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  • 1
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    Superficial anatomic landmarks can be used to triangulate the location of canine peripheral lymphocentrums: superficial cervical, axillary, and superficial inguinal
    American Veterinary Medical Association (AVMA) ; 2023
    In:  Journal of the American Veterinary Medical Association ( 2023-01-25), p. 1-10
    Details
    In: Journal of the American Veterinary Medical Association, American Veterinary Medical Association (AVMA), ( 2023-01-25), p. 1-10
    Abstract: To utilize the geometry of superficial anatomic landmarks to guide incisional location and orientation for peripheral lymphadenectomy, document deep anatomic landmarks for lymphocentrum identification, and develop novel surgical approaches to the superficial cervical, axillary, and superficial inguinal lymphocentrums in dogs. ANIMALS 12 canine cadavers. PROCEDURES 2 cadavers were used for a pilot investigation to determine optimal body positioning, select superficial anatomic landmarks for lymphocentrum identification, and evaluate novel surgical approaches to the 3 lymphocentrums. These lymphocentrums were then dissected in 10 additional cadavers using these novel surgical approaches. Measurements of the distances from lymphocentrum to landmark and between landmarks were obtained for each lymphocentrum. Deep anatomic landmarks were recorded for each dissection. The mean and SD were calculated for each measurement and used to develop geometric guidelines for estimating the location of each lymphocentrum for these surgical approaches. RESULTS Each peripheral lymphocentrum was found in the same location relative to the respective, predetermined, superficial, anatomic boundaries in all cadavers. Briefly, the superficial landmarks to each lymphocentrum were as follows: (1) superficial cervical: wing of atlas, acromion process of scapula, greater tubercle of humerus; (2) axillary: caudal border of transverse head of superficial pectoral muscle, caudal triceps muscle, ventral midline; and (3) superficial inguinal: origin of pectineus muscle, ipsilateral inguinal mammary gland, ventral midline. The proposed superficial and deep surgical landmarks were identified within every cadaver. The previously undescribed surgical approaches were effective for lymphocentrum identification. CLINICAL RELEVANCE Anatomic landmarks provided in this study may help reduce surgical time and tissue trauma during peripheral lymphadenectomy in dogs. This study was also the first to describe a surgical approach to the superficial inguinal lymphocentrum and ventral approaches to the superficial cervical and axillary lymphocentrums and provided previously unpublished anatomic landmarks for a lateral approach to the superficial cervical lymphocentrum.
    Type of Medium: Online Resource
    ISSN: 0003-1488
    URL: Article
    DOI: 10.2460/javma.22.11.0518
    Language: Unknown
    Publisher: American Veterinary Medical Association (AVMA)
    Publication Date: 2023
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  • 2
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    Geometric, landmark-guided technique reduces tissue trauma, surgery time, and subjective difficulty for canine peripheral lymphadenectomies: an educational crossover study
    American Veterinary Medical Association (AVMA) ; 2023
    In:  Journal of the American Veterinary Medical Association ( 2023-07-31), p. 1-9
    Details
    In: Journal of the American Veterinary Medical Association, American Veterinary Medical Association (AVMA), ( 2023-07-31), p. 1-9
    Abstract: To compare the effect of a geometric, landmark-guided lymphadenectomy (LL) approach to peripheral lymph nodes (LNs) on successful LN identification, surgical time, tissue trauma, and ease of LN identification compared to standard lymphadenectomy (SL) and methylene blue–guided lymphadenectomy (MBL). SAMPLE 18 adult, mixed-breed canine cadavers operated on by 7 veterinarians and 5 fourth-year veterinary students between July 23 and October 12, 2022. METHODS Participants were provided standardized, publicly available materials regarding the anatomy and surgical techniques for SL of 3 peripheral lymphocentrums: superficial cervical, axillary (ALN), and superficial inguinal (SILN). Participants performed the 3 SLs unilaterally on canine cadavers. Thereafter, they were randomly assigned to 2 crossover groups: MBL and LL. All dissections were separated by at least 2 weeks for each participant. Primary outcome measures included successful LN identification, surgical time, tissue trauma scores, and subjective difficulty. RESULTS Successful LN identification was highest with LL (86%) compared to SL (69%) and MBL (67%). Subjective difficulty scores were reduced with LL for SILN dissections. Tissue trauma scores were reduced when using LL for ALN and SILN compared to MBL and SL. Time to LN identification was reduced for ALN with LL. No significant differences were observed between MBL and SL, or for the superficial cervical dissections. CLINICAL RELEVANCE Peripheral lymphadenectomies are time consuming and difficult for veterinarians in early stages of surgical training. Little surgical guidance is provided within current literature. Geometric, landmark-guided lymphadenectomies may improve LN identification success and reduce surgical time, tissue trauma, and procedure difficulty, which could encourage their clinical application.
    Type of Medium: Online Resource
    ISSN: 0003-1488
    URL: Article
    DOI: 10.2460/javma.23.04.0206
    Language: Unknown
    Publisher: American Veterinary Medical Association (AVMA)
    Publication Date: 2023
    detail.hit.zdb_id: 2904887-4
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  • 3
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    Feasibility of laparoscopic liver lobectomy in dogs
    Wiley ; 2021
    In:  Veterinary Surgery Vol. 50, No. S1 ( 2021-07)
    Details
    In: Veterinary Surgery, Wiley, Vol. 50, No. S1 ( 2021-07)
    Abstract: To determine the feasibility of laparoscopic liver lobectomy (LLL) in dogs by using canine cadavers and to describe the clinical application in dogs with liver disease. Study design Ex vivo experiment and descriptive case series. Sample population Twelve canine cadavers and six client‐owned dogs. Methods Cadavers underwent LLL with an endoscopic stapler. The percentage of liver lobe resected was determined by volume. The distance from the staple line to hilus was measured. Medical records of dogs undergoing LLL were reviewed. Results In cadavers ≤15 kg, left lateral lobectomy completeness was 87.3% (84.6%–96.6%), and remaining median (interquartile range) hilar length was 1 cm (0.25‐1.75). Left medial lobectomy completeness was 72.5% (66.7%–80%), and remaining hilar length was 1.6 cm (0.47‐1.75). Central division resection completeness was 68.3% (60%–92.9%), and remaining hilar length was 2.7 cm (0.8‐5). Laparoscopic liver lobectomy was not feasible for right division lobes and in cadavers 〉 15 kg. Five dogs with peripheral quadrate or left lateral lobe masses underwent stapled, partial laparoscopic lobectomy (30%–90%). One dog underwent stapled, left lateral lobectomy (90%) after open procedure conversion. Histopathological diagnoses included hepatocellular carcinoma (3), nodular hyperplasia (1), biliary cyst adenoma (1), and fibrosis (1). Conclusion Laparoscopic liver lobectomy of the left and central divisions is feasible in cadavers ≤15 kg with an endoscopic stapler. Partial LLL of the left and central divisions is feasible in select dogs with liver disease. Clinical significance Laparoscopic liver lobectomy may be a viable alternative to laparotomy in small‐to‐medium size dogs with peripheral liver masses of the left and central divisions.
    Type of Medium: Online Resource
    ISSN: 0161-3499 , 1532-950X
    URL: Issue
    URL: Article
    DOI: 10.1111/vsu.v50.S1
    DOI: 10.1111/vsu.13566
    Language: English
    Publisher: Wiley
    Publication Date: 2021
    detail.hit.zdb_id: 1491071-8
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  • 4
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    Comparison of intestinal leak pressure between cadaveric canine and commercial synthetic intestinal tissue that did and did not undergo enterotomy
    American Veterinary Medical Association (AVMA) ; 2020
    In:  American Journal of Veterinary Research Vol. 81, No. 10 ( 2020-10), p. 827-831
    Details
    In: American Journal of Veterinary Research, American Veterinary Medical Association (AVMA), Vol. 81, No. 10 ( 2020-10), p. 827-831
    Abstract: To compare initial leak pressure (ILP) between cadaveric canine and synthetic small intestinal segments that did and did not undergo enterotomy. SAMPLE Eight 8-cm grossly normal jejunal segments from 1 canine cadaver and eight 8-cm synthetic small intestinal segments. PROCEDURES Intestinal segments were randomly assigned to undergo enterotomy (6 cadaveric and 6 synthetic segments) or serve as untreated controls (2 cadaveric and 2 synthetic segments). For segments designated for enterotomy, a 2-cm full-thickness incision was created along the antimesenteric border. The incision was closed in a single layer with 4-0 suture in a simple continuous pattern. Leak testing was performed with intestinal segments occluded at both ends and infused with dilute dye solution (999 mL/h) until the solution was observed leaking from the suture line or serosal tearing occurred. Intraluminal pressure was continuously monitored. The ILP at construct failure was compared between cadaveric and synthetic control segments and between cadaveric and synthetic enterotomy segments. RESULTS Mean ± SD ILP did not differ significantly between cadaveric (345.11 ± 2.15 mm Hg) and synthetic (329.04 ± 24.69 mm Hg) control segments but was significantly greater for cadaveric enterotomy segments (60.77 ± 15.81 mm Hg), compared with synthetic enterotomy segments (15.03 ± 6.41 mm Hg). CONCLUSIONS AND CLINICAL RELEVANCE Leak testing should not be used to assess the accuracy or security of enterotomy suture lines in synthetic intestinal tissue. Synthetic intestinal tissue is best used for students to gain confidence and proficiency in performing enterotomies before performing the procedure on live animals.
    Type of Medium: Online Resource
    ISSN: 0002-9645
    URL: Article
    DOI: 10.2460/ajvr.81.10.827
    Language: Unknown
    Publisher: American Veterinary Medical Association (AVMA)
    Publication Date: 2020
    detail.hit.zdb_id: 2056942-7
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  • 5
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    Initial leak pressures of four anastomosis techniques in cooled cadaveric canine jejunum
    Wiley ; 2020
    In:  Veterinary Surgery Vol. 49, No. 3 ( 2020-04), p. 480-486
    Details
    In: Veterinary Surgery, Wiley, Vol. 49, No. 3 ( 2020-04), p. 480-486
    Abstract: To compare the effectiveness of four different intestinal anastomosis techniques at preventing leakage after enterectomy. Study design Experimental study. Sample population Grossly normal jejunal segments (N = 70) from three fresh canine cadavers. Methods Eight‐centimeter cooled canine cadaveric jejunal segments were randomly assigned to a control group (six segments) and four treatment groups (16 segments each [two segments/anastomotic construct]): (1) handsewn anastomosis (HSA), (2) barbed suture anastomosis (B‐HSA), (3) stapled functiona l end‐to‐end anastomosis (SFEEA), and (4) stapled functional end‐to‐end anastomosis with an oversew (SFEEA‐O). Control segments and anastomotic constructs were infused intraluminally to the point of leakage. Initial leak pressures were recorded and compared. Results Initial leak pressures (median + range) for jejunal control segments, HSA, B‐HSA, SFEEA, and SFEEA‐O were 331.88 mmHg (range, 315.34–346.64), 35.17 (20.29–56.24), 24.99 (6.08–38.64), 28.77 (18.80–85.09), and 35.92 (12.05–80.71), respectively. No difference was detected between leak pressures of anastomosed segments ( P = .35), all of which were more variable and lower than those of intact segments. Conclusion No difference in initial leak pressures was detected between the four anastomosis techniques tested in cooled canine cadaveric jejunum. Clinical significance All four anastomosis techniques evaluated in this study may be suitable in dogs.
    Type of Medium: Online Resource
    ISSN: 0161-3499 , 1532-950X
    URL: Issue
    URL: Article
    DOI: 10.1111/vsu.v49.3
    DOI: 10.1111/vsu.13392
    Language: English
    Publisher: Wiley
    Publication Date: 2020
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  • 6
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    Intestinal surgery in small animals: historical foundations, current thinking, and future horizons
    Wiley ; 2019
    In:  Veterinary Surgery Vol. 48, No. 7 ( 2019-10), p. 1171-1180
    Details
    In: Veterinary Surgery, Wiley, Vol. 48, No. 7 ( 2019-10), p. 1171-1180
    Abstract: Intestinal wounds require precise closure after intestinal biopsy, enterotomy, or enterectomy in small animals. Preexisting factors such as intra‐abdominal sepsis and hypoalbuminemia as well as poor surgical technique increase the risk of intestinal dehiscence, with considerable negative impact on patient morbidity and mortality. Live dog studies have demonstrated the dangers of mucosal eversion especially in the septic abdomen. Approximating patterns preserve luminal diameter, heal optimally, and have equal bursting strength compared with inverting patterns after 24 hours. Simple interrupted and simple continuous suture patterns and disposable skin staples are established alternatives for manual wound closure. Knotless quilled suture currently used in laparoscopic gastropexy techniques shows bursting strength equal to monofilament sutures in dog cadaveric intestine. Dehiscence rates with hand sewn vs titanium automated stapling anastomosis are similar in uncomplicated cases; however, auto stapling devices may be the preferred method of anastomosis when preexisting abdominal sepsis is present and when patient size allows it. Regardless of the technique, current standard of care involves leak testing and omental wrapping, followed by early postoperative feeding. The past decade has ushered in an exciting new era of laparoscopic assisted techniques that have the potential to reduce postoperative pain and patient morbidity. An understanding of these applications will establish the future of minimally invasive small animal intestinal surgery for veterinary specialists. In summary, surgeons have a variety of methods at their disposal for optimal clinical outcome in small animal intestinal surgery.
    Type of Medium: Online Resource
    ISSN: 0161-3499 , 1532-950X
    URL: Issue
    URL: Article
    DOI: 10.1111/vsu.v48.7
    DOI: 10.1111/vsu.13275
    Language: English
    Publisher: Wiley
    Publication Date: 2019
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  • 7
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    In vitro holding strength of the laparoscopic Miller's knot compared with open Miller's knot, open surgeon's throw, and laparoscopic surgeon's throw in a vascular pedicle model
    Wiley ; 2020
    In:  Veterinary Surgery Vol. 49, No. 8 ( 2020-12), p. 1563-1570
    Details
    In: Veterinary Surgery, Wiley, Vol. 49, No. 8 ( 2020-12), p. 1563-1570
    Abstract: To compare in vitro knot holding strength of the laparoscopic Miller's knot (LMK), open Miller's knot (MK), open surgeon's throw (Sx), and laparoscopic surgeon's throw (LSx) in a vascular pedicle model when used as the first throw for vascular ligation. Study design Experimental study. Sample population Ten constructs each of the Miller's knot and surgeon's throw performed openly and laparoscopically with 2‐0 polyglyconate suture. Methods Knot holding strengths of the LMK, MK, LSx, and Sx knots were evaluated on balloon dilation catheters used as vascular pedicle models. Laparoscopic knots were tied in a laparoscopic box trainer. Knot constructs were pressure tested to failure. Results were compared by Kruskal‐Wallis and Steel‐Dwass comparisons. Results Both MK and LMK had mean leakage pressures above 300 mm Hg. The MK leaked at higher pressure than all other knots, including the LMK ( P   〈  .001). The LMK leaked at greater pressures compared with the Sx and the LSx ( P   〈  .001). No difference was detected between leaking pressures of the Sx and the LSx ( P = .226), with both leaking at pressures below 40 mm Hg. Conclusion The LMK created a more secure first throw compared with the Sx and leaked at supraphysiologic pressures. Clinical significance The LMK has excellent knot holding strength on a vascular pedicle model and may be further evaluated for clinical application.
    Type of Medium: Online Resource
    ISSN: 0161-3499 , 1532-950X
    URL: Issue
    URL: Article
    DOI: 10.1111/vsu.v49.8
    DOI: 10.1111/vsu.13479
    Language: English
    Publisher: Wiley
    Publication Date: 2020
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  • 8
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    Laparoscopic ultrasonography of the liver is feasible and safe in dogs
    American Veterinary Medical Association (AVMA) ; 2023
    In:  American Journal of Veterinary Research ( 2023-08-28), p. 1-7
    Details
    In: American Journal of Veterinary Research, American Veterinary Medical Association (AVMA), ( 2023-08-28), p. 1-7
    Abstract: To describe the feasibility and technique for performing laparoscopic ultrasound (LUS) of the liver in dogs. ANIMALS 12 client-owned dogs presenting for elective laparoscopic surgery from January 1, 2022, to October 31, 2022. METHODS Laparoscopic exploration and LUS of the liver were performed in all dogs. Dogs were positioned in reverse Trendelenburg and laterally rotated to facilitate access to all liver lobes. Time to perform laparoscopic exploration and LUS, ability to visualize and access each liver lobe entirely, and any complications were recorded. Each dog underwent an elective laparoscopic procedure. The surgeon completed a National Aeronautics and Space Administration Task Load Index (NASA-TLX) questionnaire after surgery. RESULTS Mean body weight was 25.9 kg (SD, ± 4.1 kg; range, 5.7 to 62 kg). All liver lobes were scanned to the level of the hilus in 10/12 dogs. In 2 dogs, the caudate lobe could not be completely imaged. Median time to perform LUS was 9 minutes (IQR, 5 to 16.5 minutes), and median NASA-TLX score was 9/100 (IQR, 6.3 to 20). There was a significantly strong negative correlation between time to perform LUS ( r = −0.77; P = .0037) and NASA-TLX score ( r = −0.84; P = .0006) with trial number. Minor complications occurred in 2 dogs during laparoscopic exploration. No complications occurred during LUS. CLINICAL RELEVANCE LUS was feasible and safe in all dogs. The right lateral and caudate lobes were occasionally challenging to access. Technical demand and time to perform LUS improved with experience, suggesting a learning curve. Evaluation of LUS in dogs with clinical disease is warranted.
    Type of Medium: Online Resource
    ISSN: 0002-9645 , 1943-5681
    URL: Article
    DOI: 10.2460/ajvr.23.05.0088
    Language: Unknown
    Publisher: American Veterinary Medical Association (AVMA)
    Publication Date: 2023
    detail.hit.zdb_id: 2056942-7
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  • 9
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    Anatomic and volumetric characterization of the cisterna chyli using CT lymphangiography and computer‐assisted design software in dogs with idiopathic chylothorax
    Wiley ; 2020
    In:  Veterinary Radiology & Ultrasound Vol. 61, No. 3 ( 2020-05), p. 312-321
    Details
    In: Veterinary Radiology & Ultrasound, Wiley, Vol. 61, No. 3 ( 2020-05), p. 312-321
    Abstract: The objectives of this retrospective, observational study were to characterize the anatomical features of the cisterna chyli (CC) in a cohort of dogs diagnosed with idiopathic chylothorax that underwent CT lymphangiography (CTLa), and to evaluate the feasibility of computer‐assisted design (CAD) software to quantify volumetric measurements of the CC. Twenty‐three client‐owned dogs with idiopathic chylothorax were included. Additionally, CTLa was performed in three canine cadavers to assess the ability of CAD software to accurately acquire volumetric measurements. Injection sites, attenuation values, anatomic location, dimensions, and aortic diameter to CC ratio (Ao:CC) were recorded. Video records of video‐assisted thoracic surgery (VATS) thoracic duct ligation (TDL) were reviewed in eight out of 23 dogs to compare operative and CTLa findings. The CC was dorsal and right‐sided in 18 out of 23 dogs, located between L1 and L4 in 21 dogs, and extended as far cranially as T11 in two dogs. The median measurements for length, height, and width were 150.0, 5.5, and 13.3 mm, respectively. Median total volume was 1.82 mL. Median volumes to the right and left of the aorta were 1.46 and 0.49 mL, respectively ( P  = .014). Median total CC volume to body weight ratio (CC:bw) was 0.07 mL/kg. The presence of an intrathoracic CC was observed intraoperatively in six out of eight cases that underwent VATS TDL. Findings supported the use of CTLa and CAD as feasible methods for characterizing the CC in dogs diagnosed with chylothorax. These methods may facilitate interventional planning involving the CC such as embolization.
    Type of Medium: Online Resource
    ISSN: 1058-8183 , 1740-8261
    URL: Issue
    URL: Article
    DOI: 10.1111/vru.v61.3
    DOI: 10.1111/vru.12851
    Language: English
    Publisher: Wiley
    Publication Date: 2020
    detail.hit.zdb_id: 2142058-0
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  • 10
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    Dogs ≥ five years of age at the time of congenital extrahepatic portosystemic shunt diagnosis have better long-term outcomes with surgical attenuation than with medical management alone
    American Veterinary Medical Association (AVMA) ; 2022
    In:  Journal of the American Veterinary Medical Association Vol. 260, No. 7 ( 2022-04-01), p. 758-764
    Details
    In: Journal of the American Veterinary Medical Association, American Veterinary Medical Association (AVMA), Vol. 260, No. 7 ( 2022-04-01), p. 758-764
    Abstract: To determine the outcome in dogs diagnosed with congenital extrahepatic portosystemic shunts (EHPSS) at ≥ 5 years of age treated with medical management only (M) or with surgical attenuation (S). The hypothesis was that dogs undergoing surgical attenuation would have a longer survival time than dogs undergoing medical management only. ANIMALS 351 dogs definitively diagnosed with EHPSS at ≥ 5 years of age. PROCEDURES Medical records from 2009 to 2019 at 16 veterinary teaching hospitals were evaluated. Data collected included signalment, clinical signs at diagnosis, clinicopathologic data, surgical and medical treatments, shunt morphology, clinical signs and medical treatments at 6 to 12 months after diagnosis, and survival time. RESULTS 351 dogs (M, 119 [33.9%]; S, 232 [66.1%] ) were included in the study. Survival time was longer with surgery than medical management (hazard ratio, 4.2; M, 3.4 years; S, 10.9 years). Continued clinical signs at 6 to 12 months after diagnosis were more common with medical management (M, 40% [33/88]; S, 14% [21/155] ). Continued medical treatments at 6 to 12 months after diagnosis were more common in the medical management group (M, 78% [69/88]; S, 34% [53/155] ). Perioperative mortality rate was 7.3%. CLINICAL RELEVANCE Dogs diagnosed at ≥ 5 years of age with EHPSS have significantly better survival times and fewer clinical signs with surgical attenuation, compared with medical management. Older dogs have similar surgical mortality rates to dogs of all ages after surgical EHPSS attenuation.
    Type of Medium: Online Resource
    ISSN: 0003-1488
    URL: Article
    DOI: 10.2460/javma.21.09.0417
    Language: Unknown
    Publisher: American Veterinary Medical Association (AVMA)
    Publication Date: 2022
    detail.hit.zdb_id: 2904887-4
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