Quiz Question

In Niida 2024 et al., on surgical residents and TPLO time, what trend was seen across the 3 years of residency training?

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Correct. TPLO duration dropped after YR-1 but remained stable between YR-2 and YR-3.
Incorrect. The correct answer is Improvement plateaued after YR-1.
TPLO duration dropped after YR-1 but remained stable between YR-2 and YR-3.

🔍 Key Findings

  • Resident involvement significantly increased TPLO surgery duration compared to cases performed by faculty surgeons (FS)-only. Residents required 54% more surgery time (GLSM, 153 min) than FS-only cases (GLSM, 99 min), representing a 1.54-fold increase.
  • The study did not report on short-term complication rates. No conclusions can be drawn from this source regarding complications between resident and faculty groups.
  • Bone plate contouring was not evaluated. The source does not provide data regarding contouring frequency or its comparison between groups.
  • Surgery duration significantly decreased after the first year of residency, but remained stable between second- and third-year residents. This was largely due to shorter tibial osteotomy durations, while arthroscopy times remained unchanged across residency years.
  • Meniscal treatment was performed in 80% of cases, and it was associated with increased surgical duration, but the study did not compare the frequency of medial meniscal release between resident and faculty cases.
  • The study did not evaluate osteotomy healing or revision surgery. Cases requiring immediate reoperation were excluded.
  • Bone union outcomes were not assessed at 8 weeks or any other time point.
  • The study concludes that resident participation significantly prolongs surgical time, but no data are provided regarding the effect on short-term clinical outcomes.

Niida

Veterinary Surgery

5

2024

The impact of surgery resident training on the duration of tibial plateau leveling osteotomy and outcomes in dogs

2024-5-VS-niida-3

Article Title: The impact of surgery resident training on the duration of tibial plateau leveling osteotomy and outcomes in dogs

Journal: Veterinary Surgery

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In Kuvaldina 2023 et al., on axillary lymph node excision, which of the following tools was essential for minimally invasive access to the axillary region?

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Correct. The study employed a single-incision laparoscopic (SILS) port with COâ‚‚ insufflation and a laparoscope to access the axillary region.
Incorrect. The correct answer is SILS port and laparoscope.
The study employed a single-incision laparoscopic (SILS) port with COâ‚‚ insufflation and a laparoscope to access the axillary region.

🔍 Key Findings

  • Endoscopic excisional biopsy of axillary lymph nodes was successfully performed in cadavers and clinical dogs with minimal complications.
  • The technique used a SILS port and COâ‚‚ insufflation through a small incision between the latissimus dorsi and superficial pectorals.
  • In 4 cadavers (6 limbs), mean time to remove axillary nodes was 33 minutes, and single nodes were found in 5/6 limbs.
  • In 3 clinical dogs, the procedure was successful in 2 cases; 1 required conversion to open surgery due to difficulty manipulating the node.
  • Accessory axillary nodes were successfully excised when present, located adherent to deep latissimus dorsi.
  • No cases developed lymphedema, pneumothorax, or major complications postoperatively.
  • Subjective benefits included better visualization, reduced dissection, and less postoperative morbidity than open techniques.
  • Study suggests MIS lymphadenectomy may improve staging accuracy and reduce complications, though larger studies are needed.

Kuvaldina

Veterinary Surgery

6

2023

Development of a minimally invasive endoscopic technique for excisional biopsy of the axillary lymph nodes in dogs

2023-6-VS-kuvaldina-1

Article Title: Development of a minimally invasive endoscopic technique for excisional biopsy of the axillary lymph nodes in dogs

Journal: Veterinary Surgery

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In Johnson 2022 et al., on PET implant outcomes, what fixation method was used for securing the implant to bone?

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Correct. This method was chosen for simplicity, adequate fixation, and prior validation in ex vivo testing.
Incorrect. The correct answer is Bi-cortical screws, spiked washers, and absorbable interference screws.
This method was chosen for simplicity, adequate fixation, and prior validation in ex vivo testing.

🔍 Key Findings

  • Only 2 of 10 PET implants were fully intact and functional at 6 months post-op.
  • Owner-reported function (LOAD scores) improved by 51.7% (p = .008) over 6 months.
  • Gait asymmetry improved by 86% (p = .002) postoperatively.
  • Implant failure occurred in the midbody of the PET device, suggesting fatigue as a failure mechanism.
  • One dog (10%) developed implant infection, necessitating implant removal.
  • Implant fixation method (screws + washers + interference screw) was mechanically adequate and technically simple.
  • Partially intact implants (4/10) still showed improved clinical outcomes, despite structural compromise.
  • Midbody tearing and lack of long-term integrity prohibit continued use of this PET implant in CCL repair.

Johnson

Veterinary Surgery

8

2022

Outcome of cranial cruciate ligament replacement with an enhanced polyethylene terephthalate implant in the dog: A pilot clinical trial

2022-8-VS-johnson-5

Article Title: Outcome of cranial cruciate ligament replacement with an enhanced polyethylene terephthalate implant in the dog: A pilot clinical trial

Journal: Veterinary Surgery

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In Ritson 2025 et al., on feline hilar lobectomy sealants, which of the following techniques demonstrated the **highest observed incidence of leakage** at 40 cm Hâ‚‚O airway pressure?

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Correct. Only one leakage occurred in the stapler group, at 40 cm Hâ‚‚O, while PLL and DS clips had no failures.
Incorrect. The correct answer is Linear stapler.
Only one leakage occurred in the stapler group, at 40 cm Hâ‚‚O, while PLL and DS clips had no failures.

🔍 Key Findings

  • No leakage occurred using pretied ligature loops (PLL) or double-shank (DS) titanium clips up to 40 cm Hâ‚‚O airway pressure.
  • 1/10 stapled lobes leaked at supraphysiologic pressure (40 cm Hâ‚‚O), but this was not statistically significant (p = .33).
  • All techniques sealed effectively under physiologic and supraphysiologic pressures in cadaveric feline lungs.
  • PLL and DS clips required less working space than staplers, making them more practical for small thoracic cavities.
  • DS titanium clips offer enhanced security due to dual shanks and tissue-gripping design, reducing clip slippage.
  • Leak testing was cyclic and submerged, simulating physiologic ventilation and allowing robust evaluation.
  • Stapling failure occurred along the staple line, highlighting risks of air leakage due to staple misalignment or poor hilar access.
  • PLL and DS clips may be cost-effective and efficient alternatives for open or minimally invasive feline lung lobectomy.

Ritson

Veterinary Surgery

7

2025

Ex vivo comparative evaluation of feline hilar lung lobectomy using linear stapler, pretied ligature loop, and double-shank titanium clips

2025-7-VS-ritson-1

Article Title: Ex vivo comparative evaluation of feline hilar lung lobectomy using linear stapler, pretied ligature loop, and double-shank titanium clips

Journal: Veterinary Surgery

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In Williams 2024 et al., on adrenaline use in maxillary nerve blocks, what was the standard volume of local anesthetic injected per side during the block?

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Correct. A fixed dose of 0.5 mL was used per side regardless of bodyweight.
Incorrect. The correct answer is 0.5 mL per side.
A fixed dose of 0.5 mL was used per side regardless of bodyweight.

🔍 Key Findings

  • The addition of adrenaline (0.00198%) to bilateral maxillary nerve blocks significantly reduced intraoperative hemorrhage in dogs undergoing sharp staphylectomy (median reduction: 77.1%).
  • Normalized hemorrhage (g/kg) and total hemorrhage (g) were significantly lower in the adrenaline group (p = .021 and p = .013, respectively).
  • Surgeon-assessed hemorrhage scores were also significantly lower in the adrenaline group (median 2 vs. 3; p = .029), indicating improved surgical visibility.
  • No adverse effects (e.g. tachycardia, arrhythmia, or hypertension) were observed with adrenaline administration.
  • A standardized intraoral approach to the maxillary nerve block was used with 0.5 mL per side regardless of dog size.
  • Breed effect observed: English Bulldogs had higher normalized hemorrhage, possibly due to anatomical variation or underdosing relative to size.
  • Adrenaline may also prolong local anesthetic action and reduce blood aspiration risks, though this was not directly measured.
  • The study supports the routine inclusion of adrenaline in maxillary nerve blocks for staphylectomy in BOAS patients to improve surgical field and reduce bleeding.

Williams

Veterinary Surgery

8

2024

Evaluation of the addition of adrenaline in a bilateral maxillary nerve block to reduce hemorrhage in dogs undergoing sharp staphylectomy for brachycephalic obstructive airway syndrome. A prospective, randomized study

2024-8-VS-williams-2

Article Title: Evaluation of the addition of adrenaline in a bilateral maxillary nerve block to reduce hemorrhage in dogs undergoing sharp staphylectomy for brachycephalic obstructive airway syndrome. A prospective, randomized study

Journal: Veterinary Surgery

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In Smith 2024 et al., on ergonomics and preferences in veterinary laparoscopy, which subgroup of surgeons experienced significantly greater difficulty with endoscopic staplers?

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Correct. Left-handed users reported more difficulty due to right-hand-dominant designs.
Incorrect. The correct answer is Left-handed surgeons.
Left-handed users reported more difficulty due to right-hand-dominant designs.

🔍 Key Findings

  • Surgeons with smaller glove sizes experienced more difficulty using laparoscopic instruments, especially endoscopic staplers, cup biopsy forceps, and vessel sealing devices.
  • Endoscopic stapler was rated the most difficult instrument, with a median difficulty score of 4/10 and 25% usage difficulty.
  • Female surgeons reported significantly more difficulty with several instruments due to smaller glove size.
  • Reusable instruments were preferred over disposable ones for all tasks.
  • Pistol grips were preferred for grasping/retracting and fine dissection, while axial grips were preferred for suturing/knot tying.
  • Articulating handles were consistently associated with increased reported difficulty, especially with scissors and cup biopsy forceps.
  • Left-handed surgeons had more difficulty operating endoscopic staplers, suggesting limited design inclusivity.
  • Surgeons in academic settings reported more difficulty with laparoscopic maneuvers than those in private practice.

Smith

Veterinary Surgery

3

2024

Variables affecting surgeons’ use of, and preferences for, instrumentation in veterinary laparoscopy

2024-3-VS-smith-5

Article Title: Variables affecting surgeons’ use of, and preferences for, instrumentation in veterinary laparoscopy

Journal: Veterinary Surgery

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In Niida 2024 et al., on surgical residents and TPLO time, how much longer did residents take compared to faculty surgeons (FS)?

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Correct. Resident surgeries took 1.54x the time of FS cases (153 vs 99 min).
Incorrect. The correct answer is 54% longer.
Resident surgeries took 1.54x the time of FS cases (153 vs 99 min).

🔍 Key Findings

  • Resident involvement significantly increased TPLO surgery duration compared to cases performed by faculty surgeons (FS)-only. Residents required 54% more surgery time (GLSM, 153 min) than FS-only cases (GLSM, 99 min), representing a 1.54-fold increase.
  • The study did not report on short-term complication rates. No conclusions can be drawn from this source regarding complications between resident and faculty groups.
  • Bone plate contouring was not evaluated. The source does not provide data regarding contouring frequency or its comparison between groups.
  • Surgery duration significantly decreased after the first year of residency, but remained stable between second- and third-year residents. This was largely due to shorter tibial osteotomy durations, while arthroscopy times remained unchanged across residency years.
  • Meniscal treatment was performed in 80% of cases, and it was associated with increased surgical duration, but the study did not compare the frequency of medial meniscal release between resident and faculty cases.
  • The study did not evaluate osteotomy healing or revision surgery. Cases requiring immediate reoperation were excluded.
  • Bone union outcomes were not assessed at 8 weeks or any other time point.
  • The study concludes that resident participation significantly prolongs surgical time, but no data are provided regarding the effect on short-term clinical outcomes.

Niida

Veterinary Surgery

5

2024

The impact of surgery resident training on the duration of tibial plateau leveling osteotomy and outcomes in dogs

2024-5-VS-niida-1

Article Title: The impact of surgery resident training on the duration of tibial plateau leveling osteotomy and outcomes in dogs

Journal: Veterinary Surgery

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In Mullins 2023 et al., on thoracolumbar pin placement, which technique had zero intraoperative technique deviations?

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Correct. 3DPGs had no intraoperative technique deviations, whereas 6 deviations occurred using the FHP technique.
Incorrect. The correct answer is 3D-printed drill guides (3DPG).
3DPGs had no intraoperative technique deviations, whereas 6 deviations occurred using the FHP technique.

🔍 Key Findings

  • Both free-hand probing (FHP) and 3D-printed guides (3DPG) enabled accurate spinal pin placement, with 87.5% vs 96.4% of pins graded as optimal (Grade I).
  • 3DPGs had fewer intraoperative deviations (0/56 pins) compared to 6/56 with the FHP technique.
  • No pins using either method fully breached the medial vertebral canal (Grade IIb) — a critical safety outcome.
  • Pins placed using 3DPGs required less time overall (mean 2.6 min) than FHP (mean 4.5 min).
  • FHP required specific experience and has a learning curve, whereas 3DPG use requires CAD software and 3D printing access.
  • FHP had more lateral canal violations (Grade IIIa: 4/56 vs 0/56 for 3DPG), suggesting slightly less precision.
  • Both techniques were safe, and all deviations were recognized and corrected intraoperatively.
  • 3DPGs may offer practical advantages in clinical settings lacking surgical expertise, while FHP allows immediate intervention without 3D printing delay.

Mullins

Veterinary Surgery

5

2023

Accuracy of pin placement in the canine thoracolumbar spine using a free-hand probing technique versus 3D-printed patient-specific drill guides: An ex-vivo study

2023-5-VS-mullins-1

Article Title: Accuracy of pin placement in the canine thoracolumbar spine using a free-hand probing technique versus 3D-printed patient-specific drill guides: An ex-vivo study

Journal: Veterinary Surgery

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In Rocheleau 2023 et al., on shoulder stabilization, what was the primary advantage of the suture-toggle technique compared to bone anchors?

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Correct. Suture-toggle stabilization was successful in all specimens and had fewer technical issues than the bone anchor group.
Incorrect. The correct answer is Simpler technique with fewer failures.
Suture-toggle stabilization was successful in all specimens and had fewer technical issues than the bone anchor group.

🔍 Key Findings

  • Arthroscopically assisted stabilization with an IAD was feasible in cadaveric canine shoulders using both bone anchor and suture-toggle techniques.
  • Suture-toggle repair was successfully performed in all specimens, while bone anchors could not be deployed in 3/10 shoulders, indicating lower feasibility.
  • Median surgical time was shorter for the suture-toggle group (25.5 min) compared to the anchor group (37.3 min).
  • Postoperative abduction angles returned to baseline in the anchor group, while the suture-toggle group had slightly reduced angles, suggesting possible overtightening.
  • Violation of the articular surface occurred in 2 anchor specimens and 1 suture-toggle specimen, but none were considered likely to be clinically significant.
  • Overall targeting accuracy using the IAD was 88%, supporting its utility in guiding tunnel/anchor placement.
  • CT measurements showed acceptable bone stock and insertion angles, but anchor insertion angles were lower than optimal for mechanical pullout strength.
  • Suture-toggle technique was considered simpler and more consistent, with fewer complications and faster execution than anchor placement.

Rocheleau

Veterinary Surgery

4

2023

Ex vivo evaluation of arthroscopically assisted shoulder stabilization in dogs using an intra-articular aiming device

2023-4-VS-rocheleau-1

Article Title: Ex vivo evaluation of arthroscopically assisted shoulder stabilization in dogs using an intra-articular aiming device

Journal: Veterinary Surgery

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In Larose 2024 et al., on fluorescence cholangiography, what ICG dose and timing produced the highest cystic duct-to-liver contrast during laparoscopic imaging?

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Correct. Low-dose ICG at 3 h pre-op yielded the best target-to-background contrast (up to 4:1).
Incorrect. The correct answer is 0.05 mg/kg at 3 hours pre-op.
Low-dose ICG at 3 h pre-op yielded the best target-to-background contrast (up to 4:1).

🔍 Key Findings

  • Near-infrared fluorescence cholangiography (NIRFC) was feasible and safe in all healthy dogs studied, with no major adverse effects noted.
  • Low-dose ICG (0.05 mg/kg) at 3 h pre-op achieved the highest target-to-background (cystic duct-to-liver) contrast ratio, reaching nearly 4:1 at 280 minutes.
  • Early imaging (time 0) favored low-dose ICG for optimal cystic duct visualization; high-dose ICG led to excessive liver fluorescence and reduced contrast.
  • Visualization of biliary tree occurred within 10–20 min post-injection regardless of dose, but longer delays improved background clearance and contrast.
  • No significant cardiovascular or histamine-related side effects were observed with either dose of ICG.
  • Repeated ICG injections showed minimal residual fluorescence when using a >72 h washout period; shorter intervals caused mild carryover in high-dose groups.
  • Surgeon scoring matched contrast ratios, confirming clinical relevance of imaging outcomes.
  • Recommended dose for laparoscopic imaging: 0.05 mg/kg ICG given 3–5 h before surgery, or at premedication for urgent cases.

Larose

Veterinary Surgery

4

2024

Near-infrared fluorescence cholangiography in dogs: A pilot study

2024-4-VS-larose2-1

Article Title: Near-infrared fluorescence cholangiography in dogs: A pilot study

Journal: Veterinary Surgery

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Quiz Results

Topic: Surgical Techniques & Planning
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