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ABSTRACT Purpose: Surgical patients are routinely subjected to long periods of fasting, a practice that can exacerbate the metabolic response to trauma and impair postoperative recovery. The aim of this study was to evaluate the association between preoperative fasting time and clinical outcomes in surgical patients. Methods: An observational, prospective study with a non-probabilistic sample that included patients of both sexes, aged over 18, undergoing elective surgeries. Data were extracted from electronic medical records, and a questionnaire was applied in 48 hours after surgery. Variables related to postoperative discomfort were assessed using an 11-point numeric rating scale. Results: The sample consisted of 372 patients, and the duration of the surgical event ranged from 30-680 minutes. The incidence of nausea (26.34%) was twice that of vomiting (13.17%) and showed an association with the surgical procedure's size (p = 0.018). A statistically significant difference was observed only between pain intensity and preoperative fasting times for liquids (p = 0.007) and postoperative fasting time (p = 0.08). The occurrence of postoperative complications showed no association with preoperative fasting time (p = 0.850). Conclusions: Although no association was observed between preoperative fasting time and surgical complications, it is noteworthy that both recommended and actual fasting time exceeded the proposed on clinical guidelines.

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There are no reported estimates of normal or abnormal bleeding in dogs during the hemilaminectomy and intervertebral disc fenestration procedures (HF), and that makes it difficult to study intraoperative complications, hemostasis methods, and the impact of bleeding on surgical performance. This prospective study estimated blood loss during HF procedures in dogs with intervertebral disc extrusion (IVDE). Blood loss was quantified by weighing gauzes during the surgical procedure, in addition to measuring the aspirated blood. Total blood volume was estimated according to body weight, and blood loss as a percentage of the total blood volume. The surgeon also subjectively classified the procedures, dividing them into intraoperative difficulty due to bleeding (G1) and absence of intraoperative difficulty (G2). Thirty-two dogs that underwent HF due to IVDE were included. The median blood loss (%) of dogs submitted to HF was 3.9 ± 9.67 of the total blood volume. There was a weak correlation between blood loss and weight, age, incision size, and procedure time.

Não existem valores estimados de sangramento normal ou anormal durante procedimentos de hemilaminectomia e fenestração do disco intervertebral (HF), o que torna difícil o estudo de complicações transoperatórias, métodos de hemostasia e o impacto do sangramento na performance cirúrgica. Este estudo prospectivo objetiva estimar a perda sanguínea durante os procedimentos cirúrgicos de HF em cães com extrusão do disco intervertebral (EDIV). A perda sanguínea foi quantificada pela pesagem de gazes usadas durante o procedimento, além da mensuração do sangue aspirado. O volume de sangue total foi estimado de acordo com o peso do animal, e a perda de sangue como porcentagem do volume de sangue total. O cirurgião também classificou os procedimentos subjetivamente, dividindo-os em dificuldade transoperatória devido ao sangramento (G1) e ausência de dificuldade transoperatória (G2). Trinta e dois cães submetidos a HF devido a EDIV foram incluídos. A perda sanguínea mediana (%) dos cães submetidos a HF foi de 3,9 ± 9,67 do volume de sangue total. Houve uma fraca correlação entre perda sanguínea e peso, idade, tamanho da incisão e tempo de procedimento.

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Purpose: To evaluate the use of the latest generation smartphone camera in performing arterial microanastomosis in rats. Methods: Ten Wistar rats were divided into 2 groups and underwent anastomosis of the right carotid artery with the aid of magnification from a microscope (group M) and a smartphone camera (group S), to compare patency in 72 hours, as well as to measure the weight of the animals, diameter of the carotid arteries and anastomosis time. Results: There was no statistical difference between the weight of the animals or the diameter of the carotid arteries. There was a statistical difference for the time spent on anastomoses, which was greater in group S, with higher rates of thrombosis (p < 0.05). Conclusions: Although our patency and anastomosis time results were statistically lower in the smartphone group, there was success in some cases. As the segment continues to progress, it is likely that the results will improve in line with the evolution of camera technology.

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Purpose: To compare the indicators, postoperative pneumoretroperitoneum-related complications, and postoperative recovery of laparoscopic preperitoneal inguinal hernia repair under different CO2 pneumoperitoneum pressures. Methods: The total of 187 adult patients with primary inguinal hernia who successfully underwent transabdominal preperitoneal prosthesis (TAPP) from September 2021 to September 2023 in the Department of General Surgery, Haimen People's Hospital affiliated to Nantong University, were collected. These patients were randomly divided into low abdominal pressure group (group A: pneumoperitoneum pressure = 8 mmHg), sub-low abdominal pressure group (group B: pneumoperitoneum pressure = 10 mmHg), moderate abdominal pressure group (group C: pneumoperitoneum pressure = 12 mmHg), and standard pressure group (group D: pneumoperitoneum pressure = 14 mmHg), with 40 patients each. Results: The operation time in group C (43.90 ± 9.75) was significantly lower than group A (51.98 ± 12.65, p 0.001), group B (46.70 ± 10.59, p 0.001), and was higher than that in group D without significant statistical differences (38.15 ± 7.98, P = 0.05). The peritoneal suturing time in group C (5.03 ± 1.07) was significantly higher than group A (4.23 ± 0.70, p 0.001), group B (4.55 ± 0.85, p = 0.03), and was significantly lower than that in group D (6.95 ± 1.96, p 0.001). Conclusion: Selecting sub-low abdominal pressure (12 mmHg) can help to have a shorter operation time, with less blood loss, and it did not add pneumoretroperitoneum-related complications. Changing the pneumoperitonium pressure during different phases of the surgery is also an optimal option.

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Purpose: This study aimed to introduce and evaluate two new microvascular anastomosis techniques compared to the conventional method in a rat renal transplant model. Methods: Using a Fisher-to-Lewis rat kidney transplantation model, the renal artery anastomosis was performed using the interrupted (I) suture technique, Y-shaped continuous (Y) suture technique, and anterior-interrupted and posterior-continuous (I-C) suture technique. The rats were then divided into three groups: I group, Y group, and I-C group. Parameters such as arterial anastomosis time, warm ischemia time, seven-day survival rate of the rats, and vessel histopathology were assessed. Results: The mean arterial anastomosis time, blood leakage scores, and warm ischemia time were significantly reduced in groups Y and I-C compared to group I. Moreover, the seven-day survival rate was significantly higher in the I-C group compared to the other two groups. Arterial histopathology demonstrated vessel wall recovery without damage in all three groups, suggesting the safety of both Y and I-C techniques. Conclusions: The anterior-interrupted and posterior-continuous suture method is particularly beneficial for small artery reconstruction in organ transplantation.

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Purpose: Full-endoscopic spine surgery (FESS) is associated with specific complications, possibly linked to increased intracranial pressure (ICP) resulting from continuous saline infusion into the epidural space. This study aimed to assess the impact of saline irrigation and its correlation with noninvasively obtained ICP waveform changes. Methods: Patients undergoing FESS between January 2019 and November 2020 were included. Noninvasive ICP (n-ICP) monitoring utilized an extracranial strain sensor generating ICP waveforms, from which parameters P2/P1 ratio and time to peak (TTP) values were derived and correlated to irrigation and vital parameters. Documentation occurred at specific surgical intervals (M0-preoperatively; M1 to M4-intraoperatively; M5-postoperatively). Mixed-model analysis of variance and multiple comparisons tests were applied, with M0 as the baseline. Results: Among 31 enrolled patients, three experienced headaches unrelated to increased ICP at M5. The P2/P1 ratio and TTP decreased during surgery (p < 0.001 and p < 0.004, respectively). Compared to baseline, P2/P1 ratio and vital parameters remained significantly lower at M5. No significant differences were observed for fluid parameters throughout surgery. Conclusions: This study demonstrated a decline in the n-ICP parameters after anesthetic induction despite the anticipated increase in ICP due to constant epidural irrigation. The n-ICP parameters behaved independently of fluid parameters, suggesting a potential protective effect of anesthesia.

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The aim of this paper is to better understand the dynamics of crystallogenic and starting activity in biological fluids of patients throughout surgery and the late postoperative phase in alveococcosis. Samples of saliva from 22 individuals with alveococcosis were included in the research. Biological fluid samples were taken at the time of admission and before the patient was discharged. Following that, slides were made utilizing the teziocrystalloscopy method, which incorporates the investigation of the crystal forming activity of mixed saliva with its starting characteristics using a 0.9 percent sodium chloride solution as the foundation ingredient. Using our own set of criteria, we evaluated the outcomes of crystalloscopic and tezigraphic experiments. Specrophotometric examination of tezigraphic and crystalloscopic facies was done using a PowerWave XS microplate spectrophotometer at wavelengths of 400, 350, and 300 nm to augment the results from ocular morphometry of dried saliva micro slides. Surgical therapy results in a partial normalization of physical and chemical parameters, as well as the composition of the patient's biological fluids after the patient is discharged from the hospital.

O objetivo deste trabalho foi compreender melhor a dinâmica da atividade cristalogênica e inicial nos fluidos biológicos dos pacientes durante a cirurgia e na fase pós-operatória tardia da alveococose. Amostras de saliva de 22 indivíduos com alveococose foram incluídas na pesquisa. Amostras de fluidos biológicos foram coletadas no momento da admissão e antes da alta do paciente. Em seguida, foram confeccionadas lâminas utilizando a técnica de teziocristaloscopia, que combina a investigação da atividade formadora de cristais da saliva mista com suas características iniciais, utilizando uma solução de cloreto de sódio a 0,9% como ingrediente-base. Usando nosso próprio conjunto de critérios, avaliamos os resultados de experimentos cristaloscópicos e tezigráficos. O exame espectrofotométrico da fácies tezigráfica e cristaloscópica foi feito usando um espectrofotômetro de microplaca PowerWave XS nos comprimentos de onda de 400, 350 e 300 nm para aumentar os resultados da morfometria ocular de microplacas de saliva seca. A terapia cirúrgica resulta na normalização parcial dos parâmetros físicos e químicos, bem como da composição dos fluidos biológicos do paciente, após a alta hospitalar.

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Purpose: The current study aimed at evaluating the repair of a partial defect of the trachea with a muscle flap, an advanced technique that employs combined suture patterns. Methods: Sixteen healthy male New Zealand white rabbits were used as an experimental model. A partial defect in the trachea within the ventral region of the fourth to eighth tracheal ring was created. Subsequently, repair was initiated with a flap of the sternocephalicus muscle. The animals were divided into four groups for postoperative evaluation using clinical, tracheoscopic, and histopathological analyses. Each group was separated according to the time of euthanasia, programmed at interval of seven (G7), 15 (G15), 30 (G30), and 60 days (G60). Results: One animal from the G60 group died, whereas the other animals had good surgical recovery without serious changes in the breathing pattern. The major clinical signs observed were stridor and coughing. Tracheoscopy revealed secretions in the tracheal lumen, exuberant granulation, and stenosis. Histopathological analysis showed growth of the ciliary respiratory epithelium at the flap site 30 days after implantation. Conclusions: Partial repair showed satisfactory results owing to the anatomical location of the muscle, adequate vascular support, and structural and physiological maintenance without serious changes in the respiratory system.

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Purpose: To explore artificial intelligence's impact on surgical education, highlighting its advantages and challenges. Methods: A comprehensive search across databases such as PubMed, Scopus, Scientific Electronic Library Online (SciELO), Embase, Web of Science, and Google Scholar was conducted to compile relevant studies. Results: Artificial intelligence offers several advantages in surgical training. It enables highly realistic simulation environments for the safe practice of complex procedures. Artificial intelligence provides personalized real-time feedback, improving trainees' skills. It efficiently processes clinical data, enhancing diagnostics and surgical planning. Artificial intelligence-assisted surgeries promise precision and minimally invasive procedures. Challenges include data security, resistance to artificial intelligence adoption, and ethical considerations. Conclusions: Stricter policies and regulatory compliance are needed for data privacy. Addressing surgeons' and educators' reluctance to embrace artificial intelligence is crucial. Integrating artificial intelligence into curricula and providing ongoing training are vital. Ethical, bioethical, and legal aspects surrounding artificial intelligence demand attention. Establishing clear ethical guidelines, ensuring transparency, and implementing supervision and accountability are essential. As artificial intelligence evolves in surgical training, research and development remain crucial. Future studies should explore artificial intelligence-driven personalized training and monitor ethical and legal regulations. In summary, artificial intelligence is shaping the future of general surgeons, offering advanced simulations, personalized feedback, and improved patient care. However, addressing data security, adoption resistance, and ethical concerns is vital. Adapting curricula and providing continuous training are essential to maximize artificial intelligence's potential, promoting ethical and safe surgery.

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Purpose: To evaluate patient characteristics and factors associated with surgical resection in patients with Crohn's disease (CD). Methods: An analysis was performed on data from 295 patients with CD in follow-up from 2001 to 2018. Medical record data comprised age, gender, location, behavior and duration of the CD, smoking, and extraintestinal manifestation. Patients were divided into two groups according to the presence or absence of surgical resection. Results: Out of the 295 patients with CD, 155 underwent surgical resection (53.2% male, mean age: 43.88 ± 14.35 years). The main indications for surgery were stenosis (44.5%), clinical intractability (15.5%), and intra-abdominal fistulas (15.5%). Smoking (p < 0.001), longer CD duration (p < 0.0001), ileo-colonic location (p = 0.003), stenosing behavior (p < 0.0001), and fistulizing behavior (p < 0.0001) were significantly associated with surgical resection. Initial use of biological was significantly more frequent in the group of patients without surgical resection (p < 0.001). Conclusions: Patients with CD still frequently need surgical treatment. Smoking (current or past), longer disease time, stenosing and fistulizing behavior, and ileo-colonic localization in CD patients were associated with a higher risk of surgery. Awareness about factors associated with unfavorable outcome allows such patients to be treated more appropriately.

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This study evaluated two surgical sterilization techniques in free-ranging female capybaras (n = 21). The first group underwent uterine horn ligature (HL; n = 11), while the second was subjected to partial salpingectomy (S; n = 10). We assessed total operative time, incision length, the ease of identifying reproductive structures, the adequacy of exposure for surgical performance through flank or midline approaches, and the extent of abdominal viscera manipulation for each method. The HL method emerged as faster, with an average operative time difference of 16 minutes. In the S group, a flank mini-laparotomy over the ovarian topography facilitated easy exposure of the ipsilateral ovary and uterine tube, enabling ligature and partial resection of the uterine tube but not the uterine horn exposure. However, accessing the contralateral uterine tube without a bilateral incision was impractical, thus prolonging the total operative time due to the need for patient repositioning and new antisepsis procedures. Conversely, a post-umbilical approach for the HL method necessitated only one mini-laparotomy incision, offering ample uterine exposure for hysterotomy in pregnant females. Both methods involved minimal abdominal viscera manipulation and resulted in no fatalities or postoperative complications. Although direct comparison is limited by the distinct sterilization techniques and surgical approaches, this study underscores the challenges and surgical access of each method. Our findings endorse the HL technique as an effective contraception method for female capybaras to prevent the birth of seronegative offspring that could amplify Rickettsia sp., the causative agent of Brazilian spotted fever.(AU)

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Non-steroidal anti-inflammatory drugs are extensively used in veterinary practice. COX-2 inhibitors are considered to be safer than non-selective inhibitors; however, there are few studies address of their long-term use in equine species. The goal of this study was to identify the possible adverse effects of meloxicam (a preferential COX-2 inhibitor) in healthy horses, administered at a dose of 0.6 mg/kg, orally, once a day, for 28 days. A paired test was performed with seven animals, and the clinical, hematological, biochemical, and gastroscopic parameters, as well as bleeding time, were evaluated in five timepoints and an electrocardiogram at three timepoints. No relevant adverse effects were observed in terms of the parameters evaluated. Significant differences were found in heart rate, AST and P wave duration, segmented neutrophils (%), and the levels of erythrocytes, hemoglobin, hematocrit, and MCH, compared with these parameters at T0; however, no animal manifested clinical alterations. Gastroscopy revealed discrete lesions (Grade 1) in the squamous gastric mucosa on day 14 of treatment in all animals; however, at the end of the study (day 28) these lesions had regressed to grade 0 in three of the horses and remained at grade 1 in the other four animals. Based on these results, we conclude that the use of meloxicam at a daily dose of 0.6 mg/kg, orally, for 28 consecutive days, did not cause relevant adverse effects in healthy horses.(AU)

Os anti-inflamatórios não esteroides são amplamente utilizados na prática veterinária e os inibidores da COX-2 são propostos como mais seguros que os inibidores não seletivos, porém, poucos estudos abordam seu uso por tempo prolongado na espécie equina. Este estudo teve como objetivo identificar os possíveis efeitos adversos do uso de meloxicam (inibidor preferencial da COX-2) em equinos hígidos, na dose de 0,6 mg/kg, por via oral, uma vez ao dia, durante 28 dias. Um teste pareado foi realizado com sete animais e os parâmetros clínicos, hematológicos, bioquímicos, tempo de sangramento e gastroscópicos foram avaliados em cinco momentos e eletrocardiograma em três. Não foram observados efeitos adversos relevantes nos parâmetros avaliados. As variáveis frequência cardíaca, eritrócitos, hemoglobina, hematócrito, HCM, neutrófilos segmentados, AST e duração da onda P apresentaram diferença significativa em relação ao T0, porém nenhum animal manifestou alterações clínicas. Na gastroscopia foram observadas lesões discretas (grau 1) na mucosa gástrica escamosa no dia 14 de tratamento em todos os animais, porém, ao final do estudo (dia 28) essas lesões regrediram para grau 0 em três pacientes e permaneceram em grau 1 em quatro animais. O uso de meloxicam na dose diária de 0,6mg/kg, por via oral, durante 28 dias consecutivos, não causou efeitos adversos relevantes em cavalos hígidos.(AU)

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Background: Urethropreputial fistulas are communicative conduits between the urethra, prepuce, and environment whose origin deviates the urinary flow from its physiological path. The condition has a multifactorial cause and is considered uncommon in dogs. By the scarce occurrence of this malformation, as well as the scarcity of case reports on the subject, the present work aims to report a case of congenital urethropreputial fistula in a mixed breed dog and the surgical procedures performed to correct this genitourinary abnormality. In addition, it seeks to cross information available in the literature with the changes found during the case attendance. Case: An approximately 1-year-old male canine, mixed breed, was attended at the Veterinary Hospital of the Federal Rural University of Pernambuco (HOVET - UFRPE) with a complaint of dysuria, where the urinary flow occurred by dripping through an orifice caudal to the external urethral ostium. According to the tutor, the animal presented the condition since its adoption at 2 months old. The general physical examination did not show any changes in the physiological parameters. The mucous membranes were normal in color, the capillary refill time was 2 s, there was no pain or discomfort on superficial and deep palpation of the abdomen, and the heart and respiratory rates were within the range considered normal for the species. The specific examination found the existence of a fistula on the ventral aspect of the foreskin, whose resolution required a surgical intervention that consisted of obliteration of the fistula communication channel by suturing the defect using an absorbable suture thread. However, this was not effective in solving the problem of the animal, which returned to the hospital complaining of ischuria, leading to the need for 2 other surgical procedures: A scrotal urethrostomy, whose result was also inadequate due to the displacement of the urethral catheter given the postoperative conditions and the animal's temperament, and, to guarantee the proper functioning of the lower urinary tract, avoiding recurrences, a new urethrostomy dorsal to the first, in the perineal region, was performed. The animal did not present episodes of urinary retention after the third procedure and had a significant improvement in the condition in which it was before the initial treatment. Discussion: Urogenital anomalies are rare in dogs and can be acquired or congenital. With an etiology still not fully elucidated, the variety of fistula presentations indicates that the condition probably has multifactorial causes. The affection may be confused with hypospadias. However, in this case, the external urethral ostium is out of its anatomical location, and several other abnormalities are present, like cryptorchidism, intersexuality, and penile underdevelopment. The his-tory obtained through the anamnesis, associated with the absence of traumatic episodes in the region and other associated congenital alterations, leads to the understanding that it is a urethral fistula not associated with hypospadias and has a congenital origin. The failure of the first surgical intervention provides relevant data in search of the probable causes of fistula formation. The impossibility of urethral catheterization associated with ischuria consequent to the obliteration of the defect is indicative that the urethral path was blind-ended or with a significant reduction of the lumen, and the resulting increase in pressure can be considered a factor for the formation of the fistula.

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Ischemic stroke is the second leading cause of death and the leading cause of disability in the world. This is because current interventions are effective only in a narrow window of time. To prolong the period in which the interventions are effective, several in vivo animal models have been developed, among which an ischemic stroke is induced by introduction of an intraluminal catheter through the internal carotid artery or by inoculation of a thrombus into the common carotid artery. However, these models are not easy to execute in regions where access to specialized surgical material is difficult. We propose a study in a cadaveric model with Wistar rats with the aim of producing a surgical approach, like that achieved by introducing an intraluminal catheter at the base of the middle cerebral artery, using resources that are easily accessible to any laboratory. 40 rat carcasses, watchmaker tweezers, 0.17 mm diameter nylon suture and silicone were used to produce catheters, office clips, disposable cauterizer, 0.6 mm diameter soft wire as vascular clamp and hypodermic needles G -22 and G-32. Two surgical techniques for intraluminal introduction and occlusion are described. It was possible to introduce the catheter to the middle cerebral artery between 33 and 45 minutes, with a value in Colombian pesos for the total supplies of 200,000 COP / 27 USD for reusable materials. Although the procedure was reproducible in all the animals used, it is necessary to run this model in-vivo to observe its reproducibility by testing different treatments.

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Purpose: To evaluate the viability of the porcine vas deferens as a realistic microsurgical training model for vasectomy reversal Methods: The model uses swine testicles (vas deferent), which are usually discarded in large street markets since they are not part of Brazilian cuisine. The spermatic cord was carefully dissected, and the vas deferens were isolated, measuring 10 cm in length. A paper quadrilateral with 5 cm2 was built to delimit the surgical training field. The objective of the model is to simulate only the microsurgical step when the vas deferens are already isolated. The parameters analyzed were: feasibility for reproducing the technique, patency before and after performing the vasovasostomy, cost of the model, ease of acquisition, ease of handling, execution time, and model reproducibility. Results: The simulator presented low cost. All models made were viable with a texture similar to human, with positive patency obtained in 100% of the procedures. The internal and external diameters of the vas deferens varied between 0.2-0.4 mm and 2-3 mm, respectively, with a mean length of 9 ± 1.2 cm. The total procedure time was 43.28 ± 3.22 minutes. Conclusions: The realistic model presented proved to be viable for carrying out vasectomy reversal training, due to its low cost, easy acquisition, and easy handling, and providing similar tissue characteristics to humans.

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Purpose: To evaluate the effects of deep resection of endometriosis in the posterior pelvic region on urodynamic parameters. Methods: A prospective observational study conducted with female patients diagnosed with deep pelvic endometriosis before and after endometriosis resection surgery. Clinical history, image exams, the Female Lower Urinary Tract Symptoms questionnaire, urodynamic examination, cystometry, and voiding study were evaluated. Results: Patients aged 30-39 years old, operative duration of 132.5 minutes, and 2.7 days of hospital stay. Uroflowmetry and cystometry showed tendency for an increase after the surgery in the flow duration, time to maximum flow, and first voiding desire and decreased residual volume and maximum cystometric capacity. Opening, maximum urinary flow, and maximum flow pressure decreased at T1, and the closing parameters increased, although statistically non significant. The variables decreased at T1 in the urodynamic, except for detrusor overactivity. Although we observed a reasonable number of low bladder compliance and abnormal bladder sensation, the results were maintained at T1. General scores for filling and incontinence showed a significant decrease after surgery. Conclusions: A significant response in the patient's perception of urinary function was demonstrated after surgery. It is observed that the surgical procedure did not affect the uroflowmetric and cystometric characteristics of the evaluated patients.

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ABSTRACT Purpose: To introduce a new low-cost simulation model for training basic surgical skills. Methods: The training model was made from a mixture of 20 g of acetic silicone with 11 g of maize starch. Validation consisted of serial training sessions, evaluating the mean pre- and post-training time and the mean final score according to the global rating scale. Results: A decrease in the time required to perform the sutures was observed, comparing the average post and pre-training time of each training day, with a significant correlation between the order of training and the time for performing the simulation. Conclusions: The presented model proved to be capable of simulating the basic suture training skills. It is easy to make, has low cost, and can be easily reproduced in educational institutions.

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Background: Hydrodissection is a minimally invasive procedure that consists of injecting fluid into an anatomical space to facilitate dissection during surgery. Although this procedure is employed in several areas of veterinary medicine, including ophthalmology, there are no reports of the use of this maneuver in conjunctival procedures in dogs. The use of this technique can facilitate the construction of conjunctival pedicle flaps, thereby improving the results. The purpose of this work was to evaluate the use of hydrodissection in the construction of conjunctival pedicle flaps in dogs. Materials, Methods & Results: The sample consisted of 20 eyes from 10 healthy dogs that had been subjected to elective surgical procedures of ovariohysterectomy and orchiectomy. The dogs were divided into 2 groups; the 1st group of 10 eyes underwent hydrodissection and the 2nd group of 10 eyes did not. All the patients underwent a complete ophthalmic examination and assessment of their systemic conditions. The patients were then anesthetized and the procedures were performed under a surgical microscope. In the group subjected to hydrodissection, the conjunctival flap was prepared by means of a previous subconjunctival injection of 0.7 mL of 0.9% sodium chloride, followed by preparation of the flap. In the group without hydrodissection, the flap was prepared by means of conventional divulsion using iris scissors. After producing the conjunctival flaps, a conjunctival fragment was collected from both groups for histological analysis and evaluation of the presence of the Tenon capsule. The operating time, degree of hemorrhage and ease of handling the conjunctiva in the intraoperative period were evaluated. Postoperative evaluations were performed at 1, 7 and 14 days after surgery and included: blepharospasm, conjunctival hyperemia and edema, which were classified as absent, mild, moderate or severe; tear production was evaluated using the Schirmer test, and the appearance of the conjunctival scar was assessed based on photographs taken in the postoperative period, and by a visual analogue scale, with healing classified as fair, good or excellent. The 2 groups showed no statistical difference in terms of operating time, bleeding, ease of handling and conjunctival divulsion. A volume of 0.48 ± 0.12 mL of 0.9% sodium chloride was administered to the conjunctiva. Postoperative assessments of hyperemia, blepharospasm, conjunctival edema, and tear production also did not differ statistically. Conjunctival scarring was considered optimal until the 14th postoperative day, with no statistically significant difference between the 2 groups. These results demonstrate that both maneuvers are effective in creating conjunctival flaps. The Tenon capsule could not be identified in histological stains. Discussion: The literature offers numerous descriptions of the use of hydrodissection in surgical procedures in humans in order to facilitate dissection and reduce surgical duration and handling, thereby improving the clinical recovery of patients. Conversely, this technique has not been described frequently in veterinary medicine, notably with respect to conjunctival procedures. In this study, we demonstrated that conjunctival hydrodissection was perfectly feasible, contributing to the divulsion and preparation of conjunctival flaps, thus proving to be a viable option for this type of procedure. The absence of the Tenon capsule in the evaluated samples demonstrates that, in both groups, the techniques were effective in separating them from the conjunctiva. It was therefore concluded that the hydrodissection technique is a feasible maneuver in the construction of conjunctival flaps, providing a new option for surgeons, especially for novice ophthalmologists.

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Purpose: The aim of this randomized study was to compare the complications and perioperative outcome of three different techniques of laparoscopic cholecystectomy (LC). Changes in the liver function test after LC techniques were investigated. Also, we compared the degree of postoperative adhesions and histopathological changes of the liver bed. Methods: Thirty rabbits were divided into three groups: group A) Fundus-first technique by Hook dissecting instrument and Roeder Slipknot applied for cystic duct (CD) ligation; group B) conventional technique by Maryland dissecting forceps and electrothermal bipolar vessel sealing (EBVS) for CD seal; group C) conventional technique by EBVS for gallbladder (GB) dissection and CD seal. Results: Group A presented a longer GB dissection time than groups B and C. GB perforation and bleeding from tissues adjacent to GB were similar among tested groups. Gamma-glutamyl transferase and alkaline phosphatase levels increased (p ≤ 0.05) on day 3 postoperatively in group A. By the 15th postoperative day, the enzymes returned to the preoperative values. Transient elevation of hepatic transaminases occurred after LC in all groups. Group A had a higher adherence score than groups B and C and was associated with the least predictable technique. Conclusions: LC can be performed using different techniques, although the use of EBVS is highly recommended.

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Background: The maned wolf (Chrysocyon brachyurus) is the largest canid in South America and the only representative of its genus. The scientific literature presents studies referring to the management and anaesthesia of the species but is scarce in case of emergency procedures, and to date, there are no reports of anaesthesia for emergency procedures in a neonatal maned wolf. Thus, this study aimed to report xenotransfusion and emergency anaesthesia for thoracic limb amputation in an approximately 8-days-old maned wolf pup. Case: A maned wolf pup, approximately 8-day-old, with a history of an accident with an agricultural machine, was referred to the Veterinary Hospital of the Federal University of Paraná - Palotina Sector (HVP - UFPR) with a grade III open fracture of left radius and ulna. At the physical evaluation, bullous rales were observed in the right caudal lobe on pulmonary auscultation, hypoglycemia and severe dehydration, the latter being determined by the occurrence of enophthalmos, increased capillary refill time and skin turgor (3 s). The hemogram revealed regenerative hypochromic macrocytic anaemia, thrombocytopenia and leukopenia, and the chest radiograph showed alveolar pattern opacification, associated with the presence of air bronchograms in the caudal lobes, more evident on the right side, suggestive of pulmonary contusion. Considering the laboratory alterations and the need for amputation of the thoracic limb, xenotransfusion was chosen before the anaesthetic procedure. The animal was pre-medicated with methadone 0.2 mg/kg and anaesthetic induction was performed with propofol titrated to effect, requiring 10 mg/kg. This was followed by endotracheal intubation and anaesthetic maintenance using the partial intravenous technique with an infusion of 5 µg/kg/h of remifentanil and Isoflurane vaporised through a non-rebreathing system in oxygen at 0.6. Anaesthetic monitoring included heart rate and electrocardiogram tracing, respiratory rate, oxyhemoglobin saturation, end-tidal partial pressure of carbon dioxide, systemic blood pressure by the oscillometric method, and oesophageal body temperature. Although the blood tests after the transfusion showed an increase in hematocrit, changes suggestive of a delayed hemolytic reaction because of the transfusion were also noticed. Discussion: Preanesthetic stabilisation is critical, as anaesthesia of unstable patients may result in a higher risk of anaesthetic complications. Critically ill patients may present systemic imbalances that can trigger pharmacokinetic and pharmacodynamic changes of anaesthetics and analgesics. Neonates have several marked physiological differences, since some organs are still immature, have a high body volume of water, and present a reduced amount of total fat and concentrations of circulating proteins, making it necessary to adjust protocols and doses used for these patients. Blood transfusion between the same species is always the best option, though xenotransfusion becomes an option when there is no homologous donor available. However, it can present a great risk to life, as there is a lack of studies regarding the blood typing of the species and blood compatibility tests. We concluded that there was an increase in hematocrit after 24 h of xenotransfusion and, even with signs of delayed hemolytic reaction observed in the blood test, the patient did not show specific clinical signs of transfusion reaction. The pup was sensitive to methadone but required a high dose of propofol for anaesthetic induction. The use of methadone as a pre-anaesthetic agent and the infusion of remifentanil provided adequate analgesia based on the parameters evaluated.