When Clarence Rawlings, DVM, Dipl. ACVS, began his veterinary practice nearly 40 years ago, the scalpel was his main surgical tool.

Today, this University of Georgia professor is more apt to reach for an endoscope to remove bladder stones or perform other surgeries on dogs and cats.

"Endoscopy reduces trauma, reduces blood loss, frequently is quicker and usually produces quicker recovery rates," says Dr. Rawlings.

Laparoscopic biopsy of a canine liver diagnosed with chronic active hepatitis.

That's the message he and several small-animal surgeons plan to deliver in lab sessions at the upcoming American College of Veterinary Surgeons Symposium in San Diego Oct. 27-29.

Step aside, scalpel—make way for the new generation of diagnostic and surgical tools: endoscopes, arthroscopes, laparoscopes, lasers, radio waves and more. As more veterinarians train to use these tools, they are better able to diagnose and treat countless conditions.

Progress, however, still depends on two age-old variables: time and money. Practitioners must be willing to spend money to purchase these tools and devote time with their staff to master their use.

"From my standpoint, the equipment is expensive to buy and there is always a learning curve," say's Loretta Bubenik, DVM, Dipl. ACVS, assistant professor and veterinary surgeon at Louisiana State University who is considered an expert in the latest orthopedic techniques, including arthroscopy.

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"Besides the potential to lessen pain and decrease hospital stays, a big advantage of arthroscopy is that visualization is much improved since joint structures are magnified. Depending on the scope used, you can see around corners, giving you a better look inside."

Dr. Bubenik relies on arthroscopes to evaluate joint interiors, perform biopsies and treat diseases such as osteochondritis dissecans. She uses arthroscopy to explore the interior condition of an animal's knee, clean it out and repair a torn meniscus. Still, she acknowledges a bit of frustration with the pace of progress.

"Veterinary medicine still trails with what human medicine can accomplish," Bubenik says. "Human medicine, for example, can do extensive intestinal resections and bypass procedures using laparoscopic techniques. Our veterinary surgical teams, at this point, are not as advanced."

Well aware that veterinary medicine can sometimes be a step or two behind human medicine, David Sobel, DVM, became the first veterinarian to enroll in a minimally invasive surgery program designed for first-year human medicine residents at a New England medical center in the early 1990s.

Dr. Sobel, who operates Metropolitan Veterinarian Consultants in Hanover, N.H., says his center has performed more operative endoscopies than any other veterinary practice in northern New England.

"Now, 15 years later, we have high-quality veterinary continuing education courses on everything from laparoscopy to rhinosinusoscopy to arthroscopy."

Five years ago, Sobel says, most veterinarians relied on traditional surgery to open the chest and remove cancerous lesions from lungs in dogs. Now that procedure can be done more effectively and less invasively using an endoscope.

He now performs about 90 percent of canine liver biopsies using a laparoscope.

"I can put the scope within a couple millimeters of every place in the liver," Sobel says. "With traditional surgery, you never get that degree of visualization. Plus, the scope provides magnifications to increase your ability to see the liver."

During a laparoscopic ovariohysterectomy, the canine ovarian bursa, ligament and vasculature are seen.

Manufacturers of minimally invasive medical tools are constantly unveiling new models, often based on success from human medicine. The challenge for veterinarians is selecting the right tool—and technique—for their procedures.

For example, veterinary procedures using laparoscopes typically call for two or more port entries. However, a new technology requiring a single port entry can be ideal for surgeons wishing to take a liver biopsy or remove bladder stones from a dog, Rawlings says.

"This single-port laparoscope has been around in human medicine for decades, but is new in the veterinary market," Rawlings says.

Ken Bartels, DVM, a professor of surgery at Oklahoma State University in Stillwater, likes partnering endoscopes with lasers.

"If you can see it with an endoscope, you can often get it with a laser," he says. "For example, if you can see the soft tissue pathology in an esophagus or uterus with an endoscope, you can get it with a laser and vaporize it using thermal energy.

The future of veterinary medicine looks bright as laser technology continues to improve and expand, predicts Dr. Bartels.

In this photo, rhinoscopy is performed to look for nasal parasites in a dog. Minimally invasive surgical techniques, including rhinoscopy, allow practitioners to diagnose patients without traditional surgical complications.

"Research focused on basic laser-tissue interaction and selective tissue destruction will become increasingly important," Bartels says. "Companies are working on developing smaller guides to allow us to use carbon monoxide lasers within endoscopes. hopefully, that will be available in the next year or two."

Expect new advances in all forms of minimally invasive techniques, says Sobel, adding, "We say that any place there is a hole in the body, we can put in a scope.

"Yes, this is still a new field in veterinary medicine," he says. "We can't do everything that our human medical counterparts can do on a routine basis—yet."

Rawlings believes that public awareness of benefits in human medicine will serve to alert veterinarians to the need to incorporate lasers, endoscopes and other high-tech tools into their practices.

Arden Moore is a freelance writer who specializes in pets and human health topics.