News and Press Releases on exciting new operations and breakthroughs in the field of veterinary keyhole surgery

March 2012:
A recent feature on Italian national TV (RAI) discussing veterinary minimally invasive surgery in Rome with Klaus Friedrich 


January 2011:

World first keyhole surgery removal of diseased gallbladders in bears rescued from bile farms

Click here to access the Press Release - Moon bear is the first in the world to have damaged gallbladder removed using keyhole surgery at Free The Bears sanctuary in Vietnam.  Copyright free Photos for Press Use here. Video for Press Use here.

The worlds first laparoscopic cholecystectomies (keyhole surgery) for the removal of diseased gall bladders in moonbears rescued from illegal bile farms was perfromed by Royal Zoological Society of Scotland (RZSS) veterinary surgeon Romain Pizzi, and wildlife anaesthetist Jonathan Cracknell, at the Free The Bears (FTB) Hon Me rescue centre in Vietnam, working with FTB's veterinary team of Veterinarian Sylvain David, veterinary nurse and health program coordinator Denise Laughlin, and veterinary nurse Michelle Rouffignac, under direction of Manager Nev Broadis and CEO Mat Hunt.

Asiatic black bears (Ursus thibetanus) are kept illegally for bile farming in Vietnam, and are classified as vulnerable by the IUCN. Bears are "milked" for bile, used in traditional Chinese medicine, by repeated needle puncture of the gallbladder, or by use of an indwelling catheter, or creation of a fistula. Bears rescued from bile farms have demonstrated a very high incidence of gallbladder and liver disease related to the practice of "milking" bile, and previous studies have shown almost half of fistulated bears later died of liver and gallbladder tumours, believed a consequence of the chronic inflammation and infections caused by invasive bile collection techniques. Even in non-fistulated bears, almost all bears have chronic cholecystitis (infection/inflammation of the gallbladder). Many rescued bears in a number of charities in Asia have had to have a cholecystectomy (gallbladder removal) performed by open abdominal surgery to remove a diseased gallbladder, and to try prevent the later development of malignant liver and gallbladder tumours.

This video records the worlds first gallbladder removals performed by minimally invasive surgical technique in bears rescued from bile farming. The technique has notable welfare benefits over the standard open abdominal surgical approach and prolonged recovery. All bears made a rapid recovery, and returned to normal activities such as swimming, climbing, and interacting with other bears within 1 week of surgery.

Click here to access the Press Release - Moon bear is the first in the world to have damaged gallbladder removed using keyhole surgery

Open abdominal surgery is associated with large, painful wounds, and the prolonged healing time necessitates keeping bears confined in very small cages for 6 weeks or more to allow healing to occur. Open surgery to remove the gallbladder in humans is associated with high levels of post-operative pain, prolonged hospitalisation, slow recovery, increased risk of dehiscence (the wound breaking open), increased risk of infection, and an increased risk of developing a hernia (needing a second corrective surgery to repair). In human hospitals in developed countries, this type of surgery has been almost entirely replaced by laparoscopic, so-called "keyhole surgery" cholecystectomy, also referred to as minimally invasive surgery. Laparoscopic cholecystectomy is now firmly established as the gold standard for gallbladder removal in human patients. Animal patients need much less post-operative care, and have a lower risk of developing post-operative infections or complications.

This veterinary trip was made by Royal Zoological Society of Scotland (RZSS) veterinary surgeon Romain Pizzi, and wildlife anaesthetist Jonathan Cracknell, to the Free The Bears (FTB) Hon Me rescue centre in Vietnam's Mekong Delta in November and December 2010. Working with FTB's veterinary team , the team gave all of the centres rescued Asiatic black bears (Ursus thibetanus) a comprehensive general health check under anaesthesia, including haematology, serum biochemistry testing, and abdominal ultrasonography. Bears had minimally invasive laparoscopic abdominal examinations and liver biopsies were taken for histological assessment, and bears that were found to have significantly diseased and fibrotic gallbladders with abdominal adhesions, had their gallbladders removed by minimally invasive laparoscopic cholecystectomy (keyhole surgery).

Sponsors and Donors were the Royal Zoological Society of Scotland, Surgical Innovations, Woodley Equipment Company, and Vetronic Services 

Click here to access the Press Release  - Moon bear is the first in the world to have damaged gallbladder removed using keyhole surgery at Free The Bears sanctuary in Vietnam.  Copyright free Photos for Press Use here. Video for Press Use here.

December 2009: 

Ground breaking surgery saves Christmas -  A reindeer at Edinburgh Zoo is the first in the world to receive keyhole surgery

 Eskimo, a reindeer at Edinburgh Zoo has received life-saving surgery just in time for Christmas, making him the first reindeer in history to receive keyhole surgery.

Leading vet Romain Pizzi successfully removed one of Eskimo's testes, which had been lodged in its abdomen since birth using specialist surgical instruments donated by Surgical Innovations - a Leeds based designer and manufacturer of innovative surgical devices.

The Zoo was concerned that the retained testicle may have been developing into a tumour giving off abnormal hormones, and that this could become life-threatening. Thankfully, the Zoo surgeons were relieved to find that the retained testicle, although abnormally sized, had not yet developed a tumour.

It is believed that the abnormal testicle was affecting Eskimo's production and flow of testosterone and, as a result, he was showing submissive behaviour and being bullied by the other male reindeer in the herd. He had also started to show some abnormal and delayed antler growth and development. Removing the testicle will halt any abnormal hormone production so hopefully Eskimo will return to full vigour just in time for Christmas.

 Although keyhole (or laparoscopic surgery as its also known) is routine in humans, the standard procedure in animals is still open abdominal surgery.  Open abdominal surgery is 20 years behind human medical advances and has a number of negative factors on animals such as more post-operative pain, slower recovery and a higher risk of post-operative complications and infections.

Romain, a Veterinary Surgeon for the Royal Zoological Society of Scotland, based at Edinburgh Zoo, said: "The operation was been a great success and Eskimo has made a speedy recovery."

"Laparoscopic surgery is still very uncommon in veterinary medicine, even amongst common species such as dogs, cats and horses, so for keyhole surgery to be carried out on a reindeer shows a great advancement in veterinary surgery."

It is estimated that nearly one out of every two households in the UK are pet owners.  Veterinary surgeons perform on average 600,000 open abdominal procedures annually but it is believed that less than 1% of them currently practice laparoscopic surgery. 

Veterinary laparoscopic pioneer Romain believes that with the right instrumentation developed by companies such as Surgical Innovations, UK vets now have the opportunity to introduce laparoscopic techniques as part of their operating procedure. 


 "This procedure was only really possible thanks to a cutting-edge designed retractor which we were able to use in this case. Ironically although a reindeer is a reasonably large animal, due to their unique anatomy and massive four chambered stomach that takes up most of the space in the abdomen, there is a very limited internal operating space. For this reason the operation was much more difficult than in a human, or in a dog, where there is more space to work, despite their smaller size."

The minimally invasive nature of laparoscopic surgery means there are numerous benefits for animals such as a reduction in post-operative pain, a faster recovery and reduced post-operative care.   It also has a decreased risk of infection after surgery and a lower risk of any wound complications. 

"We were especially pleased with how quickly Eskimo recovered after surgery, he was standing and happily eating lichen again within 10 minutes of recovery from anaesthesia. He hardly seemed to notice he had even had surgery. This would simply not have been possible with traditional open abdominal surgery, as the long wound would have been much more painful and debilitating"

For veterinary surgeons laparoscopic surgery can offer better visualisation of the operated area, allowing them to be more precise and reach areas that are difficult to see in open surgery such as the liver and pelvic canal.

Romain carries out laparoscopic operations on dogs, cats and exotic pets at his own veterinary practice Inglis Veterinary Centre (Scotland) and has pioneered several new laparoscopic techniques.

He commented: "Laparoscopic surgery has so many benefits for the animal, the veterinary surgeons and the Zoo, so there is no reason why it should not be more common practice within veterinary surgery.  I hope Eskimo's experience helps raise its profile and encourage more veterinary surgeons to look into it as a standard surgical procedure."

Surgical Innovations have a worldwide reputation for the development of innovative laparoscopic devices and following their global success within the medical laparoscopic field, the pioneering company is working with the UKs leading vets and agencies such as the Royal Zoological Society of Scotland, as well as the UK's fastest growing veterinary distributor Ark Surgical, to be at the forefront of veterinary laparoscopic surgery.

Managing Director, Graham Bowland, said: "We are delighted to be working with Romain in the advancement of laparoscopic surgery within the veterinary community and are pleased that the operation on Eskimo was a success and he will be fit and ready for a busy Christmas Eve."

In this short extract from the series "Michaela's Animal Road Trip" on FIVE (2009), presented by Michaela Strachan, laparoscopic surgery is performed on a young dog by Romain Pizzi at a private practice in Dunfermline, Scotland.