Soft Tissue Surgery

• Willows has one of the most experienced
  Soft Tissue Surgery teams in the UK
• Three highly trained Specialists…
• with over 100 first author papers in peer reviewed journals
• who are regularly invited to speak at conferences/CPD meetings in the UK and overseas
• one of whom is also an RCVS Specialist in Veterinary Oncology
• Unsurpassed, comprehensive service,
  24 hours a day, 365 days of the year
• Hospitalised patients benefit from
  24-hour veterinary and nursing care
• Urgent and emergency cases seen the same day
• Free telephone advice given with the minimum
  of delay

RCVS and European Specialists in Soft Tissue Surgery

Rob White
BSc BVetMed CertVA DSAS (Soft Tissue) DipECVS MRCVS

Chris Shales
MA VetMB CertSAS DipECVS MRCVS

RCVS and European Specialist in Soft Tissue Surgery
RCVS Specialist in Veterinary Oncology

Stephen Baines
MA VetMB PhD CertVR CertSAS DipECVS DipClinOnc MRCVS

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Common clinical problems managed and procedures performed

• Gastrointestinal 
• Oesophageal FB removal, small intestinal and colorectal surgery,
  anal furunculosis 
• Wound management and reconstruction 
• Local subdermal plexus flaps, axial pattern flaps, etc. 
• Cardiothoracic 
• Congenital cardiac defects, pericardiectomy, lung lobectomy, thymectomy, pyothorax and chylothorax 
• Endocrine surgery 
• Pancreatectomy (insulinoma), adrenalectomy, thyroidectomy and parathyroidectomy 
• Hernia/rupture surgery 
• Perineal ruptures, diaphragmatic ruptures, hiatal hernia and pericardioperitoneal diaphragmatic herniation

Perineal rupture repair 

Wound reconstruction using a facial axial pattern flap

Total ear canal ablation in a cat

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Airway disease

Surgical management available for idiopathic bilateral laryngeal paralysis

• Unsurpassed experience of arytenoid lateralisation surgery

Surgical management available for brachycephalic syndrome

• Rhinoplasty
• Staphylectomy
• Excision of laryngeal saccules
• Arytenoid laryngoplasty for severe laryngeal collapse

Surgical management available for collapsing trachea

• Placement of intraluminal stents
• Placement of extraluminal prosthetic tracheal rings

Management of fungal rhinitis

• Endoscopic removal of fungal plaques
• Topical non-invasive administration of anti-fungal agents
• Open rhinotomy surgery for select cases

Rhinoplasty in a Persian cat - pre- and post-operative appearance

Intra-nasal endoscopic view of fungal plaque due to aspergillosis

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Surgical Oncology

Particular areas of interest include:

• Soft tissue sarcomas
• Mast cell tumours
• Oral tumours
• Thoracic tumours – lung, thymoma, chest wall
• Abdominal tumours – liver, spleen, pancreas, kidney, adrenal, intestinal, colorectal

Surgical resection of a large rib chondrosarcoma

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Urinary incontinence

Surgical management available for ureteral ectopia

• Neoureterocystostomy
• Neoureterostomy

Surgical management available for urethral sphincter mechanism incompetence (USMI)

• Urethroscopy and the transurethral injection of a bulking agent
• Urethropexy
• Colposuspension

Contrast radiography demonstrating an ectopic ureter

Intramural ectopic ureter seen on cystoscopy

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Porto-systemic shunts

Our Specialists have performed over 600 extra- and intra-hepatic shunt procedures

• Full ligation
• Partial attenuation
• Cellophane banding
• Ameroid constrictor
• Intravascular repair
• Transvenous coil occlusion/embolisation

Willows' Specialists have unsurpassed expertise in shunt surgery

Porto-azygous shunt - subtraction fluoroscopy after contrast injection

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Minimally Invasive Surgery

Willows offers a full range of minimally invasive surgery techniques.

Common veterinary applications include:

    Laparoscopy

• Laparoscopy-assisted procedures,
  e.g. gastropexy, cystotomy
• Cholecystectomy, adrenalectomy, partial pancreatectomy
• Elective ovariectomy and cryptorchidectomy

    Thoracoscopy

• Exploratory thoracoscopy and biopsies
• Pericardectomy
• Lung lobectomy
• Thoracic duct ligation
• Resection of cranial mediastinal masses

Laparoscopy procedure at Willows

Laparoscopic orchidectomy

Laparoscopic liver biopsy

Ovariectomy

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Interventional radiology

Willows offers a wide range of interventional radiology techniques and stents for the management of a number of disorders affecting dogs and cats.

This service is provided by close co-operation between Specialists in Soft Tissue Surgery, Internal Medicine and Diagnostic Imaging.

Facilities include:

• State-of-the-art, Specialist-run imaging facilities
  • Ultrasonography
  • 16-slice computed tomography (CT)
  • Fluoroscopy with digital subtraction and road mapping
• Full range of catheters, guidewires, balloons, stents and coils

Current veterinary applications include:

    Vascular:

• Trans-arterial embolisation for haemorrhage, vascular malformations or metastases
• Intra-arterial chemotherapy and chemo-embolisation for malignancies
• Transvenous coil embolisation of portosystemic shunts
• Palliative venous stenting for malignant obstructions

    Non-vascular:

• Tracheal stenting for tracheal collapse
• Palliative stenting for benign stenosis,
  e.g. nasopharyngeal stenosis
• Palliative stenting for malignant obstruction,
  e.g. oesophagus, colon, urethra
• Ureteral stenting for ureteric calculi
• Retrieval of tracheobronchial foreign bodies
• Balloon dilation of benign stenosis,
  e.g. oesophageal stricture
• Antegrade urethral catheterisation in urethral obstruction or trauma

Fluoroscopic placement of a tracheal stent

Radiographic and endoscopic views of a tracheal stent placed for treatment of collapsing trachea

Oesophageal stent used for treatment of intractable oesophageal stricture

Urethral stent in a male dog with prostatic/urethral carcinoma

Portosystemic shunt seen on colour-flow Doppler ultrasonography

Post-contrast volume rendered CT scan showing abdominal vasculature