Quiz Question
In Wood 2024 et al., on knot security and locking throws, which knot type had the highest failure load regardless of locking status?
🔍 Key Findings
- Adding a single locking throw significantly increased holding security for specific knots, including the surgeon's throw (p = .0001) and square throw (p = .0002).
- For the Miller's throw (p = .166) and strangle throw (p = .808), no significant improvement was observed with a locking throw.
- After locking throw addition, all five knots leaked at similar pressures (p = .5233), and these pressures exceeded physiologic arterial pressures.
- Surgeon's throw without a locking throw had the lowest leak pressure (62.5 ± 46.2 mm Hg), below physiologic arterial values.
- The square throw without locking also leaked below physiologic pressures (148.7 ± 109.4 mm Hg), though it outperformed the surgeon's throw.
- Miller’s and strangle throws performed significantly better than square or surgeon’s throws without locking, achieving leak pressures >200 mm Hg.
- All knots used 2-0 polyglyconate monofilament (Maxon); no comparisons across suture types or sizes were performed.
- Authors concluded that correct tensioning and locking throw addition are key to safe vascular ligation. Miller’s, strangle, or slip knots are preferred for challenging surgical fields.
Veterinary Surgery
4
2024
Influence of a single locking throw on the in vitro holding security of five friction knots using two monofilament suture materials in a canine model
2024-4-VS-wood-1
In Chik 2024 et al., on cholangioscopy feasibility, what was the most distal biliary region consistently visualized using the 3.8 mm disposable flexible endoscope?
🔍 Key Findings
- Open transcholecystic cholangioscopy was feasible using a 3.8 mm disposable flexible endoscope in all 8 canine cadavers.
- Visualization was consistently achieved up to the junction of the hepatic ducts, common bile duct, and cystic duct.
- Advancement past the junction was limited by the endoscope diameter (3.8 mm) and anatomical flexure.
- The 1.9 mm flexible ureteroscope could visualize the entire biliary tree, including the major duodenal papilla, in a large dog (43.8 kg).
- Endoscopic tools (e.g., 3 Fr grasping forceps) could be passed through the working channel only after removing the irrigation line.
- Standard biopsy forceps were incompatible with the disposable endoscope's 1.2 mm working channel.
- Cadaver study showed no rupture, but clinical extrapolation is limited due to lack of diseased tissue.
- Disposable endoscope setup cost (~$6,100) was significantly lower than traditional endoscopy systems (~$75,000–100,000), improving accessibility.
Veterinary Surgery
7
2024
Feasibility of open cholangioscopy with disposable flexible endoscopes
2024-7-VS-chik-1
In Ritson 2025 et al., on feline hilar lobectomy sealants, which of the following techniques demonstrated the **highest observed incidence of leakage** at 40 cm H₂O airway pressure?
🔍 Key Findings
- No leakage occurred using pretied ligature loops (PLL) or double-shank (DS) titanium clips up to 40 cm H₂O airway pressure.
- 1/10 stapled lobes leaked at supraphysiologic pressure (40 cm H₂O), but this was not statistically significant (p = .33).
- All techniques sealed effectively under physiologic and supraphysiologic pressures in cadaveric feline lungs.
- PLL and DS clips required less working space than staplers, making them more practical for small thoracic cavities.
- DS titanium clips offer enhanced security due to dual shanks and tissue-gripping design, reducing clip slippage.
- Leak testing was cyclic and submerged, simulating physiologic ventilation and allowing robust evaluation.
- Stapling failure occurred along the staple line, highlighting risks of air leakage due to staple misalignment or poor hilar access.
- PLL and DS clips may be cost-effective and efficient alternatives for open or minimally invasive feline lung lobectomy.
Veterinary Surgery
7
2025
Ex vivo comparative evaluation of feline hilar lung lobectomy using linear stapler, pretied ligature loop, and double-shank titanium clips
2025-7-VS-ritson-1
In Logothetou 2024 et al., on SPF complications, how did staple use for skin closure compare to sutures in terms of complication rate?
🔍 Key Findings
- Complication rate for subdermal plexus flaps (SPFs) in dogs was 53.6%.
- Skin staples had a numerically higher complication rate (72.2%) than sutures (49.3%), but not statistically significant due to small sample size.
- Most common complication was wound dehiscence (35%), followed by seroma (14%) and wound discharge (14%).
- Increased body weight was significantly associated with higher complication risk (OR = 1.056 per kg; p = .029).
- Advancement flaps were associated with a lower incidence of complications on univariable analysis (p < .001).
- Head region flap closures had fewer complications, while proximal pelvic limb closures had the highest complication rate.
- Age was a risk factor—each additional year increased odds of complications (OR = 1.019; p = .004).
- Closure technique did not significantly influence complication severity, though staple use was numerically worse.
Veterinary Surgery
3
2024
Complications and influence of cutaneous closure technique on subdermal plexus flaps in 97 dogs (2006–2022)
2024-3-VS-logothetou-5
In Canever 2022 et al., on labial flap vascular anatomy, what did angiographic evaluation of feline cadavers reveal about the blood supply to the upper and lower lips?
🔍 Key Findings
- Superior and inferior labial arteries in cats perfuse robust angiosomes, which support musculomucosal axial pattern flaps.
- Cadaver angiography confirmed vascular anatomy, with consistent patterns between sides and among specimens.
- The vascular supply is located primarily in the musculomucosal layer, not the skin, critical for flap viability.
- Flap harvest requires inclusion of the orbicularis oris (± buccinator) muscle to ensure vascular integrity and flap survival.
- Two clinical cases demonstrated successful use of superior and inferior labial musculomucosal flaps for palatal reconstruction with complete flap survival and resolution of clinical signs.
- Intraoperative transillumination aided vessel localization, facilitating surgical planning and flap design.
- No cases of distal flap necrosis or dehiscence occurred, although mild donor site morbidity (lip retraction, mucosal denuding) was noted.
- These flaps offer a valuable option when local tissues are compromised, especially after failed previous repairs or radiation therapy.
Veterinary Surgery
4
2022
Evaluation of the superior and inferior labial musculomucosal flaps in cats: An angiographic study and case series
2022-4-VS-canever-1
In Monnet 2023 et al., on barbed vs conventional suture in vesicourethral anastomosis (VUA), how did the number of suture bites compare between the UBS and conventional groups?
🔍 Key Findings
- Leakage pressure was not significantly different between unidirectional barbed suture (UBS) and conventional (C) suture groups (p = .236).
- UBS group had a 28% lower median leakage pressure than the C group (8.6 mmHg vs. 11.7 mmHg), suggesting higher biological risk of leakage.
- UBS significantly reduced suturing time (median 12.7 vs. 17.3 minutes; p < .0002).
- Fewer suture bites were needed in the UBS group (median 14 vs. 19; p = .012).
- No suture breakage or urethral narrowing occurred in either group.
- Leakage site distribution (ventral vs lateral) was similar between groups; no dorsal leaks noted.
- Leakage occurred as low as 5 mmHg in UBS group, indicating potential for postoperative extravasation.
- UBS may aid intracorporeal suturing in minimally invasive prostatectomy, but catheterization remains necessary postoperatively.
Veterinary Surgery
5
2023
Influence of conventional versus unidirectional barbed suture on leakage pressures in canine vesicourethral anastomosis: An ex-vivo study
2023-5-VS-monnet-4
In Dekerle 2022 et al., on ectopic ureter correction, **what factor was significantly associated with recurrence of incontinence** after neoureterostomy?
🔍 Key Findings
- Cystoscopic-guided laser ablation (CLA) was associated with significantly fewer minor complications (13%) than neoureterostomy (100%) (P < .01)
- CLA resulted in significantly fewer recurrences of incontinence compared to neoureterostomy (0/7 vs 5/12; P < .05)
- 80% of dogs achieved continence within 1 month postoperatively, with a median continence score of 10
- Long-term continence was achieved in 88% of dogs, with or without adjunctive treatment, over a median of 66 months
- Major complications occurred in only 8% of dogs, and all were successfully managed with surgical revision
- Persistent ureteral remnants were seen only in neoureterostomy dogs, potentially contributing to incontinence recurrence
- All dogs with incontinence recurrence responded to medical treatment, while only 1/5 with persistent incontinence after surgery did
- CLA is recommended over open surgery for iEU correction, due to lower complication and recurrence rates
Veterinary Surgery
4
2022
Outcomes of 25 female dogs treated for ectopic ureters by open surgery or cystoscopic-guided laser ablation
2022-4-VS-dekerle-4
In Poggi 2025 et al., on laparoscopic cholecystectomy in cats, what was the most commonly reported indication for surgery?
🔍 Key Findings
- Laparoscopic cholecystectomy (LC) was successfully performed in all 22 cats without conversion to open surgery.
- Complication rate was low: 3 cats had postoperative complications (1 seroma, 1 vomiting, 1 EHBDO and death).
- Median operating time was 41 minutes; median hospitalization was 3 days.
- No cases required conversion to open laparotomy, even in cats as small as 2.5 kg.
- Common devices used: Hemoclips or Hem-o-lok for cystic duct ligation; Ligasure, harmonic scalpel, or j-hook for dissection.
- Most common indications: cholelithiasis (9/22) and cholecystitis (10/22), with one biliary mucocele and one adenoma.
- Histopathology confirmed diagnosis in all cases; concurrent liver or intestinal biopsies were performed in some cats.
- Postoperative AUS and bloodwork were routine and important for detecting early signs of EHBDO.
Veterinary Surgery
5
2025
Laparoscopic cholecystectomy in 22 cats (2018–2024)
2025-5-VS-poggi-1
In Logothetou 2024 et al., on SPF complications, which flap type had the lowest complication rate on univariable analysis?
🔍 Key Findings
- Complication rate for subdermal plexus flaps (SPFs) in dogs was 53.6%.
- Skin staples had a numerically higher complication rate (72.2%) than sutures (49.3%), but not statistically significant due to small sample size.
- Most common complication was wound dehiscence (35%), followed by seroma (14%) and wound discharge (14%).
- Increased body weight was significantly associated with higher complication risk (OR = 1.056 per kg; p = .029).
- Advancement flaps were associated with a lower incidence of complications on univariable analysis (p < .001).
- Head region flap closures had fewer complications, while proximal pelvic limb closures had the highest complication rate.
- Age was a risk factor—each additional year increased odds of complications (OR = 1.019; p = .004).
- Closure technique did not significantly influence complication severity, though staple use was numerically worse.
Veterinary Surgery
3
2024
Complications and influence of cutaneous closure technique on subdermal plexus flaps in 97 dogs (2006–2022)
2024-3-VS-logothetou-4
In Pilot 2022 et al., on closure methods in sternotomy, what was concluded regarding closure technique choice in large dogs?
🔍 Key Findings
- Overall closure-related complication rate was 14.1%, lower than previously reported (17–78%).
- No clinically meaningful difference in complication rate between orthopedic wire (17.4%) and suture (11.5%) closure methods.
- Dog size (≥20 kg) was the only significant risk factor associated with increased closure-related complications (p = .01).
- Type of closure (wire vs. suture) did not affect risk, even in larger dogs.
- Suture closure showed a non-significant trend toward fewer complications (mean reduction 2.3%, 95% CI: –9.1% to +4.5%).
- Most complications were mild (62%), with only 10 severe cases requiring surgical revision.
- Infection rate was low (2.7%), and not significantly different between wire and suture.
- Suture closure is a valid alternative to wire, including in large dogs, based on this large, multi-institutional study.
Veterinary Surgery
6
2022
Comparison of median sternotomy closure‐related complication rates using orthopedic wire or suture in dogs: A multi-institutional observational treatment effect analysis
2022-6-VS-pilot-5
Quiz Results
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Key Findings