Veterinary Surgery最新文献

Objective: To describe a repeated-measures model permitting evaluation of up to four implants intended for maxillofacial applications in sheep.

Animals: Two-year-old Merino wethers (n = 5).

Methods: A retromandibular subparotid approach was developed through anatomical study of  atlases, predissected models and cadaveric experiments. A purpose-designed surgical guide and test miniplates were produced to improve standardization among test implants. Five sheep were monitored for 6 months postoperatively to demonstrate the safety and practicality of the model.

Results: All animals resumed food intake within 5 min of regaining the righting reflex. The only complication consisted of a mild unilateral swelling over the surgical site in two sheep, which resolved spontaneously within 8 weeks.

Conclusion: The approach provided a safe and reliable surgical corridor to the mandibular ramus in sheep. Surgical site swelling should be assessed by ultrasonography to exclude implant involvement. This model may improve standardization and reduce animal numbers in studies evaluating maxillofacial implants.

This technical note describes the use of a manual graphic roadmap (MGR) to assist fluoroscopic guidance during transarterial coil embolization (TACE) for guttural pouch (GP) arterial hemorrhage. Horses underwent MGR-assisted TACE at the Equine Clinic, Free University of Berlin, between 2012 and 2024. Surgery was performed under general anesthesia with fluoroscopic guidance. Following the initial angiogram, a transparent foil was secured to the fluoroscopy monitor, and an assistant traced the vascular anatomy with a waterproof marker to create the MGR, which then served as a guide for catheter advancement and coil placement. This technique was applied in all TACE procedures performed at the authors' institution. The MGR provided continuous anatomical orientation throughout catheter navigation and coil placement; additional contrast injections were required only to confirm vessel occlusion. We describe a practical approach to support anatomical orientation during TACE in settings without access to fluoroscopy with roadmap technology. Further studies should evaluate cases treated with this technique and assess subjective and objective procedural parameters, including contrast usage, radiation exposure, and overall efficiency, under standardized model conditions.

Objective: To evaluate functional and histopathologic outcomes of standing selective laryngeal reinnervation using the spinal accessory nerve (SAN) in horses with experimentally induced recurrent laryngeal neuropathy (RLN).

Animals: Five Thoroughbred mares.

Study design: Prospective cohort study.

Methods: The horses underwent left recurrent laryngeal neurectomy followed 8 weeks later by selective laryngeal reinnervation using the SAN. Follow-up evaluations at 4.5, 6, 8, and 12 months included treadmill exercising endoscopy, ultrasonography of intrinsic laryngeal muscles, and percutaneous electrical stimulation of the SAN. Twelve months postoperatively, the horses were euthanized for macroscopic and histopathologic examination of the cricoarytenoideus dorsalis (CAD), cricoarytenoideus lateralis (CAL), sternomandibularis (SM), spinal accessory and recurrent laryngeal nerves.

Results: Twelve months following laryngeal reinnervation, mean left-to-right quotient angle ratio (LRQ) recovered to 94% of predenervation values with no difference from the baseline (95% CI [90, 98]; p = .69). One horse exhibited a slower and incomplete recovery. Post-mortem examination confirmed successful spinal accessory nerve implantation in the left CAD muscle in all horses. Histopathologic examination revealed axonal regeneration of the spinal accessory nerve and reinnervation of the left lateral CAD muscle belly with fiber type grouping and a shift toward an increased proportion of type I fibers consistent with functional reinnervation.

Conclusion: Selective laryngeal reinnervation using the spinal accessory nerve restored functional arytenoid abduction at exercise in 4/5 horses with experimentally induced RLN.

Clinical significance: In horses with RLN and mild to moderate CAD muscle atrophy, selective laryngeal reinnervation using the SAN represents a physiological and effective treatment option.

Objective: To determine the benefit of using a three-dimensional (3D)-printed titanium aiming device for placing two 5.5-mm transarticular screws during proximal interphalangeal joint (PIPJ) arthrodesis in equine species.

Study design: Ex vivo study.

Sample population: A total of 40 cadaveric forelimbs from adult horses.

Methods: A senior surgeon and a first-year resident each performed 20 constructs: 10 using the device and 10 using a freehand technique. Procedure duration and number of intraoperative radiographs were recorded. Final radiographs were evaluated by an ECVS-certified surgeon unaware of treatment group, based on two criteria: compliance with the AO principles, and symmetry and homogeneity of the construct. Following implants removal, the position of the thread hole on the articular surface of the second phalanx was assessed and graded for accuracy.

Results: For the inexperienced surgeon, the device reduced mean procedure time from 27.24 to 20.16 min (-25%, p < .01), decreased mean radiograph number from 6.1 to 2.1 (-60%, p < .01), and improved mean accuracy scores from 4.4 to 5.8 (+31%, p < .01). Construct symmetry also improved from 1.5 to 2.2 (+47%, p < .05). For the senior surgeon, only the number of radiographs was significantly reduced, from 3.1 to 1.3 (-58%, p < .01), with no significant difference in duration, accuracy, or symmetry.

Conclusion: The aiming device improved feasibility, accuracy, and repeatability of transarticular screw placement for the inexperienced surgeon.

Impact: This 3D-printed device appears to be as a promising tool for achieving gold-standard transarticular screw placement and may increases the accuracy of this surgery.

Objective: To date, there is little evidence on laparoscopic repair of peritoneopericardial diaphragmatic hernias (PPDH). The present study reports on surgical technique considerations, complications and outcome.

Study design: This was a multicentric retrospective cohort study of patients with laparoscopic PPDH repairs, using low-pressure CO₂ insufflation (3-4 mmHg) who were operated between October 2022 to November 2024 in two specialist centers.

Animals: Dog and cat patients were diagnosed with PPDH and treated laparoscopically using low-pressure CO₂ insufflation (3-4 mmHg). Patients were either symptomatic or their owners wished for repair.

Methods: Demographics of patients and details of surgical procedures including follow-up were reported in simple observational statistics. Details of surgical procedures included extent of PPDH, number of ports, insufflation pressure, suture use, use of thoracocentesis with an 18 gauge needle and/or drain, operating and total surgical time, anesthetic and surgical complications during and after surgery and a follow up at 6 months.

Results: Twelve canine and one feline patient were included in the study. One case required conversion to open surgery due to CO₂-induced pericardial tamponade. All patients survived and had no serious complications.

Conclusion: Full laparoscopic repair of PPDH using low insufflation pressure was successfully achieved in 92% (12/13) patients.

Clinical significance: This is the largest case series to report on outcomes of laparoscopic repairs of PPDH. Laparoscopic treatment of PPDH is a viable option without increased risk of complications.

Objective: To describe the procedure and short-term outcomes of two dogs that underwent laparoscopic stapled partial cystectomy with intraoperative cystoscopy for excision of solitary, non-trigonal, urothelial carcinoma lesions.

Animals: A 12-year-old female spayed mixed breed and a 13-year-old female spayed Siberian Husky.

Study design: Short case series.

Methods: Two dogs were diagnosed with a solitary, ventral body to apical, urinary bladder mass (maximal dimensions 1.2 cm and 1.4 cm) on ultrasound. No gross metastatic disease was evident on staging. Both dogs underwent general anesthesia with cystourethroscopy for evaluation of the bladder tumor and lower urinary tract. Laparoscopic stapled partial cystectomy was subsequently performed for excision of the bladder mass with gross margins of 1-3 cm based on concurrent cystoscopic transillumination and assessment of mucosal changes. Two medium/thick (purple) Tri-Staple EndoGIA cartridges (60 mm and 45 mm) were utilized to complete each cystectomy, and the excised bladder tissue was removed via a specimen retrieval bag and submitted for histopathology. The bladders were leak tested with sterile saline instilled via cystoscopy.

Results: No leakage was observed from the cystectomy sites. No intraoperative or short-term complications were reported. Histopathology was consistent with completely excised urothelial carcinoma in both cases.

Conclusion: Laparoscopic stapled partial cystectomy was successfully performed with intraoperative cystourethroscopy in two dogs with apical/ventral bladder wall urothelial carcinoma. This closed cystectomy technique may reduce the risk for peritoneal seeding, though more data is needed. Further evaluation is indicated to determine the feasibility in dogs with non-apical/ventral urinary bladder masses.

Objective: To describe postoperative subsidence observed after total hip replacement (THR) with the BFX standard stem.

Study design: Retrospective case series.

Sample population: A total of 177 THR procedures in 145 dogs.

Methods: Clinical and radiographic follow-up data were collected between 12 weeks and six months postoperatively. A proportion correction was used to calculate subsidence between immediate postoperative and follow-up radiographs. Canal flare index, coronal canal fill, sagittal canal fill, coronal stem orientation and sagittal stem orientation were measured.

Results: There were 24/177 (13.6%) intra- and postoperative complications. Of these, 11/177 (6.2%) were stem complications. Eight stem complications were intraoperative femoral fissures; one fissure progressed to postoperative femoral fracture. Subsidence was associated with stem complications (p = .005) and was not associated with non-stem complications (p = .76) or prosthetic luxation (p = .07). There were seven stems with more than 5.0 mm of subsidence; of these only 1/7 had a stem complication. There were 26 stems with more than 3.0 mm of subsidence; of these only 3/26 had a stem complication. There was no association between any femoral or stem measurements and subsidence.

Conclusion: Subsidence of the BFX standard stem was associated with stem complications, which were mostly intraoperative femoral fissures. Thresholds of 3.0 and 5.0 mm were poorly predictive of complications, and substantial subsidence was often clinically inconsequential.

Clinical significance: Cutoffs for excessive subsidence may have limited clinical utility. The significance of postoperative subsidence should be interpreted in the context of other clinical findings.

Objective: To quantify how increasing axial loads, femoral fixation methods (rigid vs. flexion-extension mobility) and joint angles reflecting early versus mid-stance impact simulated quadriceps and gastrocnemius forces.

Study design: Non-randomized, cadaveric experimental study.

Sample population: Unpaired canine pelvic limbs (n = 10) from adult large-breed dogs.

Methods: Limbs were mounted in a custom limb press with the femur sequentially rigidly fixed at 70° to horizontal or allowed flexion-extension. Quadriceps and gastrocnemius muscles were simulated with load cells and turnbuckles. Axial loads of 10%, 20% and 30% bodyweight (BW) were applied. Stifle and hock angles were sequentially fixed to represent mid- (135° and 145°) or early stance (145° and 135°). Outcome measures were BW normalized simulated muscle loads and their ratio. Data were analyzed using non-parametric repeated measures.

Results: Quadriceps and gastrocnemius forces increased with axial load (p < .001). Quadriceps force was unaffected by fixation method but showed higher mid-stance values in flexion-extension models at 20% and 30% loads (p = .03). Gastrocnemius force varied by configuration (p = .01) and showed significant load-configuration interactions (p = .003); mid-stance values were lower than early stance in flexion-extension models. Muscle force ratios were consistent across loads (p = .2) but differed by configuration (p = .02), with higher mid-stance values in flexion-extension models.

Conclusion: Femoral fixation method and stance configuration had limited impact on simulated muscle forces. Flexion-extension mobility did not substantially increase muscle loading.

Impact: Rigid femoral fixation remains a valid approach for canine limb press models.

Objective: To report perioperative morbidity and mortality in dogs and cats undergoing total lung lobectomy using a hilar circumferential ligature (HCL).

Study design: Retrospective clinical study.

Sample population: Client owned dogs (n = 65) and cats (n = 15).

Methods: Medical records were searched for dogs and cats undergoing surgery for total lung lobectomy using a HCL, consisting of either a commercial pre-tied ligature loop (CPLL) or handtied circumferential ligature (HTCL). Cases were collected between 2017 and 2022 from six different hospitals and included signalment and perioperative data.

Results: A total of 94 lung lobes were removed, 59 with CPLL and 35 with HTCL, in 80 dogs and cats. The HTCL group comprised seven sliding, 25 modified Miller's and three Roeder knots. Intraoperative hemorrhage occurred in 4/94 (4.3%) lung lobectomies using 2/59 (3.4%) CPLL and 2/7 (28.6%) sliding knots. There was no association between hemorrhage and use of CPLL versus HTCL (p > .99), knot type (p = .09), or number of sutures per pedicle (p = .30). One dog died intraoperatively from tumor extrusion into the bronchus. One dog required revision surgery for pneumothorax eight days postoperatively.

Conclusion: The overall incidence of intraoperative complications was low. Our findings support the use of CPPLs, handtied Roeder and modified Miller's knots for total lung lobectomy in dogs and cats with clinical disease. Sliding knots should be used with caution.

Clinical significance: The low complication rate, together with the ease of use and cost efficiency of HCL, makes this technique a promising option for total lung lobectomy.