1 Introduction

VMinimally Invasive Surgery (MIS) has transformed surgical practices by allowing procedures to be performed through small incisions, utilizing advanced imaging technologies to enhance visualization and precision. This approach has been widely adopted in human medicine since the late 20th century, significantly reducing patient morbidity and recovery times compared to traditional open surgeries (Mayhew, 2011a). In veterinary medicine, MIS is increasingly being used for both diagnostic and therapeutic purposes, offering similar benefits to companion animals. Techniques such as laparoscopy and thoracoscopy are now commonly employed for a variety of procedures, including organ biopsies and tumor removals, providing less invasive options for treatment (Peláez et al., 2012; Balsa and Culp, 2019).

The adoption of MIS in veterinary medicine is crucial due to its numerous advantages over conventional surgical methods. These include reduced postoperative pain, shorter hospital stays, and decreased risk of complications such as wound dehiscence and infections (Mayhew et al., 2011; Peláez et al., 2012). For older or debilitated animals, MIS can significantly lower the risk of postoperative complications, making it a preferred choice for many veterinarians and pet owners. Despite these benefits, the widespread implementation of MIS in veterinary practice faces challenges such as the high cost of equipment and the need for specialized training (Mayhew, 2011b). Nonetheless, the growing demand for improved animal welfare and surgical outcomes continues to drive advancements in this field.

This study attempts to explore the advancements in minimally invasive surgical techniques specifically for companion animals, discuss the challenges faced in the adoption of these techniques, and provide an overview of the current state of MIS in veterinary medicine. It highlights technological innovations, clinical applications, and the benefits these techniques offer to both animals and their owners. Additionally, the study examines future directions for research and practice in this rapidly evolving field, underscoring the transformative impact of MIS on veterinary surgical practices and its potential to enhance the quality of care for companion animals.

2 Evolution of Minimally Invasive Surgical Techniques

2.1 Historical background of veterinary surgery

Veterinary surgery has evolved significantly over the years, transitioning from traditional open surgical methods to more advanced techniques. Historically, veterinary procedures were limited by the availability of technology and the level of expertise among practitioners. The development of minimally invasive techniques in human medicine has gradually influenced veterinary practices, leading to the adoption of these methods in animal care (Milovancev and Townsend, 2015; Marinov and Zlateva-Panayotova, 2019).

2.2 Early developments in minimally invasive techniques

The initial foray into minimally invasive techniques in veterinary medicine was marked by the adaptation of human surgical methods. Early developments included the use of laparoscopy and endoscopy, which provided veterinarians with new tools to perform surgeries with reduced trauma and faster recovery times for animals. These techniques were initially limited by the availability of specialized equipment and the need for specific training (Marinov and Zlateva-Panayotova, 2019; Saha, 2023; Dejescu et al., 2023). Despite these challenges, the benefits of minimally invasive procedures, such as reduced blood loss and fewer complications, have driven their adoption in veterinary practices (Sumner et al., 2022).

2.3 Key technological advancements

Laparoscopy has become a cornerstone of minimally invasive surgery in veterinary medicine. It offers significant advantages over traditional open surgery, including better visualization, less pain, and quicker recovery times. Specific procedures such as biopsy, cystotomy, and gastropexy have been successfully performed using laparoscopic techniques, highlighting its growing importance in veterinary care (Milovancev and Townsend, 2015; Saha, 2023). Endoscopic techniques have expanded the capabilities of veterinarians to diagnose and treat conditions with minimal invasiveness. These procedures are particularly beneficial in the field of small animal urology, where traditional methods were often associated with high complication rates. The use of endoscopy allows for precise interventions with reduced morbidity (Heilmann, 2016). Although still in its nascent stages in veterinary medicine, robotic-assisted surgery represents a significant technological advancement. It offers the potential for enhanced precision and control during surgical procedures. The adaptation of robotic systems from human medicine to veterinary applications is ongoing, with the promise of further reducing surgical trauma and improving outcomes for companion animals (Marinov and Zlateva-Panayotova, 2019; Dejescu et al., 2023).

In summary, the evolution of minimally invasive surgical techniques in veterinary medicine has been driven by technological advancements and the adaptation of human medical practices. These techniques offer numerous benefits, including reduced recovery times and fewer complications, making them increasingly popular among veterinarians and pet owners alike.

3 Advantages of Minimally Invasive Surgery for Companion Animals

3.1 Reduced surgical trauma

Minimally invasive surgical techniques significantly reduce surgical trauma compared to traditional open surgeries. These techniques involve smaller incisions, which lead to less tissue damage and reduced blood loss during procedures. For instance, laparoscopy, a common minimally invasive technique, is associated with less pain and scarring, contributing to a more favorable surgical experience for companion animals (Milovancev and Townsend, 2015; Saha, 2023).

3.2 Shorter recovery times

One of the most notable benefits of minimally invasive surgery is the shorter recovery time for animals. Due to the reduced trauma and smaller incisions, animals experience less postoperative pain and can return to normal activities more quickly. Studies have shown that procedures like minimally invasive spine surgery and laparoscopic interventions allow for faster recovery, enabling pets to resume their daily routines sooner than with traditional surgical methods (Milovancev and Townsend, 2015; Guevar et al., 2020; Saha, 2023).

3.3 Decreased postoperative complications

Minimally invasive techniques are associated with a lower risk of postoperative complications. The precision and reduced invasiveness of these procedures minimize the likelihood of infection and other complications that can arise from larger surgical wounds. For example, minimally invasive video-assisted parathyroidectomy in dogs has been shown to be feasible without complications, highlighting the safety and effectiveness of these techniques in reducing morbidity (Heilmann, 2016; Marinov and Zlateva-Panayotova, 2019; Sumner et al., 2022).

3.4 Enhanced precision in surgical procedures

The use of advanced imaging and surgical tools in minimally invasive procedures enhances the precision of surgical interventions. Techniques such as laparoscopy and endoscopy provide better visualization of the surgical field, allowing veterinarians to perform delicate procedures with greater accuracy. This precision is particularly beneficial in complex surgeries, such as those involving the spine or urogenital tract, where detailed visualization is crucial for successful outcomes (Heilmann, 2016; Guevar et al., 2020; Saha, 2023).

In summary, minimally invasive surgical techniques offer significant advantages for companion animals, including reduced surgical trauma, shorter recovery times, decreased postoperative complications, and enhanced precision in surgical procedures. These benefits contribute to improved overall outcomes and quality of life for pets undergoing surgery (Ayme et al., 2023).

4 Types of Minimally Invasive Surgical Techniques for Companion Animals

4.1 Laparoscopic surgery

Laparoscopic surgery is widely used in veterinary medicine for various abdominal procedures, including biopsy, cystotomy, enterotomy, cryptorchidectomy, and gastropexy. These procedures benefit from the minimally invasive nature of laparoscopy, which allows for better visualization and access to the abdominal cavity （Figure 1） (Milovancev and Townsend, 2015; Saha, 2023). The primary benefits of laparoscopic surgery include reduced blood loss, less postoperative pain, minimal scarring, faster recovery times, and fewer complications compared to traditional open surgery. However, challenges include the need for specialized equipment and training, which can limit its widespread adoption in veterinary practices (Dejescu et al., 2023).

Figure 1 Laparoscopic ileocecal resection cryptorchidectomy (Adopted from Saha, 2023)

4.2 Endoscopic surgery

Endoscopic surgery is employed for both diagnostic and therapeutic purposes in veterinary medicine. It is particularly useful for examining and treating conditions within the gastrointestinal and respiratory tracts. Common endoscopic procedures include biopsies and the retrieval of foreign bodies. These procedures are less invasive than traditional surgical methods, offering quicker recovery and reduced risk of complications (Heilmann, 2016).

4.3 Robotic-assisted surgery

Robotic-assisted surgery is an emerging field in veterinary medicine, offering precision and control that surpasses traditional methods. Innovations in this area are still developing, with a focus on enhancing surgical outcomes and reducing recovery times (Marinov and Zlateva-Panayotova, 2019). While specific case studies in veterinary robotic-assisted surgery are limited, the technology has shown promise in improving surgical precision and outcomes. Success rates are expected to improve as the technology becomes more refined and accessible.

4.4 Laser surgery

Laser surgery offers significant advantages for soft tissue procedures, including reduced bleeding, minimized pain, and decreased risk of infection. These benefits make it an attractive option for various surgical interventions in companion animals (Marinov and Zlateva-Panayotova, 2019; Ayme et al., 2023). In oncologic surgery, laser techniques are used to precisely remove tumors with minimal impact on surrounding healthy tissues. This precision is crucial in reducing the likelihood of cancer recurrence and improving overall patient outcomes (Wardlaw et al., 2019; Summers, 2021; Piao et al., 2024).

In summary, minimally invasive surgical techniques in veterinary medicine, such as laparoscopic, endoscopic, robotic-assisted, and laser surgeries, offer numerous benefits over traditional methods. These techniques provide improved visualization, reduced recovery times, and fewer complications, although they require specialized equipment and training. As these technologies continue to advance, they hold the potential to significantly enhance surgical outcomes for companion animals.

5 Case Study: Minimally Invasive Surgery for Canine Spinal Disorders

5.1 Introduction to canine spinal disorders

Canine spinal disorders, such as intervertebral disc disease (IVDD), are prevalent conditions that can lead to significant pain and neurological deficits in dogs. These disorders often require surgical intervention to alleviate symptoms and prevent further deterioration. The thoracolumbar region is particularly susceptible to disc extrusions, especially in chondrodystrophic breeds, which are characterized by their short limbs and long bodies (MacQuiddy et al., 2024). Traditional surgical approaches, while effective, can be invasive and lead to prolonged recovery times. As a result, there is growing interest in minimally invasive surgical (MIS) techniques that aim to reduce tissue trauma and improve recovery outcomes (Guevar et al., 2020; Bitterli et al., 2021).

5.2 Surgical challenges and risks

Surgical intervention for canine spinal disorders presents several challenges and risks. Traditional open surgeries often involve extensive soft tissue dissection, which can lead to increased postoperative pain, longer recovery periods, and higher risks of complications such as infection and wound dehiscence (Dent et al., 2016; Guevar and Olby, 2020). Additionally, the precision required to decompress the spinal cord without causing further damage is a significant challenge. MIS techniques, while promising, also come with their own set of challenges, including the need for specialized equipment and a steep learning curve for surgeons (Guevar et al., 2020). The risk of incomplete decompression and the potential for longer surgical times are also considerations that must be addressed (Drury et al., 2018).

5.3 Application of minimally invasive techniques

Minimally invasive techniques, such as endoscopic hemilaminectomy and fluoroscopic-guided stabilization, have been applied to treat canine spinal disorders with promising results. These procedures involve smaller incisions and less soft tissue disruption compared to traditional methods. For instance, the use of an integrated endoscopic system for hemilaminectomies in dogs with thoracolumbar disc extrusions has shown to provide adequate spinal cord decompression with minimal soft tissue trauma (Figure 2) (MacQuiddy et al., 2024). Clinical outcomes indicate that these techniques can achieve similar success rates to open surgeries, with the added benefits of reduced postoperative pain and faster recovery times (Guevar and Olby, 2020; Bitterli et al., 2021). However, the learning curve associated with these procedures can result in longer surgery durations initially (Dent et al., 2016).

Figure 2 (A) Image of the EasyGo! Endoscopic surgical system (B) intra-operative image of the use of serial dilator sleeves (C) intra-operative image displaying the position of the endoscopic equipment including the trocar, articulating arm, endoscope, and light source (D) endoscopic view of the surgical site showing the exposed spinal cord (Adopted from MacQuiddy et al., 2024)

5.4 Comparison to traditional open surgery

When compared to traditional open surgery, minimally invasive techniques offer several advantages, including reduced incision lengths, minimized muscle trauma, and potentially shorter hospital stays. Studies have shown that while the surgical exposure and decompression achieved are comparable between the two approaches, MIS techniques often result in less postoperative pain and quicker functional recovery (Guevar et al., 2020; Guevar and Olby, 2020). However, traditional open surgeries may still be preferred in cases where extensive decompression is required or when the surgeon is not yet proficient in MIS techniques (Dent et al., 2016; Drury et al., 2018). The choice between MIS and open surgery should be based on the specific case requirements and the surgeon's expertise.

5.5 Conclusion and future directions

Minimally invasive surgical techniques represent a significant advancement in the treatment of canine spinal disorders, offering benefits such as reduced tissue trauma and faster recovery. While current studies demonstrate the feasibility and effectiveness of these techniques, further research is needed to optimize procedures and improve success rates (Guevar and Olby, 2020; Bitterli et al., 2021; MacQuiddy et al., 2024). Future directions may include the development of more advanced imaging and surgical tools to enhance precision and reduce the learning curve associated with MIS. Additionally, larger clinical trials are necessary to fully establish the long-term benefits and potential limitations of minimally invasive approaches in veterinary spinal surgery (Guevar et al., 2020; Dent et al., 2016).

6 Challenges in Implementing Minimally Invasive Surgery in Veterinary Practice

6.1 High cost and equipment requirements

The implementation of minimally invasive surgery (MIS) in veterinary practice is often hindered by the high cost of specialized equipment and the financial burden it places on veterinary clinics. The need for advanced tools such as laparoscopes, endoscopes, and imaging devices makes the initial investment substantial (Heilmann, 2016; Saha, 2023). Additionally, the maintenance and upgrading of this equipment can further increase costs, making it challenging for smaller practices to adopt these techniques (Hettlich, 2018; Marinov and Zlateva-Panayotova, 2019).

6.2 Limited access to specialized training

Another significant challenge is the limited access to specialized training for veterinary professionals. While there are some training programs and simulators available, they are often not widely accessible or comprehensive enough to cover the specific needs of veterinary procedures. The lack of training opportunities can result in a steep learning curve for veterinarians, which may deter them from adopting MIS techniques (Fransson et al., 2016; Dejescu et al., 2023). This gap in training is particularly pronounced in regions where veterinary education resources are limited.

6.3 Ethical considerations in veterinary practice

Ethical considerations also play a crucial role in the adoption of MIS in veterinary practice. The use of advanced surgical techniques raises questions about the quality of life and the potential for unnecessary procedures that may not significantly benefit the animal (Quain et al., 2021). There are concerns about the ethical implications of practicing advanced procedures on live animals for training purposes, which can lead to ethical dilemmas for veterinary professionals (Fransson et al., 2016). Strategies such as ethical reviews and the development of humane endpoints are suggested to address these concerns.

6.4 Patient selection and surgical limitations

Patient selection and the inherent limitations of MIS present additional challenges. Not all animals are suitable candidates for MIS due to factors such as size, health status, and the nature of the condition being treated. The limitations of MIS, such as restricted access to certain anatomical areas and the complexity of some procedures, can also limit its applicability (Balsa and Culp, 2019; Lhermette and Sobel, 2020). These factors necessitate careful patient assessment and selection to ensure the benefits of MIS are realized without compromising patient outcomes.

In summary, while minimally invasive surgery offers numerous benefits, its implementation in veterinary practice is challenged by high costs, limited training opportunities, ethical considerations, and patient selection issues. Addressing these challenges requires strategic investments in training, ethical frameworks, and careful patient assessment to fully harness the potential of MIS in veterinary medicine (Balsa et al., 2020; Fransson, 2022).

7 Future Directions and Emerging Technologies

7.1 Innovations in surgical tools and techniques

The field of minimally invasive surgery (MIS) for companion animals is rapidly evolving, with significant advancements in surgical tools and techniques. Laparoscopy, for instance, has become a cornerstone of MIS, offering benefits such as reduced blood loss, better visualization, and faster recovery times compared to traditional open surgery (Saha, 2023). The development of specialized equipment and techniques, such as minimally invasive video-assisted parathyroidectomy and spine surgery, has expanded the scope of procedures that can be performed with minimal invasiveness (Guevar et al., 2020; Sumner et al., 2022). However, the growth of this field is somewhat hindered by the high cost of equipment and the need for specialized training (Marinov and Zlateva-Panayotova, 2019).

7.2 Integration of artificial intelligence and machine learning

The integration of artificial intelligence (AI) and machine learning (ML) into veterinary surgery holds promise for enhancing surgical outcomes and efficiency. AI can assist in preoperative planning, intraoperative navigation, and postoperative monitoring, potentially reducing the learning curve associated with complex minimally invasive procedures (Dejescu et al., 2023). Although the application of AI in veterinary surgery is still in its infancy, its potential to revolutionize surgical practices by providing real-time data analysis and decision support is immense.

7.3 The role of telemedicine in postoperative care

Telemedicine is emerging as a valuable tool in the postoperative care of animals undergoing minimally invasive surgery. It allows for remote monitoring and consultation, which can be particularly beneficial in managing recovery and identifying complications early (Milovancev and Townsend, 2015). The use of telemedicine can enhance communication between veterinarians and pet owners, ensuring that postoperative care instructions are followed accurately and that any concerns are addressed promptly.

7.4 Prospects for veterinary robotic surgery

Robotic surgery represents a frontier in veterinary medicine, offering precision and control that surpasses human capabilities. While robotic systems are well-established in human medicine, their application in veterinary surgery is still developing. The potential for robotic systems to perform complex procedures with minimal invasiveness could significantly enhance surgical outcomes for companion animals (Heilmann, 2016). As technology advances and becomes more accessible, the adoption of robotic surgery in veterinary practices is likely to increase, providing new opportunities for innovation in surgical care.

In summary, the future of minimally invasive surgical techniques for companion animals is bright, with ongoing advancements in surgical tools, the integration of AI, the expansion of telemedicine, and the potential for robotic surgery. These innovations promise to improve surgical outcomes, reduce recovery times, and enhance the overall quality of care for companion animals.

8 Concluding Remarks

Minimally invasive surgical techniques have significantly advanced in the field of veterinary medicine, particularly for companion animals. These techniques, including laparoscopy and minimally invasive spine surgery, offer numerous benefits over traditional open surgeries. They are associated with reduced blood loss, better visualization, less postoperative pain, minimal scarring, faster recovery times, and fewer complications. The application of minimally invasive surgery (MIS) in the diagnosis and treatment of cancer in dogs and cats has also been effective, providing less invasive options for organ biopsy and treatment. Furthermore, advancements in equipment and surgical techniques have expanded the scope of procedures that can be performed minimally invasively, such as adrenalectomy and parathyroidectomy, enhancing the overall surgical outcomes for companion animals.

Despite the clear benefits, several challenges remain in the widespread adoption of minimally invasive techniques in veterinary practice. The high cost of specialized equipment, the need for extensive training, and the limited availability of advanced simulators for veterinary-specific procedures are significant barriers. Additionally, while the safety and feasibility of these techniques have been demonstrated, further research is needed to fully understand their long-term benefits and potential complications, particularly in oncologic surgeries. There is also a need for more comprehensive studies to validate the effectiveness of these techniques across a broader range of species and conditions.

The future of minimally invasive surgery in companion animals is promising, with ongoing advancements in technology and surgical techniques. As more veterinary professionals gain access to specialized training and equipment, the adoption of these techniques is expected to increase, leading to improved surgical outcomes and enhanced animal welfare. Continued research and development in this field will likely result in new applications and innovations, further solidifying the role of minimally invasive surgery as a cornerstone of modern veterinary practice. The growing popularity of these techniques among pet owners, due to their reduced morbidity and faster recovery times, will also drive their continued evolution and integration into standard veterinary care.

Acknowledgments

We express our heartfelt gratitude to the two anonymous reviewers for their valuable comments on the manuscript.

Conflict of Interest Disclosure

The author affirms that this research was conducted without any commercial or financial relationships that could be construed as a potential conflict of interest.

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