Quiz Question
In Barnes 2024 et al., on knot performance, what advantage does the DF knot provide in confined surgical spaces?
🔍 Key Findings
- Double forwarder (DF) knots had significantly higher knot holding capacity (KHC) than square (SQ) and surgeon’s (SU) knots when tied with <6 throws.
- In 3 USP polyglactin 910, DF knots with 4–5 throws were not significantly stronger than SU knots with 6–8 throws (p > .43).
- DF knots never unraveled, while SQ and SU knots with 4–5 throws showed substantial unraveling.
- KHC did not increase in DF knots when throws increased from 3 to 5.
- Knot volume and weight were significantly higher in DF knots than SQ/SU knots at the same throw count (p < .003).
- DF knots allow sliding placement, potentially useful in minimally invasive or deep cavity procedures.
Veterinary Surgery
2
2024
Evaluation of the in vitro performance of the double forwarder knot, compared to square and surgeon's knots using large gauge suture
2024-2-VS-barnes-5
In Monnet 2023 et al., on barbed vs conventional suture in vesicourethral anastomosis (VUA), despite reduced suturing time, what is a clinical limitation of using unidirectional barbed suture for VUA?
🔍 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-5
In Poggi 2025 et al., on laparoscopic cholecystectomy in cats, which instrument was most frequently used for gallbladder dissection?
🔍 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-4
In Miller 2024 et al., on staple vs. hand-sewn feline GI techniques, what was the most common location of leakage for skin staple enterotomy (SSE)?
🔍 Key Findings
- Skin staple anastomosis (SSA) had comparable leak pressures to hand-sewn anastomosis (HSA) but required half the time to complete.
- Skin staple enterotomy (SSE) had significantly lower leak pressures than hand-sewn enterotomy (HSE) and failed in 12/20 constructs during pressure testing.
- HSE constructs took 8× longer to complete than SSE, but had much higher intraluminal pressure tolerance.
- All SSE constructs leaked from the center, with 35% leaking immediately and 60% showing catastrophic failure.
- SSA leakage occurred at the center in 40% of constructs, likely due to a learning curve in early samples.
- All constructs had higher pressures than normal physiologic intestinal pressure (4.0 mmHg ±2.0), except some SSEs with immediate leaks.
- Authors recommend SSA as a viable alternative with appropriate training but do not recommend SSE using the tested technique in live cats.
- Staple size and placement technique are key factors; smaller or more precisely placed staples may reduce leak risk.
Veterinary Surgery
4
2024
Performance time and leak pressure of hand-sewn and skin staple intestinal anastomoses and enterotomies in cadaveric cats
2024-4-VS-miller-2
In Miller 2024 et al., on staple vs. hand-sewn feline GI techniques, what did the authors conclude about skin staple enterotomy (SSE) for use in live cats?
🔍 Key Findings
- Skin staple anastomosis (SSA) had comparable leak pressures to hand-sewn anastomosis (HSA) but required half the time to complete.
- Skin staple enterotomy (SSE) had significantly lower leak pressures than hand-sewn enterotomy (HSE) and failed in 12/20 constructs during pressure testing.
- HSE constructs took 8× longer to complete than SSE, but had much higher intraluminal pressure tolerance.
- All SSE constructs leaked from the center, with 35% leaking immediately and 60% showing catastrophic failure.
- SSA leakage occurred at the center in 40% of constructs, likely due to a learning curve in early samples.
- All constructs had higher pressures than normal physiologic intestinal pressure (4.0 mmHg ±2.0), except some SSEs with immediate leaks.
- Authors recommend SSA as a viable alternative with appropriate training but do not recommend SSE using the tested technique in live cats.
- Staple size and placement technique are key factors; smaller or more precisely placed staples may reduce leak risk.
Veterinary Surgery
4
2024
Performance time and leak pressure of hand-sewn and skin staple intestinal anastomoses and enterotomies in cadaveric cats
2024-4-VS-miller-5
In Fink 2025 et al., on Roux-en-Y outcomes, which anastomosis type was preferred when the common bile duct was severely dilated?
🔍 Key Findings
- Roux-en-Y procedures were successfully completed in all 11 cases (6 dogs, 5 cats), despite case complexity and disease severity.
- Median survival post-discharge was longer in cats (365 days) vs. dogs (82 days), with better outcomes in non-neoplastic vs. neoplastic disease (192 vs. 5 days).
- Complication rate was high, with septic peritonitis, dehiscence, and cardiac arrest as leading causes of postoperative death; mortality rate = 36%.
- Dehiscence rate was 8.6% (2 of 23 anastomoses), considered lower than typical rates for GI anastomoses in high-risk patients.
- Feeding tubes (gastrostomy/jejunostomy) were used in all cases, enabling early nutritional support and stomach decompression.
- Postoperative nausea and vomiting were common but mostly self-limiting; managed with metoclopramide, cisapride, and antiemetics.
- Choledochojejunostomy was preferred when common bile duct was dilated, offering a favorable size match and potentially reducing bile leakage.
- Roux-en-Y reduced typical Billroth II complications (e.g., bile reflux, afferent loop syndrome, dumping syndrome), with none observed in discharged patients.
Veterinary Surgery
5
2025
Roux‐en‐Y procedure to reconstruct the upper gastrointestinal tract in six dogs and five cats: A descriptive case series
2025-5-VS-fink-2
In Jones 2024 et al., on surgical technique mortality, what was found when comparing CO₂ laser and conventional incisional techniques?
🔍 Key Findings
- Study compared 606 dogs (English Bulldogs, French Bulldogs, Pugs) undergoing partial staphylectomy via CO₂ laser, bipolar vessel sealing device (BVSD), or conventional incision.
- Mortality rate: 4.0% (24/606).
- BVSD was associated with significantly increased perioperative mortality compared to other methods (OR = 6.0, 95% CI: 1.3–28.4, p = .023).
- High-grade laryngeal collapse (stage II or III) independently increased mortality risk (OR = 4.6, 95% CI: 1.8–11.8, p = .002).
- No difference in mortality between CO₂ laser and conventional incision techniques.
- CO₂ laser and conventional techniques had similar complication rates.
Veterinary Surgery
1
2024
Comparison of mortality of brachycephalic dogs undergoing partial staphylectomy using conventional incisional, carbon dioxide laser, or bipolar vessel sealing device
2024-1-VS-jones-4
In Kurogochi 2025 et al., on cardioplegia in mitral repair, what was the effect of mDN solution on sinus rhythm recovery?
🔍 Key Findings
- No significant difference in cardiac troponin I levels 12h post-op between mDN and St. Thomas cardioplegia groups (p = 0.478)
- Sinus rhythm returned faster in the mDN group after aortic cross-clamp removal (median 60s vs 362s, p = 0.027)
- Lower serum potassium at cross-clamp removal in the mDN group (median 4.5 mEq/L vs 5.4, p = 0.005)
- Fewer doses needed in the mDN group (median 2.5 vs 4.0, p = 0.040)
- Higher total crystalloid volume used in mDN group (23.6 vs 12.6 mL/kg, p < 0.001)
- No difference in survival (700-day survival 90% in both groups, p = 0.958)
- No difference in hospitalization duration (median 6 days for both, p = 0.789)
- Echocardiographic remodeling similar between groups at 24h post-op
Veterinary Surgery
7
2025
Saline‐based modified del Nido cardioplegia versus multidose St. Thomas cardioplegia in canine mitral valve repair: A randomized controlled trial
2025-7-VS-kurogochi-1
In Schroeder 2022 et al., on fascial anatomy mapping, which region is most prone to fascial disruption during resection?
🔍 Key Findings
- Fascial planes in dogs were consistently classifiable into four surgical types:
- Type I (discrete sheets), Type II (tightly adhered to thin muscle), Type III (tightly adhered to thick muscle), and Type IV (periosteum-associated).
- Two junction types were identified: Type A (easily elevated) and Type B (higher risk of disruption).
- Disruption-prone areas include the scapular spine (type IV fascia) and lateral thorax near the 13th rib, where rib resection may be needed to preserve margins.
- The latissimus dorsi transition zones and fascial areas near the thoracic inlet and scapulohumeral joint were prone to fascial thinning or disruption.
- Partial muscle resections or periosteal elevations may be required in areas with fragile fascia to maintain oncologic margins.
- Dorsal spinous processes (T6–L6) showed type IV fascia; however, osteotomy may be needed in some dogs for clear margins.
- Blended fascial transitions (e.g., rectus abdominis: type II cranially, type I caudally) necessitate intraoperative judgment on resection depth.
- Cutaneous trunci may suffice as a deep margin for small, low-grade tumors in well-muscled dogs, but not reliably for high-grade or larger masses.
Veterinary Surgery
1
2022
Fascial plane mapping for superficial tumor resection in dogs. Part I: Neck and trunk
2022-1-VS-schroeder-2
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
Quiz Results
You answered 7 out of 10 questions correctly
Key Findings