Historical perspectives guide advances in equine minimally invasive soft tissue surgery

Equine minimally invasive soft tissue surgical techniques have increased in demand and frequency with concurrent expansion of training programs under the oversight of the American College of Veterinary Surgeons. Benefits of recent advances in laparoscopic techniques include reduced cost and risk associated with general anesthesia and anesthetic recovery, improved visualization of the surgical field relative to open procedures, and more rapid return to performance, further improving patient welfare and limiting economic loss to the industry following surgical interventions. The evolution of laparoscopic techniques and instrumentation in human and veterinary practice predates contemporary practice by more than a thousand years. Current strategies in equine minimally invasive surgery emphasize applications related to gastrointestinal and urogenital disease, with thoracoscopic approaches less frequently applied, representing an area for growth in the field. This review seeks to summarize the origins and development of laparoscopic procedures and instrumentation in large animal surgery, current applications, and opportunities for expansion to meet evolving surgical demands such as integration of NOTES (ie, natural orifice transluminal endoscopic surgery), near-infrared technology for improved perfusion and lymphatic detection, and robotic control options. The overall aim is to provide background and incorporate perspectives from small animal and human practice toward a One Health approach to enhance acceptance and integration of minimally invasive procedures in large animal surgery.