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Avian Specialty Veterinary Services of Alaska
13861 Hillcrest St NW
Poulsbo, WA 98370-8134
(360)271-7000
vet@alaskabirddoc.com
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Minimally-Invasive Endosurgery (MIES)
By: Scott Ford, DVM, Dipl. ABVP-Avian
I love birds and I hate to see them suffer from illness or injury, particularly when that illness or injury could have been averted. However, I must confess, that one of my favorite parts of my job is performing surgery. Used at appropriate times and circumstances, it can be an extremely useful part of treatment. The best reward is always the safe return of a patient to health. Second-best, though, is the thrill of taking hold of a problem in tangible, physical terms and removing or correcting it. And, of course, using cool cutting-edge gadgets is always fun too.
One of the latest surgical tools to come on the scene is the use of multiple ports in endosurgery. Traditionally, surgery has been performed in birds by cutting an opening large enough to peek inside and fit microinstruments. Some 15 years ago, several pioneers advocated the use of video endoscopy for surgery, which greatly improved our ability to biopsy organs, visually inspect the inside of birds, and perform simple surgeries. This has now been improved upon by the use of multiple ports. The way it works is that the endoscope is inserted into one small hole (Usually less than 5 mm). A metal or plastic cannula can then be inserted through another hole to allow the insertion of specialized endosurgery instruments. If the patient is large enough, 2 of these cannulae can be inserted-- one to each side of the endoscope. This allows the surgeon to have two instruments working together inside the bird while watching their work, magnified, on a television.
This technology has already been in use in human medicine for many years. Some veterinarians, such as Dr. New in Juneau, Alaska, now perform routine spays using endosurgery. Because the incisions are smaller, pain, recovery time, and likelihood of infection are all reduced. It is hoped that this modality will also increase the safety of avian surgery.
 Mark Stetter at Disney's Animal Kingdom has developed a technique utilizing minimally-invasive endosurgery in mallard ducks. You see, in Florida, there has been rising concern for the spotted duck and increasing mallard numbers have placed further pressure on this species in terms of available nest sites and harassment by competing drake mallards. Disney, and other wildlife centers, receive hundreds of orphaned or injured mallards annually. To avoid adding to the spotted duck's problems and yet still treat these birds compassionately, a solution had to be developed for sterilizing the birds and remove their reproductive drive, prior to release. Only complete removal of the testicles or ovary would suffice. So, in cooperation with Florida Department of Fish and Game, Dr. Stetter developed a minimally-invasive endosurgical technique for complete gonad removal. The program has been quite successful so far.
I went to Disney's Animal Kingdom to watch Dr. Stetter and his staff at work and was quite impressed. Having removed testes and ovaries from birds through traditional microsurgery, I found this technique to be faster and less traumatic. I am hoping to acquire portable equipment and begin using this surgical modality myself. Immediate applications would be in the areas of wild waterfowl management and gonadectomies (removal of testes or ovary) in pet waterfowl and galliformes (chickens, pheasants, pea fowl, etc). It would also be immediately useful to improve the quality and safety of biopsies. It remains to be seen how it will work under conditions of severe abdominal disease, which frequently involves masses and accumulated fluid or inflammatory debris. But I believe that with modifications of equipment and technique, it will become a useful tool for many types of abdominal surgery.
If you would like to learn more about Disney's Animal Kingdom's veterinary and wildlife programs, go to http://corporate.disney.go.com/environmentality/ and http://disney.go.com/disneyhand/environmentality/animals/ak_care.html
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