Comparison of the diagnostic yield of 3 and 5 mm laparoscopic liver biopsy forceps in cats.

OBJECTIVE: To determine whether 3 and 5 mm laparoscopic cup biopsy forceps provide samples of equivalent diagnostic quality in cats. STUDY DESIGN: Experimental study. ANIMALS: Twelve colony cats undergoing a concurrent nutrition study. METHODS: Two biopsy forceps (3 and 5 mm) and three biopsy techniques (twist, pull, and twist + pull) were used to collect 68 laparoscopic liver samples. Biopsies were performed consecutively with the 3 and 5 mm biopsy sites adjacent to each other. Data analyzed included the number of portal triads and hepatic lobules, tissue crush and fragmentation, overall sample area (mm2 ), sample weight, and agreement regarding morphologic diagnosis. RESULTS: The 5 mm forceps provided more hepatic lobules, portal triads, and a larger tissue weight and histologic area (mm2 ) (p < .01). The twist and pull techniques provide more hepatic lobules and portal triads compared to the twist + pull technique while the twist + pull technique resulted in greater tissue crush compared to the twist technique (p = .0097). There was good agreement for morphological diagnosis between the 3 and 5 mm samples using the twist + pull technique but not for the twist or pull techniques. CONCLUSION: Liver samples can be safely collected with 3 or 5 mm laparoscopic biopsy forceps and provide sufficient tissue for histopathology analysis in cats, with minimal artifact. The diagnostic accuracy of 3 mm samples remains unknown. CLINICAL SIGNIFICANCE: Although 3 mm laparoscopic cup biopsy forceps provided samples of sufficient diagnostic quality for histopathologic interpretation in cats, further studies are required to assess their diagnostic accuracy.

The use of a linear versus curvilinear oscillating saw blade for femoral head and neck excision surgery in cats.

OBJECTIVE: To determine the effects of using either a linear or curvilinear oscillating, battery-powered saw blade on the extent of bone resection, bone fissure or fragmentation, soft tissue trauma, and surgical time for femoral head and neck excision (FHNE) in feline cadavers. ANIMALS: 18 feline cadavers. METHODS: Paired feline cadaveric femora were randomly assigned to either a 10 mm linear or 12 mm curvilinear blade for FHNE by 2 surgical residents. CT of each femur pre- and postoperatively were used to create 3D reconstructions of each femur. The residual remaining or excessively resected bone volume at the ostectomy site was compared to an "ideal" ostectomy line made by a board-certified surgeon on preoperative CTs. RESULTS: There were no significant differences in residual or excessive bone resection by a saw blade (P = .84), between surgeons (P = .65), or in surgery time (P = .39). When compared to the "ideal" ostectomy, the linear saw blade removed slightly less bone compared to the curvilinear blade, but was not statistically significant (P = .82). No fissures or fractures were noted; however, the curvilinear blade removed the entire lesser trochanter in 1 cadaver and the linear blade partially removed the greater trochanter in 1 femur and 2 lesser trochanters in 2 femora. CLINICAL RELEVANCE: The use of a curvilinear blade may be a viable option for performing FHNE in cats. In vivo studies are warranted to determine its efficacy in clinical cases where FHNE is performed and the incidence of complications postoperatively.

Comparison of two advanced bipolar tissue sealer/dividers for laparoscopic ovariectomy in dogs: articulating enseal G2 versus Ligasure Maryland device.

BACKGROUND: Advanced bipolar tissue sealer/dividers provide the most reliable and efficient means of tissue dissection and blood vessel sealing in laparoscopic surgery and the techniques are continuously improved. In veterinary practice, cost-effectiveness is of major impact, leading to re-use of instruments designed and sold for single use. Two high-end devices were evaluated and compared in a highly standardized laparoscopic ovariectomy procedure in dogs: The new generation Ligasure Maryland Sealer/Divider (LMSD) with improved atraumatic curved jaw shape for delicate tissue handling and dissection and non-stick nanocoating, and the new-generation Articulating Enseal G2 (AENG2) with several proclaimed features improving surgical performance, including articulation of the forceps tip; improved tissue compression during sealing; unique offset electrode configuration; and specific nanoparticle coating minimizing thermal spread and tissue sticking. Twenty-one client-owned dogs admitted for elective laparoscopic ovariectomy were randomly assigned to one of two groups: ovariectomy using AENG2 on the left ovary and LMSD in the right ovary or vice-versa. Procedural video recordings were used to assess ovarian ligament fat score, smoke formation, occurrence of bleeding, and excision duration. Excised tissues were examined histopathologically and collateral thermal damage was scored in three anatomic zones: suspensory ligament, vascular pedicle, and uterine junction. Tissue sealers were used repeatedly following standardized cleaning protocol with instrument washing machine and ethylene oxide gas sterilization and the number of uses until device failure was recorded. RESULTS: Excision times were significantly increased for AENG2 (median 01:35 min) compared to LMSD (median 01:00 min). Minor hemorrhage from incomplete sealing occurred in 3 sites in 2 patients (2x AENG2, 1x LMSD) and was not significantly different between groups. Smoke production as scored on videos and thermal tissue damage scores on histopathology also did not differ between AENG2 and LMSD. Both vessel sealers could be re-used repeatedly. CONCLUSION: AENG2 provides a good alternative to LMSD in laparoscopic ovariectomy, with only minor differences in measured variables. Subjectively, the articulating feature of AENG2 did not improve surgical performance in laparoscopic ovariectomy and the use of LMSD appeared more straight-forward for this specific procedure. However, differences in operating these devices may be subject to personal preference.

A vessel sealing device and an ultrasonic dissector are equally effective and safe for single port laparoscopic ovariectomy in dogs.

OBJECTIVE: To evaluate ovary removal surgery times and intraoperative complication rates between a 5-mm Sonicision cordless ultrasonic dissector (SCUD) and 5-mm vessel sealing device (VSD) for laparoscopic ovariectomy in dogs. ANIMALS: Client-owned, intact female dogs (n = 10) presented for elective laparoscopic ovariectomy. METHODS: In each dog, 1 ovarian pedicle was randomly assigned to the SCUD group and 1 to the VSD group. In the SCUD group (n = 10), the ovariectomy was performed using the SCUD device; the ovariectomy in the VSD group (10) was performed using a VSD. The number of applications of each device during ovariectomy, surgery time required for each ovary removal, total surgery duration, ovarian pedicle fat score, and intraoperative complications were recorded. RESULTS: Both left and right ovaries had median pedicle fat scores of 2 (range, 1 to 3). To complete an ovariectomy, the median number of SCUD applications was 9 (range, 7 to 13) times; the VSD had a median of 10 (range, 5 to 18) times (P = .98). Median surgery times for the removal of 1 ovary with the SCUD and VSD were 96 seconds (range, 45 to 417 seconds) and 110 seconds (range, 42 to 164 seconds), respectively (P = 1). No intraoperative complications were associated with either device. Therefore, the VSD was not required for rescue in the SCUD group, and no conversions to open ovariectomy were necessary. CLINICAL RELEVANCE: A standard approach laparoscopic ovariectomy performed with the SCUD was successful in our population of dogs, making the 5-mm SCUD safe for laparoscopic ovariectomy in healthy dogs, which provides a more affordable option for practitioners and clients.

Clip ligation for treatment of patent ductus arteriosus occlusion in three cats.

Patent ductus arteriosus (PDA) is a rare congenital cardiovascular anomaly in cats. Due to their small body, intercostal thoracotomy is the most common option to close the PDA. However, few reports detail the surgical technique for ligating PDA in kittens. In this case report, three cats weighing 1.4 kg, 1.2 kg, and 2.9 kg were diagnosed PDA. Clip ligation via left fourth intercostal thoracotomy was performed and the cats were successfully treated. Postoperative echocardiography showed no residual flow in any of the cases. This case report highlights clip occlusion for small cats with PDA could be safe and effective.

Effectiveness of the Glass Bead Sterilizer for Sterilizing Surgical Instruments.

Survival rodent surgery requires the use of sterile instruments for each animal, which can be challenging when performing multiple surgeries on batches of animals. Glass bead sterilizers (GBS) are widely considered to facilitate this practice by sterilizing the tips of the instruments between animals. However, other disciplines have raised questions about the efficacy of the GBS, especially when used with surgical tools that have grooves or ridges that may contain organic debris. In this study, we evaluated the efficacy of the GBS to sterilize instruments commonly used in rodent surgery by intentionally contaminating a selection of instruments with a standardized bacterial broth inoculated with Staphylococcus aureus and Escherichia coli. As expected, a simple ethanol wipe was ineffective in sterilizing instruments in all treatment groups. An ethanol wipe followed by GBS was effective in sterilizing 82.5% (99 of 120) of the instruments. Our study suggests that the GBS may not be effective for consistent sterilization of surgical instruments.

Effect of three different needle holders on gastrointestinal anastomosis construction time and bursting pressure in equine jejunal segments.

BACKGROUND: Equine small intestinal resection and anastomosis is a procedure where optimizing speed, without compromising integrity, is advantageous. There are a range of different needle holders available, but little is published on the impact surgical instrumentation has on surgical technique in veterinary medicine. The objectives of this study were to investigate if the needle holder type influences the anastomosis construction time, the anastomosis bursting pressure and whether the bursting pressure is influenced by the anastomosis construction time. Single layer end-to-end jejunojejunal anastomoses were performed on jejunal segments harvested from equine cadavers. These segments were randomly allocated to four groups. Three groups based on the needle holder type that was used: 16.5 cm Frimand (Group 1), 16 cm Mayo-Hegar (Group 2) or 20.5 cm Mayo-Hegar (Group 3) needle holders. One (Group 4) as control without anastomoses. Anastomosis construction time was recorded. Bursting pressure was determined by pumping green coloured fluid progressively into the lumen whilst recording intraluminal pressures. Maximum pressure reached prior to failure was recorded as bursting pressure. Construction times and bursting pressures were compared between needle holder, and the correlation between bursting pressure and construction time was estimated. RESULTS: Construction times were not statistically different between groups (P = 0.784). Segments from Group 2 and Group 3 burst at a statistically significantly lower pressure than those from Group 4; P = 0.031 and P = 0.001 respectively. Group 4 and Group 1 were not different (P = 0.125). The mean bursting pressure was highest in Group 4 (189 ± 61.9 mmHg), followed by Group 1 (166 ± 31 mmHg) and Group 2 (156 ± 42 mmHg), with Group 3 (139 ± 34 mmHg) having the lowest mean bursting pressure. Anastomosis construction time and bursting pressure were not correlated (P = 0.792). CONCLUSIONS: The tested needle holders had a significant effect on bursting pressure, but not on anastomosis construction time. In an experimental setting, the Frimand needle holder produced anastomoses with higher bursting pressures. Further studies are required to determine clinical implications.

The utility of patent ductus arteriosus closure with hemostatic clip in dogs.

This study investigated the utility of patent ductus arteriosus (PDA) closure with hemostatic clip by comparing with traditional PDA closure. Medical records of 51 dogs with surgical closure of PDA were reviewed and retrospective study was conducted. 29 dogs were treated by procedure with hemostatic clip (Group HC), and 22 dogs were treated by surgical ligation (Group SL). Data pertaining to breed, sex, age and body weight at the time of surgery, echocardiographic minimal ductal diameter, duration of surgery, hemostatic clip size, echocardiographic findings, hemor-rhage, residual ductal flow and recanalization were collected from records. The results showed that procedure with hemostatic clip had been selected in lighter dogs than traditional PDA closure. Duration of surgery performed only hemostatic clip technique was significantly shorter than that in group SL. Preoperative LVIDd, E-wave and FS were significantly lower than postoperative ones. As regard all parameters, the differences between pre- and postoperative periods were not significantly different between group HC and group SL. Hemorrhage, residual ductal flow, and recanalization were not significantly different in both groups. The present study showed that procedure with hemostatic clip is beneficial in that it is available in smaller dogs and can make shorter operation duration than traditional PDA closure. Moreover, the procedure is effective for the resolution of volume overload of the left atrium and ventricle in short-term outcome. Complications including hemorrhage, residual ductal flow and recanaliza-tion were not significantly different with both techniques.

Evaluation of the performance of an endoscopic 3-mm electrothermal bipolar vessel sealing device intended for single use after multiple use-and-resterilization cycles.

OBJECTIVE: To evaluate the performance of an endoscopic 3-mm electrothermal bipolar vessel sealing device (EBVS) intended for single use after multiple use-and-resterilization cycles. STUDY DESIGN: Ex vivo study. SAMPLE POPULATION: Eight 3-mm EBVS handpieces. METHODS: Handpieces were subjected to a maximum of 15 cycles of testing, including simulated surgery, sealing and burst pressure testing of porcine carotid arteries, reprocessing, and hydrogen peroxide plasma resterilization. Failure was defined as two sequential vascular seal leakage events occurring at <250 mm Hg. Histological evaluation, maximum external temperature of the jaws, sealing time, tissue adherence, jaw surface characterization, and mechanical deterioration were studied. Failure rate was analyzed by using a Kaplan-Meier curve. Linear and ordinal logistic mixed models were used to analyze sealing time, handpiece jaw temperature, and adherence score. RESULTS: Mean ± SD diameter of arteries was 3.22 ± 0.35 mm. Failure was observed starting at cycle 10 and going up to cycle 13 in 37.5% (3/8) of the handpieces. Tissue adherence increased after each cycle (P < .001). Maximum external temperature (79.8°C ± 13.9°C) and sealing time (1.8 ± 0.5 seconds) were not significantly different throughout cycles up to failure. A flatter surface and large scratches were observed microscopically throughout the jaw surface after repeated use and resterilization. CONCLUSION: The 3-mm EBVS handpiece evaluated in this study can be considered safe to use for up to nine reuse-and-resterilization cycles. CLINICAL SIGNIFICANCE: These data provide the basis for establishing preliminary guidelines for the reuse and hydrogen peroxide plasma resterilization of an endoscopic 3-mm EBVS handpiece.

Complete resection of the alar folds in eight standing horses with a bipolar dividing and vessel-sealing device.

OBJECTIVE: To describe a resection technique of the alar folds in the standing horse. STUDY DESIGN: Retrospective case study. ANIMALS: Eight Standardbred racing trotters. METHODS: Horses in which alar fold collapse had been diagnosed between 2017 and 2018 were included in this study. All horses underwent alar fold resection under standing sedation and regional anesthesia with a bipolar electrosurgical open sealer/divider device (LigaSure). Intraoperative and postoperative complications were recorded. A Wilcoxon signed-rank test was used to compare differences in median prize money earning pre-surgery and post-surgery (P < .05). RESULTS: The surgical procedure was short (20-30 min), with minimal (1/8) to no (7/8) bleeding and was well tolerated in all cases. Complete resection of the alar folds along with 3 to 5 cm of the ventral conchal cartilage was achieved. No complications were observed post-surgery with satisfactory second intention healing, allowing return to training/racing within 3 to 6 weeks post-surgery in all cases. Median earnings post-surgery increased (P = .03) compared with pre-surgery. CONCLUSION: Alar fold resection with bipolar electrosurgical energy offered a good alternative to the traditional surgical approaches performed under general anesthesia. The surgery significantly improved race earnings and performance while avoiding the risk associated with general anesthesia and offered a short and complication-free rehabilitation period. CLINICAL IMPACT: This study describes a surgical technique offering a novel approach to resection of the alar folds in the standing horse.

Evaluation of Jackson-Pratt Thoracostomy Drains Compared with Traditional Trocar Type and Guidewire-Inserted Thoracostomy Drains.

A restrospective study was performed to evaluate the efficacy of and complications among Jackson-Pratt (JP) drains placed as thoracostomy drains, traditional trocar type (TRO) thoracostomy drains, and guidewire (GW)-inserted thoracostomy drains that were placed in open fashion during thoracotomy. Medical records of 65 canine and feline patients who underwent thoracic surgery were evaluated. Dogs and cats who underwent thoracotomy and had a chest drain placed intraoperatively were included. Data retrieved from medical records included signalment, body weight, diagnosis, surgical approach, surgical procedure, type of thoracostomy drain, postoperative analgesia, duration of thoracostomy drain, and postoperative complications. The incidence of complications and number of medications used in pain protocols were compared among types of thoracostomy drains. JP (n = 31), TRO (n = 25), and GW (n = 9) thoracostomy drains were placed in 65 patients. Ten minor (15.3%) and four major (6.2%) complications occurred. Cases with JP thoracostomy drains were significantly less likely to have complications (2 minor, 1 major) than cases with TRO thoracostomy drains (8 minor, 3 major, P = .009). There were no differences in the number of major complications when comparing all three drains individually (P = .350). JP drains and GW drains can be considered as an alternative to traditional TRO thoracostomy drains.

Comparison of two eyelid speculums and their effect on intraocular pressure in clinically normal cats.

OBJECTIVES: The present study was undertaken to determine the possible effects of the placement two different types of eyelid speculum on intraocular pressure (IOP) measurement in clinically normal cats. METHODS: Thirty healthy cats were divided randomly into two groups of 15, group B (Barraquer wire speculum) and group W (Williams eye speculum). All cats were sedated with intramuscular medetomidine (Dorbene vet; 100 µg/kg) then placed in right lateral recumbency, and IOP was recorded in the left eye using a Tono-Pen Vet tonometer without and with an eyelid speculum in place in both groups. RESULTS: The without-speculum IOPs for cats in group B and group W were 13.8 ± 3.0 mmHg and 13.2 ± 3.6 mmHg, respectively, and did not differ significantly. A significant increase in IOP (19.8 ± 3.7 mmHg) was observed in group W in with-speculum measurements in comparison to the without-speculum values (P <0.001).There was no significant difference between with- and without-speculum IOP values (13.8 ± 2.7 mmHg) in group B (P = 1.0). CONCLUSIONS AND RELEVANCE: The Barraquer wire speculum has no effect on IOP compared with the Williams eye speculum in normal cats, and may be an appropriate choice in cats for intraocular surgeries that cannot tolerate acute increases in IOP.

Comparison between optical coherence tomographic and histopathologic appearances of artifacts caused by common surgical conditions and instrumentation.

OBJECTIVE: To document the appearance of artifacts created by commonly encountered surgical conditions and instrumentation on optical coherence tomography (OCT) and to compare these findings with histopathology. STUDY DESIGN: Ex vivo study. ANIMALS: Five canine cadavers. METHODS: Skin, subcutaneous fat, skeletal muscle, and fascia samples were obtained from fresh canine cadavers. Blood pooling, hemostatic crushing, scalpel blade cut, monopolar electrosurgery, bipolar vessel sealing device, and ultrasonic energy surgical artifacts were induced on each tissue type. Each specimen was imaged with OCT and subsequently histologically processed. RESULTS: Most surgical instrumentation used for tumor excision created a high-scattering region with local architectural disruption. Blood pooling was visible as a high-scattering layer overlying tissue with normal architecture. Only the scalpel blade created a focal, low-scattering area representing a sharply demarcated cut within the tissue distinct from the appearance of other instrumentation. CONCLUSION: Common surgical instruments and conditions encountered during tumor excision produced high-scattering OCT artifacts in tissues commonly seen at surgical margins. CLINICAL SIGNIFICANCE: The clinical value of OCT hinges on the ability of personnel to interpret this novel imaging and recognize artifacts. Defining and describing the appearance of common surgical artifacts provides a foundation to create image libraries with known histological and OCT interpretation, ultimately improving the diagnostic accuracy of OCT for assessment of surgical margins.

Ex vivo evaluation of a novel surgical guide on the accuracy of closing wedge osteotomies.

OBJECTIVE: To determine the influence of a novel surgical guide on the accuracy and technical difficulty of closing wedge osteotomies (CWO). STUDY DESIGN: Ex vivo experimental study. SAMPLE POPULATION: Canine tibia models (n = 40). METHODS: A 20° cranial CWO (CCWO) was created without (standard procedure; STCCWO) or with the aid of a novel wedge osteotomy guide (WOCCWO). Procedures were performed by diplomate (n = 4) and resident (n = 6) surgeons, with each performing 2 STCCWO followed by 2 WOCCWO. To prevent bias, surgeons were unaware of the study purpose until after completing the STCCWO. The wedges were evaluated by comparing the deviation from the 20° target angle, divergence of the 2 osteotomies (osteotomy divergence angle [ODA]), and measurements of the wedge height at the caudomedial cortex (CMC) and caudolateral cortex (CLC). Technique difficulty was explored through a surgeon questionnaire. RESULTS: The WOCCWO resulted in smaller mean ODA (WOCCWO = 0.86°, SD ± 0.38°, P < .001), and smaller mean difference between CMC and CLC (WOCCWO = 0.29 mm, SD ± 0.19, P < .001) than for the STCCWO (4.22°, SD ± 2.16° and 1.39 mm, SD ± 0.65 respectively). Deviation from the target 20° wedge angle was greater after STCCWO (1.46°, SD ± 1.27°) than after WOCCWO (0.53°, SD ± 0.33°, P = .004). No difference was reported regarding the difficulty of the procedures, but resident surgeons stated that they were more likely to use the guide in a clinical setting compared with diplomates. CONCLUSION: The wedge osteotomy guide improved the accuracy of CCWO compared with standard technique. CLINICAL SIGNIFICANCE: The clinical significance of the differences detected in this study is unclear and warrants in vivo investigation.

Comparison of carbon dioxide laser versus bipolar vessel device for staphylectomy for the treatment of brachycephalic obstructive airway syndrome.

Carbon dioxide (CO2) laser and bipolar vessel sealing device (BSD) are industry standards for soft palate resection. No studies exist to directly compare these 2 techniques in a clinical setting. The purpose of this study was to describe and compare clinical outcomes for dogs that underwent CO2 laser versus BSD staphylectomy. Medical records of brachycephalic dogs that underwent CO2 laser (Group-L) or BSD staphylectomies (Group-B) between September 2013 and September 2017 were reviewed retrospectively. Of 60 dogs that met the inclusion criteria, 26 dogs (43%) were designated Group-L and 34 (57%) Group-B. Techniques did not differ in procedure or anesthetic time (P = 0.52 and P = 0.19, respectively) or major complication rates [intraoperative (P = 1.00), post-operative (P = 0.72), short-term (P = 1.00), and long-term (P = 0.68)]. This study suggests that patient outcomes are similar for dogs undergoing staphylectomy performed by CO2 laser and BSD.

Comparaison du laser au gaz carbonique par rapport au dispositif de coagulation bipolaire lors de la staphylectomie pour le traitement du syndrome de brachycéphalie d'obstruction des voies respiratoires. Le laser au gaz carbonique (CO2) et le dispositif de coagulation bipolaire sont des normes de l'industrie pour la résection du palais mou. Aucune étude n'existe afin de comparer ces deux techniques dans un milieu clinique. Le but de cette étude consistait à décrire et à comparer les résultats cliniques pour les chiens qui ont subi une opération au laser CO2 par rapport à une staphylectomie à l'aide d'un dispositif de coagulation bipolaire. Les dossiers médicaux de chiens brachycéphales qui ont subi des staphylectomies au laser CO2 (Groupe-L) ou à l'aide d'un dispositif de coagulation bipolaire (Groupe-B) entre septembre 2013 et septembre 2017 ont été examinés rétrospectivement. Parmi les 60 chiens qui satisfaisaient aux critères d'inclusion, 26 chiens (43 %) ont été désignés dans le Groupe-L et 34 (57 %) dans le Groupe-B. Les techniques n'ont pas différé pour la durée de l'intervention ou de l'anesthésie (P = 0,52 et P = 0,19, respectivement) ou les taux de complications majeures [intra-opératoires (P = 1,00), postopératoires (P = 0,72), à court terme (P = 1,00) et à long terme (P = 0,68)]. Cette étude suggère que les résultats des patients sont semblables pour les chiens subissant une staphylectomie réalisée par laser au CO2 et à l'aide d'un dispositif de coagulation bipolaire.(Traduit par Isabelle Vallières).

Adaptation and evaluation of a monopolar electrosurgical triangle-tip knife for transendoscopic ventriculocordectomy in healthy horses.

OBJECTIVE: To evaluate the efficacy and safety of a transendoscopic monopolar electrosurgical triangle-tip knife as instrumentation to perform unilateral ventriculocordectomy (VC) in healthy adult horses. STUDY DESIGN: In vivo experimental study. STUDY POPULATION: Nine horses donated for medical conditions unrelated to respiratory system. METHODS: The triangle-tip knife was applied in contact fashion. Left VC was performed under standing sedation. Endoscopic images of the upper airway were graded for inflammation by 2 masked surgeons preoperatively and immediately, 24 hours and, in 2 cases, 7 and 14 days postoperatively. Four larynxes were examined for histological evidence of inflammation and collagen deposition at 24 hours (n = 2) and at 14 days (n = 2) after surgery. RESULTS: Ventriculocordectomy was successfully performed in all horses. Endoscopic evidence of inflammation was scored as normal (preoperatively), mild (immediately postoperatively), mild (24 hours postoperatively), mild (7 days postoperatively), and normal (14 days postoperatively). According to histopathology, inflammation of the surgical site and ventricularis muscle was generally increased (variable is common and is present in most high-power fields) 24 hours and 14 days postoperatively. Fibrosis and collagen deposition also seemed increased at the surgical site 14 days postoperatively. CONCLUSION: Ventriculocordectomy was successfully performed with an electrosurgical triangle-tip knife and resulted in acceptable short-term outcomes. CLINICAL SIGNIFICANCE: The use of an electrosurgical triangle-tip knife alternative instrumentation may be offer an alternative option to perform VC in practices when diode laser is not available or is cost prohibitive. Longer term evaluation of the VC site is required to determine the effect on rima glottic cross-sectional area.

Prevalence of complications associated with use of the Henderson equine castrating instrument.

BACKGROUND: Castration is one of the most common surgical procedures performed in the horse. Complication rate and types of complications associated with use of the Henderson equine castrating instrument have not been determined. OBJECTIVE: To determine the complication rate and type of complications encountered when using the Henderson equine castrating instrument in equine ambulatory practice. STUDY DESIGN: Retrospective case series. METHODS: Medical records of horses undergoing routine castration using the Henderson drill were identified and evaluated for the occurrence of complications. The relationship between potential risk factors and complications was examined using basic descriptive statistics and quantified by means of logistic regression. RESULTS: Of 252 horses in the study population, 27 (10.7%) developed a complication after surgery; 25 of which were nonlife-threatening and responded to medical management. Two complications, one each of wound botulism and evisceration, resulted in euthanasia. Age at the time of castration was significantly associated with the occurrence of (P = 0.005, Wilcoxon rank sum test) complications. Compared to younger horses, the odds of having a complication were significantly greater (OR 2.99, 95% CI 1.27-7.0; P = 0.01) for horses of 4 years of age or more. MAIN LIMITATIONS: The retrospective nature of this study. There is also a lack of direct comparison between different castration methods. CONCLUSIONS: The Henderson equine castrating instrument is an acceptable alternative to traditional emasculators. Its use is associated with a low rate of complications (8.3%) in young horses (≤3 years of age) compared to older horses (21.3%) and a very low rate of serious complications (0.8%) in all ages of horses.

Comparison of Metzenbaum scissors and Y-shaped fasciotome for deep metatarsal fasciotomy for the treatment of proximal suspensory ligament desmopathy in horses.

OBJECTIVE: To quantitate the iatrogenic injury associated with deep plantar metatarsal fasciotomy performed with Metzenbaum scissors compared with a Y-shaped fasciotome. STUDY DESIGN: Experimental ex vivo surgical study. STUDY POPULATION: Cadaveric hind limbs (n = 20) from 10 sound thoroughbred racehorses. METHODS: A plantar metatarsal fasciotomy was performed, extending from the proximal extent of the deep metatarsal fascia, distally. Hind limbs were randomly assigned to 2 groups, undergoing fasciotomy with straight Metzenbaum scissors (n = 10) or a Y-shaped fasciotome (n = 10). Magnetic resonance imaging was performed before and after surgery to identify the maximal depth of any iatrogenic trauma. Gross examination of the surgical site included measuring the length of the incision in the deep metatarsal fascia and localizing iatrogenic trauma sustained by the plantar aspect of the proximal suspensory ligament (PSL) during the procedure. RESULTS: Iatrogenic injury to the PSL was identified in 6 of 10 and 9 of 10 specimens prepared with the fasciotome and Metzenbaum scissors, respectively (P = .03), and was most commonly located in the distal third of the fascial incision. Differences between the length of incision (P = .02) and the maximal depth of signal (P = .03) for incisions created with Metzenbaum scissors or a fasciotome were identified. CONCLUSION: The use of a fasciotome resulted in longer fascial incisions and less severe iatrogenic trauma to the PSL compared with using Metzenbaum scissors. CLINICAL SIGNIFICANCE: A Y-shaped fasciotome may be the preferred surgical instrument for successful desmopathy of the PSL fasciotomy because a greater release of compartmental pressure is possible through a longer incision with minimal iatrogenic trauma to the underlying PSL.

Influence of multiple reuse and resterilization cycles on the performance of a bipolar vessel sealing device (LigaSure) intended for single use.

OBJECTIVE: To determine the number of use/cleaning/resterilization cycles that can be safely applied to a vessel sealing device intended for single use (LigaSure). STUDY DESIGN: Ex vivo study. SAMPLE POPULATION: LigaSure Small Jaw handsets (n = 6) and LigaSure Impact handsets (n = 6). METHODS: Handsets underwent simulated splenectomy/cleaning/resterilization cycles until failure, defined as leaking vascular seal or blade retraction failure. Functional testing included assessment of vascular seal integrity, handset activation/tissue release, and cutting blade wear/retraction. Vascular seal failure was defined as a leak occurring at <300 mm Hg. Cycles to failure were recorded. Sealed vessels were evaluated by histology at first handset use and failure. RESULTS: Vascular seals created with the Small Jaw handset failed at a mean (95% CI) of 17.2 cycles (9.6-24.8) and a minimum of 10 cycles. Vascular seals created with the Impact failed at a mean of 20 cycles (18.4-21.6) and a minimum of 17 cycles. The majority of seal failures (73%; 95% CI 39%-94%) immediate leaked during vessel filling. The rate of vascular seal failure increased after the initial failure. Failure was associated with histologic disparities in tissue apposition. CONCLUSION: Repeated use and resterilization resulted in failure of the vascular seal due to inadequate tissue apposition after a minimum of 10 cycles. CLINICAL SIGNIFICANCE: Surgeons reusing and resterilizing LigaSure handsets (ForceTriad platform) should consider discarding handsets after 9 cycles for the Small Jaw and after 16 cycles for the Impact. Handsets should be immediately discarded after any intraoperative identification of vascular seal failure.

Comparison of standard single-bite with multiple-bite biopsy forceps for collection of gastrointestinal biopsies in dogs: a prospective study.

Various types of endoscopic biopsy forceps have been investigated in dogs. The Multibite (MB) are multiple-bite forceps that collect up to four tissue specimens in a single pass through the endoscope, reducing procedure time. The authors prospectively investigated its clinical utility by comparing procedure times and diagnostic quality of samples obtained with the MB to that of biopsies performed with a single-bite forceps (SB), in 21 dogs with gastrointestinal disorders. When comparing the depth, crush artefacts and diagnostic adequacy of the gastric and duodenal biopsies, there was no significant difference between the MB and SB forceps. The procedure time was significantly longer with the MB. There was no learning curve effect, and there were no reported adverse events. This study failed to demonstrate any significant clinical advantage associated with the use of the Multibite forceps over that of conventional disposable SB forceps.