Use of Autologous Conditioned Serum (ACS) for Osteoarthritis Treatment in Horses: A Systematic Review of Clinical Data.

The utilization of Autologous Conditioned Serum (ACS) for treating osteoarthritis (OA) in horses has seen a notable increase in recent years. In vitro studies have consistently identified ACS as a promising therapy for OA joints, contributing to its growing popularity in OA treatment. Despite this, there is a noticeable absence of systematic reviews focused solely on the clinical data of OA patients treated with ACS, excluding the in vitro perspective. This study aims to address this gap by systematically reviewing the latest literature, concentrating solely on clinical data in in vivo studies to evaluate the efficacy of ACS in OA lesions. All clinical studies involving ACS treatments for horses with OA were included in the assessment. Surprisingly, only six trials met the inclusion criteria for this systematic review. The results indicate that the majority of the considered articles support the use of ACS as a treatment for horses, albeit with a control group provided in only one study. However, the absence of a control group and the exclusion of histological evaluation diminish the validity of the majority of clinical research. While several studies suggest a beneficial effect of ACS on OA horses without significant adverse effects, this systematic review affirms that there is no definitive evidence for its effectiveness. Therefore, further investigation of the efficacy of ACS products as a treatment for OA is warranted, emphasizing the need for more controlled trials. Poorly designed and biased studies, lacking blinding or control and adopting inadequate outcome measures, may favor positive results and, thus, necessitate a more rigorous approach to validate the efficacy of ACS in OA treatment.

Effects of GLUBRAN-2 on the Burst Pressure of Jejunal Loops Thermofused With Vessel Sealing Devices.

BACKGROUND: Off-label use of radiofrequency vessel sealing devices for intestinal thermofusion has been reported as an alternate approach for closing the small and large intestines. The study aimed to evaluate if reinforcing the thermofusion line with a modified N-butyl-2-CyanoAcrylate and methacryloxysulpholane produced improved burst pressure values in ex vivo swine jejunal loops. MATERIALS AND METHOD: A suture-less full-thickness jejunal biopsy was performed with different radiofrequency vessel-sealing devices (Ligasure 5 mm: RFVS-1; Atlast 10 mm: RFVS-2; Cayman Maryland: RFVS-3), and reinforcement with modified cyanoacrylate Glubran-2 (G2) at the thermofusion defect was applied. Burst pressure(BP) values were compared with a control group, wherein a cold blade was utilized to obtain the biopsy, followed by the closing of the jejunum with seven Gambee sutures. RESULTS: Seventy (n = 70) jejunal loop samples were distributed into the experimental groups.The RFVS-1 and -2 groups exhibited BP values similar to those of the suture group. The RFVS-3 group showed significantly lower BP values (P < 0.05) than the suture group. Conversely, in the groups wherein G2 was applied, all BP values were comparable to those of the suture group. BP test in the RFVS-3G2 group showed significantly (P < 0.05) higher values in the group using the same instrument without the glue (RFVS-3). CONCLUSIONS: G2 has been shown to improve the BP on the defects created by instruments that are not completely efficient in intestinal thermofusion and sealing. This experimental model showed that the performance of full-thickness biopsies with RFVS devices and reinforcement with G2 provide feasible and promising results.

Wound Retractor Laparoscopic Port System for Laparoscopic Ovariectomy in Panthera leo.

The aim of this study was to assess the feasibility and intraoperative complications of performing ovariectomies in African lionesses (Panthera leo) using a wound retractor laparoscopic platform. Six lionesses (n = 6) were included. The surgical procedures were carried out through three portals, with a retractor platform positioned at the umbilical port and cannulas placed 3-4 cm from the cranial and caudal regions to the device at the level of the midline. An ovariectomy was performed with a vessel-sealing device. We evaluated the surgery time and the intraoperative and early postoperative complications. The mean weight was 172.83 kg. The total surgery time was 49.33 min. The installation step took a mean of 10.33 min to complete. The mean ovariectomy time was 20 min. Controlled bleeding was observed at the tip of the uterine horn in two cases due to excessive tissue thickness. The retrieval of dissected ovarian tissue and annexes was easily performed. No other complications were observed. The use of the laparoscopic platform during three-portal surgeries for laparoscopic ovariectomy in adult overweight lionesses is feasible and without intraoperative problems. The retractor meant that there were no entry-related issues due to the 25 mm mini-laparotomy. It also made it simpler to extract thick ovaries and promptly re-establish the pneumoperitoneum.

Laparoscopic salpingectomy in Papio hamadryas for birth control in captivity.

OBJECTIVE: To evaluate the feasibility of laparoscopic salpingectomy in baboons (Papio hamadryas). We hypothesized that laparoscopic salpingectomy could be performed in baboon species within a reasonable amount of surgical time, with minor complications occurring at low rates. STUDY DESIGN: Case series and technique description. ANIMALS: Sixteen baboons (n = 16). METHODS: The surgical procedures were performed using the 3-port technique, with 5 mm instruments and a telescope placed at the umbilical and hypogastric regions. A salpinx dissection was performed, using a radiofrequency bipolar vessel sealing device, from the fimbriae to the uterine attachments. We evaluated the surgical duration, learning curve, and intraoperative and early postoperative complications. RESULTS: Ten adult and 6 subadult baboons with a mean weight of 9.32 kg, a range of 4-14.2 kg, and a standard deviation (SD) of 3.09 kg were included in the study. The total duration of surgery was 28.75 min (range, 16-50 min; SD, 9.60 min). The installation phase was completed in a mean time of 7.68 min (range, 3-15 min; SD, 3.43 min), and the time to complete the salpingectomy of both salpinges was 9.68 min (range, 4-20 min; SD, 3.97 min). No complications were observed in the postoperative period. CONCLUSION: Laparoscopic salpingectomy in Papio hamadryas was feasible, with an acceptable surgical time, low invasiveness, and only minor technical perioperative complications. CLINICAL SIGNIFICANCE: Laparoscopic salpingectomy could be a viable and safe therapeutic option in nonhuman primate birth-control programs.

Swine Small Intestine Sealing Performed by Different Vessel Sealing Devices: Ex-Vivo Test.

This study aimed to evaluate the sealing quality of swine small intestine using different laparoscopic radiofrequency vessel sealing devices (two 5 mm: RFVS-1 and -2; one 10 mm: RFVS-3) and a harmonic scalpel (HS) compared to golden standard closure technique. The study was divided into two arms. In study arm 1: n = 50 swine intestinal loops (10 per group) were transected with each instrument and the loops in which the devices provided complete sealing, at the gross inspection, were tested for maximum burst pressure (BP) and histological evaluation and compared to an automatic linear stapler. After the BP tests, the devices that achieved significantly lower BP values were excluded from the second arm. The RFVS-1 and -3 provided statistically significant results and were used in study arm 2, to obtain full-thickness biopsies along the antimesenteric border of the loop and were compared with hand-sewn intestinal closure (n = 30; 10 per group). The biopsies were histologically evaluated for thermal injury and diagnostic features, and intestinal loops tested for BP. RFVS-3 achieved comparable results (69.78 ± 4.23 mmHg, interquartile range (IQR) 5.8) to stapler closing technique (71.09 ± 4.22 mmHg, IQR 4.38; p > 0.05), while the RFVS-1 resulted in significantly (p < 0.05) lower BP (45.28 ± 15.23 mmHg, IQR 24.95) but over the physiological range, conversely to RFVS-2 (20.16 ± 7.19 mmHg, IQR 12.02) and HS (not measurable). RFVS-3 resulted not significantly different (p > 0.05) (45.09 ± 8.75 mmHg, IQR 10.48) than Suture (35.71 ± 17.51 mmHg, IQR 23.77); RFVS-1 resulted significantly lower values (23.96 ± 10.63 mmHg, IQR 9.62; p < 0.05). All biopsies were judged diagnostic. Data confirmed that RFVS-1 and -3 devices provided suitable intestinal sealing, with BP pressures over the physiological range. Conversely, the HS and RFVS-2 should not be considered for intestinal sealing. RFVS devices could be employed to obtain small intestine stump closure or full-thickness biopsies. However, further studies should be performed in live animals to assess the role of the healing process.

Comparison of Laparoscopic Steerable Instruments Performed by Expert Surgeons and Novices.

As an alternative to the surgical robot, some medical companies have engineered new steerable devices that mimic the robot's capacities. This study aimed to assess how steerable instruments ameliorate the efficacy of suturing in comparison with the traditional instrument, and a combination instruments, performed by experienced and novice surgeons. The study was performed by three experienced surgeons and three novice surgeons. The instruments employed were divided into three surgical sets: two steerable dissectors; one steerable dissector and one straight needle; two straight needle holders. The study supervisor recorded the total time for the procedure, the number of bites completed, the time for each bite, and the quality of the procedure. In our study, we found consistent data demonstrating that experienced laparoscopists completed the prescribed suture pattern with more bites in less time than novices. The use of two steerable instruments was more time consuming than standard straight instruments, but a combination of instruments was significantly less time consuming, as was the use of two straight needle holders. This result was even observed in novice surgeons. Combining a steerable instrument with a traditional straight needle holder provided more advantages in this study.

Wound Retractor Laparoscopic Port System for Standing Laparoscopic Cryptorchidectomy in the Horse: A Case Report.

Cryptorchidectomy is the most commonly performed laparoscopic procedure in horses. However, its use for the extraction of an abdominal testis has disadvantages such as loss of a resected testis from grasp and fragmentation of the specimen because of the excessive tension required for extraction through a thick body wall. The ring wound retractor laparoscopic port system was recently used in human and small animal surgery to perform laparoscopic-assisted procedures and retrieve large specimens from the abdomen. In the present case, the wound retractor was placed as the ventral port in the right flank through a minilaparotomy. Thereafter, the cap with the gas inlet and instrument port was connected. The other two ports were placed dorsally using 10-mm stainless steel cannulas. Grasping forcep was introduced through the ventral port, and the laparoscope and vessel-sealing devices were introduced through the dorsal ports. After the testis was resected, it was retrieved from the abdomen through the retractor without the grasping forceps jaw being released. This is the first case report describing the use of the wound retractor laparoscopic port system for standing cryptorchidectomy in a horse. This system can be a feasible and safe option for flank laparoscopy in horses, and it facilitates specimen retrieval from the abdominal cavity, but further studies should confirm this preliminary report.

Assessment of Intra- and Inter-observer Measurement Variability in a Radiographic Metacarpophalangeal Joint Osteophytosis Scoring System for the Horse.

The study evaluated the intra- and inter-observer measurement variability of an osteophytosis metacarpophalangeal joint scoring system. Ten (n = 10) dorso/palmar, latero/medial, and oblique views of equine metacarpophalangeal joints affected by osteoarthritis were examined. Nine assessment points were graded (scale: 0-3) twice by five veterinary students (inexperienced group, I) and four equine veterinary surgeons (expert group, E). The grades for each of the nine factors were summed to obtain the osteophytosis score. The variability between the two measurements was -2.04 ± 3.5, 95% CI -3.04 to -1.03 for the I group. For the E group, they were 0 ± 1.43, 95% CI -0.45 to 0.45. In the evaluation of the same radiographs, the I group had a coefficient of variability (CV) of 37.29%. The correlation was r = 0.90%. The CV between groups was 28.85%. The mean difference between the two observations was -0.03 ± 0.29 in the E group and 0.22 ± 0.77 in the I group. The I group showed a greater CV when the score was low (r = -0.78) compared to the E group, where the CV was independent of severity of osteophytosis (r = -0.47). The osteophytosis scoring system is an easily applicable and feasible system to be used by observers with different levels of experience, but inexpert observers may need additional training or may need to be helped by reference images. These data are validated by the low inter- and intra-observer measurement variability results in the E group. Therefore, the scoring system proposed seems to be a repeatable instrument applicable to the radiographic score of the severity of metacarpophalangeal joint osteoarthritis.

Palmar annular ligament desmotomy in horses with the Arthrex-Centerline™ : An ex-vivo study.

The aim of this study was to evaluate the use of a single-portal endoscopic desmotomy of the PAL with the use of Arthrex - Centerline™. Ten horse distal front limbs from horses free of PAL disease were prepared for tenoscopy of the digital flexor tendon sheath (DFTS). A dual-port endoscopic desmotomy with a hook knife was performed in 5 specimens (Group A) and single port Arthrex-Centerline™ Desmotomy was performed in another 5 specimens (Group B). The performing time, judgments of the surgeon, number of blade passages, and gross anatomy were evaluated. The performing time and surgeon judgments were significantly lower in Group B. No significant differences were assessed in number of passages to achieve a complete PAL resection and a gross anatomy evaluation. The use of Arthrex-Centerline™ is feasible for a PAL desmotomy procedure. It was faster with more handling ease compared with the free-hand double-portal desmotomy and allowed the same results in terms of number of passages to complete the release evaluated at gross anatomy.