Thoracoscopy in the horse requires similar instrumentation to what is used in laparoscopy. The only additional item that is necessary is a way to evacuate a pneumothorax at the end of the procedure. This may be accomplished by the use of a teat cannula and suction or by the insertion of a chest tube with a Heimlich valve. Unlike laparoscopy, food and water are not restricted in the perioperative period for most procedures. Routine preoperative administration of tetanus prophylaxis, antimicrobials andanti-inflammatories should occur. The horse is restrained in a standing stocks for standing procedures and a sedative/analgesic combination administered or placed in lateral recumbency for general anesthesia procedures. Local anesthesia is infiltrated at the sites of proposed trocar insertion. A teat cannula is advanced into the thoracic cavity through the desired intercostal space until air is heard entering the thorax. The lung is allowed to collapse, creating an optical cavity. A trocar/cannula assembly is then inserted into the thorax. Additional instruments may be inserted under direct visualization. The horse should be monitored for respiratory distress and the lungs reinflated with the suction unit if the horse becomes too agitated. Oxygen maybe administered by nasal insufflation if desired. At the end of the procedure, the lung should be reinflated and the skin sutured.
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