Page 8 - RVC Clinical Connections - Summer 2025

RVC RESEARCH STUDY VETERINARY SERVICES RVC.AC.UK
Equine
HARMONIC SCALPEL’S HELP TO HORSES

Andy Fiske-Jackson, Deputy Head of RVC Equine and Associate Professor in Equine Surgery

VC Equine has a new harmonic excision can be associated with problems On the day prior to and the day of
scalpel, which has been helping a due to their location. Removal using the discharge, upper airway endoscopy was
R range of referred equine patients, currently preferred method of diode laser performed. This revealed that the blood
including several horses with melanomas. frequently results in numerous complications, clot had resolved, allowing the extent of
The technology has applications beyond including pain during defaecation and the plaque to be visualised. A firm plaque
equine oncology though and was, for resultant rectal impactions. Likewise, sharp was evident adherent to the internal carotid
example, used in the case of a horse with dissection can be hampered by bleeding artery. This extended over the stylohyoid
guttural pouch mycosis, as discussed below. and the proximity to delicate structures such bone to the region of the external carotid
The harmonic scalpel's ultrasonic as the parotid salivary gland. artery. On both occasions the site was
vibrations create a precise and controlled However, even with their slow growth, treated with topical enilconazole.
incision, whilst providing haemostasis, leaving melanomas untreated can result Angel returned to the hospital a week later
which reduces the risk of excessive tissue eventually in unacceptable morbidities for removal of the balloon catheter. She was
damage compared to other approaches, arising, for example obstruction of the anus, bright and alert, with all vital parameters
such as laser or electrosurgery. which can lead to euthanasia. within normal limits and the harmonic
In recent years, the Equine Referral scalpel incision was well healed.
Enhancing equine oncology efficacy Hospital has successfully treated Endoscopy of the right guttural pouch
The RVC has developed increasing melanomas through innovative therapy, found the fungal plaques to be darkened
expertise in equine oncology over recent including tumour specific electroporation and regressing. Topical treatment with dilute
years and the acquisition of a harmonic (TSE) and excisions. enilconazole was repeated. The staples
scalpel is helping us improve our treatment The addition of the harmonic scalpel to were removed, and a small incision was
of melanomas and other tumours. We are our capabilities has a significant positive made for the balloon catheter’s removal.
one of very few equine hospitals in the UK impact on welfare. The reduced risk No epistaxis or bleeding from the site was
that has access to a harmonic scalpel for of complications makes the procedure observed.
tumour removal. more attractive to owners of horses with Angel has recovered completely; the
Up to 80% of grey horses over 15 years melanomas – as well as enabling a variety plaque has resolved, and she is back in
old have a melanoma. They can occur of other procedures to be performed more full work. There has been no repeat of the
anywhere but have a predilection for certain safely, and with less postoperative pain. epistaxis and no complications following the
areas, including the perianal and parotid The harmonic scalpel was funded by the procedure.
region. Prowting Charitable Foundation, via the
RVC’s charity the Animal Care Trust.

Guttural pouch mycosis case – Angel
Angel was referred to the Equine Referral
Hospital towards the end of March and
stayed for six days. She had epistaxis
originating in the right guttural pouch.
Upon presentation Angel was tachycardic
but other physical parameters were within
normal limits.
Within the right guttural pouch a
large blood clot was evident, preventing
visualisation of most of the pouch. On the
medial aspect of the guttural pouch, the
edge of a fungal plaque was present in the
region of the internal carotid artery. The left
guttural pouch was normal.
Angel underwent balloon catheterisation
of the right internal carotid artery, under
general anaesthesia. The harmonic scalpel
allowed a precise dissection to the internal
carotid artery, providing haemostasis – Angel after returing home
The harmonic scalpel in use thereby improving visualisation within
the surgical field. The ability to cut whilst
Historically, they were commonly left cauterising also improved the speed of the
untreated as they are slow growing and procedure. For equine referrals, please call: 01707
666297
Email:
equinehospital@rvc.ac.uk

8 Summer 2025