Folding flap palatoplasty and a new toy
Surgeons do like their toys and the Surgeon on Site team are no exception! This week I was lucky enough to have had a new Sonicision cordless harmonic scalpel device on trial httpss://www.medtronic.com/covidien/en-gb/products/ultrasonic-dissection/sonicision-curved-jaw-ultrasonic-dissection-system.html#. Harmonic scalpels work by using ultrasonic energy to cut and coagulate the tissue. This device is unique in that it is battery-powered and has no cable which makes it much easier to manipulate and position exactly as we want it.
We have recently moved to performing more “folding-flap palatoplasty” procedures in brachycephalic dogs. The aim of this procedure is to reduce not just the length of the soft palate but also some of the thickness which is contributing to respiratory obstruction. A longer, partial-thickness piece of the palate is removed, and the remaining palate is folded over and sutured. This also means that the sutures are not along the margin of the palate, which should be less irritating to the patient. We also now fairly routinely remove the tonsils as part of surgery for brachycephalic patients, and the Sonicision made very quick work of this part of the procedure.
httpss://www.cliniciansbrief.com/article/brachycephalic-syndrome-innovative-surgical-techniques (sign-up required)
Control of haemorrhage from the palate is a little more difficult compared to a conventional staphylectomy, and the Sonicision harmonic scalpel device was a clear improvement over the combination of monopolar and bipolar diathermy that we have used up to now. We will certainly be considering investing in one of these devices.