over the past 20 years vast improvements in survival rates of horses with colic have been seen. This is aided by earlier recognition and referral for treatment of conditions requiring surgery. At the Newmarket Equine Hospital we have a theatre dedicated for abdominal surgery. For each horse treated for colic, a team of surgeons, interns and nursing staff provide round the clock care in our specialised intensive care unit.

Laparoscopic Surgery

Laparoscopic (key-hole abdominal) surgery is a rapidly evolving technique which can be performed in both standing and anaesthetised patients. Procedures which previously would have been performed under general anaesthetic through a large open incision can now be done using this minimally invasive technique, which reduces patient morbidity and speeds up the convalescent period. Examples of the use of this technique include:

  • removal of ovaries from mares with severe temperament changes whilst in season, or ovarian tumours
  • cryptorchid (rig) castration
  • investigation of chronic colic

Over the last few years, Newmarket Equine Hospital helped develop a pioneering technique for treatment of infertile mares, by instillation of prostaglandin onto obstructed oviducts using laparoscopy.

Respiratory Surgery

Abnormal function or anatomy of the respiratory tract can cause atypical noise at exercise and reduced performance in horses.

Surgeries such as tie-backs or tie-forwards are routinely performed to treat affected horses with conditions such as:

  • Laryngeal hemiplegia (roarer)
  • Dorsal displacement of the soft palate
  • Epiglottic entrapment

The hospital also performs laser surgery, which allows many procedures to be performed in the standing patient using videoendoscopy. This avoids the need for general anaesthesia and open surgical incisions, reducing patient discomfort and convalescence.

Urogenital Surgery

The hospital is equipped to perform a full range of urogenital procedures.

With the high population of breeding mares in and around Newmarket, foaling injuries are common, such as perineal lacerations and rectovaginal fistula. We routinely perform delicate surgery in the standing patient to reconstruct the normal anatomy of the urogenital tract.

In the male horse, the more frequently performed procedures are those used to treat a common neoplasm (tumour) of the penis (squamous cell carcinoma). Untreated, spread of tumours is life-threatening. Procedures performed to remove neoplastic tissue include:

  • Reefing
  • Partial phallectomy
  • En-bloc phallectomy
  • Penile retroversion

SURGICAL FACILITIES

The surgery unit in the hospital has two state of the art theatres (one dedicated for orthopaedic surgery), located in a closed suite with filtered, conditioned air delivered under positive pressure. There are four padded anaesthetic induction and recovery stalls, with one adapted to include a specialised assisted recovery system for high risk orthopaedic patients. The induction stalls lead into an intervening prep area where horses are prepared for surgery, before being taken into theatre.

In theatre there are fully networked stations for viewing radiographs and images from other diagnostic modalities. For arthroscopic and laparoscopic procedures a networked digital capture system is used to take and store images and videos during surgery.

SURGICAL STAFF

The theatres are run by a highly trained team of surgical nurses, including three qualified equine veterinary nurses and headed up by an advanced veterinary nursing Diploma holder. General anaesthesia is performed exclusively by a designated team of specially trained veterinary surgeons, under the supervision of two Diploma holders in veterinary anaesthesia (one Royal College of Veterinary Surgeons Diplomat and One American College of Veterinary Anaesthesiologists Diplomat).

Surgery at the hospital is performed by highly qualified veterinary surgeons, including three European Specialists in Equine Hospital. Two are also recognised by the Royal College of Veterinary Surgeons as Specialists in Equine Surgery. Between them, the surgery team holds three European Diplomas in Equine Surgery, two RCVS Diplomas in Equine Orthopaedics and three RCVS Certificates in Equine Surgery.