Quiz Question

In Adair 2023 et al., on PCCLm vs. open cystotomy, what outcome was significantly more common in the open cystotomy group postoperatively?

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Correct. OC group showed significantly more postoperative LUT signs than PCCLm group (60.9% vs. 13.0%).
Incorrect. The correct answer is Increased lower urinary tract signs.
OC group showed significantly more postoperative LUT signs than PCCLm group (60.9% vs. 13.0%).

🔍 Key Findings

  • PCCLm resulted in significantly fewer postoperative lower urinary tract signs compared to OC (13.0% vs 60.9%, p <.001).
  • Incomplete urolith removal was not significantly different between PCCLm and OC (11.4% vs 20%, p = .112).
  • PCCLm had significantly shorter anesthesia times than OC when no concurrent procedures were performed (97.5 vs 120 min, p < .001).
  • Surgical site infection/inflammation (SSII) rates were low and not significantly different between groups (4.5% PCCLm vs 1.8% OC).
  • Dogs undergoing PCCLm were more frequently discharged same-day (84.7% vs 0% in OC), reflecting faster recovery.
  • PCCLm had higher intraoperative complication rates (22.1% vs 3.4%), mostly due to incision extension or conversions.
  • Time to additional surgery for urolith recurrence was longer in PCCLm dogs (24 vs 11.5 months, p = .004).
  • Calcium oxalate uroliths were more prevalent in PCCLm cases, while OC had more struvite or mixed types.

Adair

Veterinary Surgery

6

2023

Retrospective comparison of modified percutaneous cystolithotomy (PCCLm) and traditional open cystotomy (OC) in dogs: 218 cases (2010–2019)

2023-7-VS-adair-1

Article Title: Retrospective comparison of modified percutaneous cystolithotomy (PCCLm) and traditional open cystotomy (OC) in dogs: 218 cases (2010–2019)

Journal: Veterinary Surgery

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In Story 2024 et al., on surgical correction of excessive tibial plateau angle (eTPA), what was a key rationale for using neutral wedge osteotomies like PTNWO and mCCWO in dogs with eTPA?

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Correct. Both techniques preserved tibial length better than TPLO-based techniques, making them preferable when length preservation is critical.
Incorrect. The correct answer is They minimize tibial length change.
Both techniques preserved tibial length better than TPLO-based techniques, making them preferable when length preservation is critical.

🔍 Key Findings

  • All four techniques achieved TPA <14°, meeting the threshold for acceptable surgical correction in eTPA cases.
  • Group A (CBLO + CCWO) and Group D (PTNWO) showed highest accuracy in achieving target TPA values.
  • Group B (TPLO + CCWO) resulted in significant tibial shortening compared to other techniques.
  • Group A caused the greatest cranial mechanical axis shift, while Group B caused the least.
  • Group C (mCCWO) resulted in consistent under-correction of TPA, despite aiming for 0°.
  • Modified or neutral wedge osteotomies (Groups C and D) had minimal effect on tibial length, making them suitable when preservation is important.
  • All techniques involved mechanical axis shifts, highlighting the importance of preoperative planning to minimize morphologic disruption.
  • Supplemental fixation was standard for all procedures to reduce risks such as tibial tuberosity fracture and plateau leveling loss.

Story

Veterinary Surgery

8

2024

Morphologic impact of four surgical techniques to correct excessive tibial plateau angle in dogs: A theoretical radiographic analysis

2024-8-VS-story-5

Article Title: Morphologic impact of four surgical techniques to correct excessive tibial plateau angle in dogs: A theoretical radiographic analysis

Journal: Veterinary Surgery

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In Bush 2023 et al., on canine salivary gland carcinoma, which complication was most commonly associated with parotid gland excision?

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Correct. Facial nerve injury was exclusive to parotid sialoadenectomy cases in the study.
Incorrect. The correct answer is Facial nerve injury.
Facial nerve injury was exclusive to parotid sialoadenectomy cases in the study.

🔍 Key Findings

Source: Bush et al., 2023, Veterinary Surgery

  • Median survival time (MST) after surgery was 1886 days, which is significantly longer than previously reported.
  • Lymph node metastasis at surgery was a negative prognostic factor, reducing MST to 248 days (vs. 2340 days without nodal involvement).
  • Local recurrence occurred in 42% of dogs, with a median disease-free interval (DFI) of 191 days.
  • Metastatic disease occurred in 32% of dogs, most commonly to the lungs, with a median DFI of 299 days.
  • Histologic features (e.g., margin status, capsular, lymphatic, or vascular invasion) were not significantly correlated with recurrence or metastasis.
  • Facial nerve injury occurred in 9.7% perioperatively, especially after parotidectomy; intraoperative facial nerve transection led to long-term deficits.
  • Adjuvant therapies (chemotherapy, radiation, NSAIDs) did not significantly affect survival time.
  • Incisional biopsy was only 38% concordant with final excisional histology, suggesting limited reliability for definitive diagnosis.

Bush

Veterinary Surgery

3

2023

Outcomes and clinical features associated with surgically excised canine salivary gland carcinoma: A multi-institutional, retrospective, Veterinary Society of Surgical Oncology study

2023-3-VS-bush-4

Article Title: Outcomes and clinical features associated with surgically excised canine salivary gland carcinoma: A multi-institutional, retrospective, Veterinary Society of Surgical Oncology study

Journal: Veterinary Surgery

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In McNamara 2022 et al., on transoral endoscopic arytenopexy, what was the mean percentage increase in rima glottis area (RGA) following the TEA procedure?

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Correct. The study found a mean 157% increase in RGA following TEA.
Incorrect. The correct answer is 157%.
The study found a mean 157% increase in RGA following TEA.

🔍 Key Findings

  • TEA significantly increased the rima glottis area (RGA) from a mean of 0.52 cm³ to 0.78 cm³ (p < .0001)
  • Mean RGA increased by 157%, equivalent to an 84% estimated decrease in airway resistance
  • LEGS (laryngeal epiglottic-glottic seal) remained intact in all cadavers post-procedure, indicating maintained airway protection
  • TEA was technically feasible in all 15 cadaveric dogs using a custom endoscopic gag port (EGP)
  • TEA avoids cervical dissection, potentially reducing surgical trauma and risks compared to UAL (unilateral arytenoid lateralization)
  • Compared to UAL, TEA showed slightly less RGA increase, but greater LEGS preservation, potentially reducing aspiration risk
  • No cartilage was included in sutures; arytenopexy involved soft tissue fixation to pharyngeal wall across the piriform recess
  • Cadaver model limitations include inability to assess functional outcomes like swallowing and respiratory motion impact

McNamara

Veterinary Surgery

7

2022

Description and evaluation of a novel transoral endoscopic arytenopexy in canine cadavers

2022-7-VS-mcnamara-2

Article Title: Description and evaluation of a novel transoral endoscopic arytenopexy in canine cadavers

Journal: Veterinary Surgery

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In Smith 2024 et al., on ergonomics and preferences in veterinary laparoscopy, which subgroup of surgeons experienced significantly greater difficulty with endoscopic staplers?

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Correct. Left-handed users reported more difficulty due to right-hand-dominant designs.
Incorrect. The correct answer is Left-handed surgeons.
Left-handed users reported more difficulty due to right-hand-dominant designs.

🔍 Key Findings

  • Surgeons with smaller glove sizes experienced more difficulty using laparoscopic instruments, especially endoscopic staplers, cup biopsy forceps, and vessel sealing devices.
  • Endoscopic stapler was rated the most difficult instrument, with a median difficulty score of 4/10 and 25% usage difficulty.
  • Female surgeons reported significantly more difficulty with several instruments due to smaller glove size.
  • Reusable instruments were preferred over disposable ones for all tasks.
  • Pistol grips were preferred for grasping/retracting and fine dissection, while axial grips were preferred for suturing/knot tying.
  • Articulating handles were consistently associated with increased reported difficulty, especially with scissors and cup biopsy forceps.
  • Left-handed surgeons had more difficulty operating endoscopic staplers, suggesting limited design inclusivity.
  • Surgeons in academic settings reported more difficulty with laparoscopic maneuvers than those in private practice.

Smith

Veterinary Surgery

3

2024

Variables affecting surgeons’ use of, and preferences for, instrumentation in veterinary laparoscopy

2024-3-VS-smith-5

Article Title: Variables affecting surgeons’ use of, and preferences for, instrumentation in veterinary laparoscopy

Journal: Veterinary Surgery

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In Williams 2024 et al., on local anesthetic protocol, what was the standard volume used per side for the maxillary nerve block?

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Correct. Each side received 0.5 mL regardless of patient size; this standardization was applied to both groups.
Incorrect. The correct answer is 0.5 mL.
Each side received 0.5 mL regardless of patient size; this standardization was applied to both groups.

🔍 Key Findings Summary

  • Design: Prospective, randomized, double-blinded controlled trial
  • Population: 32 brachycephalic dogs undergoing cut-and-sew sharp staphylectomy
  • Groups: Adrenaline + lidocaine (Group A) vs. Lidocaine only (Group NA)
  • Main Findings:
    • Total hemorrhage significantly lower in Group A (median 1.82 g) vs Group NA (7.95 g); p = .013
    • Normalized hemorrhage significantly lower in Group A; p = .021
    • Surgeon-assigned hemorrhage scores significantly lower in Group A; p = .029
    • No adverse effects (tachycardia, hypertension, arrhythmia, etc.) noted from adrenaline use
    • Breed effect: English Bulldogs bled more overall even after normalization
  • Clinical Implication: Adrenaline in nerve blocks reduces hemorrhage without added risk

Williams

Veterinary Surgery

1

2024

Evaluation of the addition of adrenaline in a bilateral maxillary nerve block to reduce hemorrhage in dogs undergoing sharp staphylectomy for brachycephalic obstructive airway syndrome. A prospective, randomized study

2024-1-VS-williams-5

Article Title: Evaluation of the addition of adrenaline in a bilateral maxillary nerve block to reduce hemorrhage in dogs undergoing sharp staphylectomy for brachycephalic obstructive airway syndrome. A prospective, randomized study

Journal: Veterinary Surgery

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In Townsend 2024 et al., on 3D osteotomy accuracy, which of the following planes showed significant improvement with PSG in both simple and complex cuts?

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Correct. Frontal plane improved in both simple and complex cuts; sagittal improved in complex cuts (Group 3).
Incorrect. The correct answer is Frontal and sagittal.
Frontal plane improved in both simple and complex cuts; sagittal improved in complex cuts (Group 3).

🔍 Key Findings:

  • Design: Ex vivo study with 24 paired limbs from normal beagle dogs.
  • Osteotomy types (3 groups):
    1. 30° uniplanar frontal wedge
    2. Oblique (30° frontal, 15° sagittal)
    3. Single oblique (30° frontal, 15° sagittal, 30° external rotation)
  • Comparison: 3D PSG vs Freehand (FH)
  • Main Outcomes:
    • PSG accuracy: Mean angular deviation = 2.8° vs 6.4° in FH (p < .001).
    • 84% of PSG osteotomies were within 5° of target vs 50% of FH.
  • Significant improvements with PSG in:
    • Group 1 (uniplanar frontal) proximal and distal frontal planes (p < .001, .006)
    • Group 3 (SOO) frontal and sagittal planes (p = .002, .043)
  • Time: PSG faster in complex SOO group (84s vs 162s, p < .001); no difference in others.
  • No difference in osteotomy location (mm) between methods.
  • Clinical relevance: PSG more consistent and accurate, especially for complex cuts.

Townsend

Veterinary Surgery

2

2024

Comparison of three-dimensional printed patient-specific guides versus freehand approach for radial osteotomies in normal dogs: Ex vivo model

2024-2-VS-townsend-4

Article Title: Comparison of three-dimensional printed patient-specific guides versus freehand approach for radial osteotomies in normal dogs: Ex vivo model

Journal: Veterinary Surgery

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In Billas 2022 et al., on SSI risk after limb amputation, which variable was **not** associated with increased SSI risk?

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Correct. Only bipolar sealing device, trauma, infection, and non-clean wounds were significant predictors.
Incorrect. The correct answer is Use of sharp dissection.
Only bipolar sealing device, trauma, infection, and non-clean wounds were significant predictors.

🔍 Key Findings

  • 12.5% overall incidence of SSI after limb amputation, and 10.9% for clean procedures.
  • Bipolar vessel sealing device use for muscle transection significantly increased SSI risk (OR 2.5; P = .023).
  • Monopolar electrosurgery and sharp transection were not associated with increased SSI risk.
  • Non-clean wound classification increased SSI odds (OR 8.2; P = .003).
  • Amputation for infection (OR 5.7) or trauma (OR 4.5) significantly increased SSI risk compared to neoplasia.
  • Preoperative infections at distant sites did not significantly increase SSI risk.
  • Neither surgery/anesthesia duration, hypothermia, hypotension, nor skin closure method significantly affected SSI risk.
  • Study supports avoiding bipolar sealing devices for muscle transection in limb amputations to reduce SSI risk.

Billas

Veterinary Surgery

3

2022

Incidence of and risk factors for surgical site infection following canine limb amputation

2022-3-VS-billas-4

Article Title: Incidence of and risk factors for surgical site infection following canine limb amputation

Journal: Veterinary Surgery

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In Downey 2023 et al., on thoracoscopic lobectomy in dogs, what was the most common histopathologic diagnosis?

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Correct. 10 of 12 dogs had pulmonary consolidation caused by infectious pneumonia.
Incorrect. The correct answer is Infectious pneumonia.
10 of 12 dogs had pulmonary consolidation caused by infectious pneumonia.

🔍 Key Findings

  • Thoracoscopic (TL) or thoracoscopic-assisted (TAL) lobectomy was successfully performed in 12 dogs with non-neoplastic pulmonary consolidation (PC).
  • 44% (4/9) of TL cases were converted to open thoracotomy due to adhesions or poor visualization—higher than rates for neoplastic lobectomies.
  • OLV was successful in 7/9 TL dogs; unsuccessful attempts were managed with intermittent ventilation, mostly in brachycephalic breeds.
  • Median hospital stay was 3 days; 91.7% (11/12) survived to discharge, and 100% of survivors showed no recurrence at median 24-month follow-up.
  • Complications were mostly minor: pneumothorax (2), minor hemorrhage (3), dehiscence (1), and 1 fatality due to BOAS complications.
  • Histopathology showed infectious pneumonia in 10 dogs, and in 4 cases, foreign body migration was suspected as the underlying cause.
  • Median surgical time for TL was 90 minutes; conversion correlated with longer symptom duration (median 90 vs. 7 days).
  • Postoperative recovery was excellent in all surviving dogs, with one case of persistent cough attributed to concurrent heart disease.

Downey

Veterinary Surgery

7

2023

Evaluation of long‐term outcome after lung lobectomy for canine non‐neoplastic pulmonary consolidation via thoracoscopic or thoracoscopic‐assisted surgery in 12 dogs

2023-7-VS-downey-1

Article Title: Evaluation of long‐term outcome after lung lobectomy for canine non‐neoplastic pulmonary consolidation via thoracoscopic or thoracoscopic‐assisted surgery in 12 dogs

Journal: Veterinary Surgery

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In Berthomé 2025 et al., on prophylactic fenestration in cervical IVDE, which statement best describes complication rates between PF and non-PF groups?

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Correct. There was no statistically significant difference in complication rates (p = .838).
Incorrect. The correct answer is Both groups had similar complication rates.
There was no statistically significant difference in complication rates (p = .838).

🔍 Key Findings

  • Prophylactic fenestration (PF) significantly reduced recurrence of cervical intervertebral disc extrusion (0% vs. 37.8%, p < .001).
  • Surgery time was longer with PF (median 182 vs. 110 min, p = .017), but no difference in perioperative complication rates (PF 16.7%, non-PF 18.9%; p = .838).
  • 25% overall recurrence rate, but all recurrences occurred in the non-PF group.
  • Medical management was effective in 92.9% of recurrence cases.
  • Most PF sites targeted adjacent discs; 88.9% were at adjacent levels, which are common recurrence sites.
  • Neurologic outcomes were similar between PF and non-PF dogs post-surgery and at follow-up.
  • Fenestration technique (blade vs. burr) not shown to affect outcome but contributed to extended surgical time.
  • No major complications or deaths linked directly to PF in initial surgeries.

Berthomé

Veterinary Surgery

6

2025

Recurrence of cervical intervertebral disc extrusion in 55 dogs after surgical decompression with or without prophylactic fenestration

2025-6-VS-berthome-4

Article Title: Recurrence of cervical intervertebral disc extrusion in 55 dogs after surgical decompression with or without prophylactic fenestration

Journal: Veterinary Surgery

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Quiz Results

Topic: Surgical Techniques & Planning
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