Quiz Question

In Sadowitz 2023 et al., on screw angle & speed, which factor **alone** was not associated with increased transcortical fracture (TCF) risk?

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Correct. Increased screw speed alone did not raise TCF risk unless combined with off-axis insertion.
Incorrect. The correct answer is Coaxial insertion at 1350 rpm.
Increased screw speed alone did not raise TCF risk unless combined with off-axis insertion.

🔍 Key Findings

  • TCF risk increased significantly with 10° insertion angle at both 650 rpm (12.5%) and 1350 rpm (17.5%), compared to 0% in the control group (0° at 650 rpm).
  • Hand insertion at 10° angle resulted in only 3.75% TCF rate, suggesting lower insertion speed reduces risk.
  • No TCFs occurred when screws were inserted coaxially (0°) at either 650 or 1350 rpm, indicating angle is a critical factor.
  • Screw speed alone did not increase TCF risk unless combined with off-axis insertion.
  • Radiographically detectable TCFs were only considered; actual rates may be higher with direct bone inspection.
  • Cutting flutes engaging undrilled bone during off-axis insertion likely contribute to TCF formation.
  • Clinical implication: Ensure screws are inserted coaxially and at lower speeds to reduce TCF risk during procedures like TPLO.
  • Statistically significant differences were found between control and high-angle insertion groups: Group C (p = .001), Group E (p < .001).

Sadowitz

Veterinary Surgery

8

2023

Effect of screw insertion angle and speed on the incidence of transcortical fracture development in a canine tibial diaphyseal model

2023-8-VS-sadowitz-1

Article Title: Effect of screw insertion angle and speed on the incidence of transcortical fracture development in a canine tibial diaphyseal model

Journal: Veterinary Surgery

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In Parlier 2024 et al., on insufflation effects on portal pressure in dogs, what clinical recommendation did the authors make regarding insufflation pressure?

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Correct. Authors recommended using the minimum insufflation pressure necessary to visualize the abdomen.
Incorrect. The correct answer is Use lowest pressure to allow visualization.
Authors recommended using the minimum insufflation pressure necessary to visualize the abdomen.

🔍 Key Findings

  • Portal pressure increased proportionally with insufflation pressure: 38% at 6 mmHg, 95% at 10 mmHg, and 175% at 14 mmHg.
  • Exponential model: average increase of 7.45% per mmHg of insufflation pressure (CI: 4.7–10.2%).
  • No systemic hemodynamic adverse effects were observed; MAP remained >60 mmHg throughout.
  • Portal hypertension threshold (15 mmHg) predicted at ~6.4 mmHg insufflation pressure.
  • No statistical impact from patient weight, pressure-to-weight ratio, or order of insufflation rounds.
  • Measurement technique was feasible and safe, with only minor challenges (e.g., catheter kinking).
  • The study supports use of the lowest insufflation pressure needed for visualization to avoid portal hypertension.
  • Baseline portal pressures returned after desufflation, supporting comparison pre- and post-attenuation.

Parlier

Veterinary Surgery

4

2024

Prospective, randomized, clinical trial on the effects of laparoscopic insufflation pressures on portal pressures in dogs

2024-4-VS-parlier-5

Article Title: Prospective, randomized, clinical trial on the effects of laparoscopic insufflation pressures on portal pressures in dogs

Journal: Veterinary Surgery

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In Aly 2024 et al., on simulator training for feline OHE, what was the average surgical time difference between simulator-trained and non-trained students?

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Correct. Simulator-trained students completed surgery 6 minutes faster on average (p = .04).
Incorrect. The correct answer is 6 minutes.
Simulator-trained students completed surgery 6 minutes faster on average (p = .04).

🔍 Key Findings

  • This study evaluated whether high-fidelity surgical simulator training improved live animal and student outcomes in a feline OHE teaching lab involving 186 cats and 146 students.
  • Simulator training significantly improved surgical performance and outcomes:
    • Live surgery was 6 minutes shorter on average in the SIM group vs. NO-SIM (115 ± 21 min vs. 121 ± 16 min, p = .04).
    • Pain scores ≥5/20 occurred in 1% of SIM group cats vs. 15% of NO-SIM group cats (p < .01).
    • Rescue analgesia was needed less frequently in the SIM group (5% vs. 15%, p = .03).
    • Student confidence was significantly higher in the SIM group (median 7/10 vs. 6/10, p < .01).
  • The simulator used a realistic abdominal model with friable tissues and required performance of a full OHE procedure.
  • The study design was nonrandomized, grouped by class year, with limitations including lack of blinding during pain assessment in year two.
  • Authors concluded that pre-lab simulator competency improves both animal welfare and student confidence, recommending it as a prerequisite for live surgical training.

Aly

Veterinary Surgery

6

2024

Effect of surgical simulator training on student and live animal outcomes in a feline ovariohysterectomy teaching laboratory

2024-6-VS-aly-1

Article Title: Effect of surgical simulator training on student and live animal outcomes in a feline ovariohysterectomy teaching laboratory

Journal: Veterinary Surgery

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In Walker 2025 et al., on ventral slot guides, which surgeon experience level performed all procedures?

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Correct. All ventral slots were performed by a single novice resident to assess usability of the guide.
Incorrect. The correct answer is Novice surgery resident.
All ventral slots were performed by a single novice resident to assess usability of the guide.

🔍 Key Findings

Design: Ex vivo cadaver study (n=8 dogs, 24 sites)
Comparison: Freehand vs. 3D-printed drill guide-assisted ventral slot (GAVS vs FHVS)
Findings:

  • GAVS produced slots not significantly different from planned dimensions (p = .722–.875)
  • FHVS produced significantly shorter slots than intended (p < .01)
  • No difference in surgical time (p = .071)
  • Shape ratio and slot divergence from midline were similar between groups (p > .4)
  • Use of guide significantly reduced variability in slot position (63% → 29%), shape (65% → 24%), and divergence (54% → 50%)

Conclusion: 3D-printed guides improved accuracy and consistency of ventral slot creation by novice surgeons; supports future evaluation in live dogs and small breeds

Walker

Veterinary Surgery

3

2025

Evaluation of a patient‐specific 3D‐printed guide for ventral slot surgery in dogs: An ex vivo study

2025-3-VS-walker-3

Article Title: Evaluation of a patient‐specific 3D‐printed guide for ventral slot surgery in dogs: An ex vivo study

Journal: Veterinary Surgery

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In Lotsikas 2025 et al., on stifle distraction portal, what major procedural advantage did the new portal approach provide?

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Correct. The new portal allowed safe insertion of the VSTL without needing to remove the arthroscope or shave the fat pad【69†Veterinary Surgery†L1-L20】
Incorrect. The correct answer is Avoided fat pad shaving and scope removal.
The new portal allowed safe insertion of the VSTL without needing to remove the arthroscope or shave the fat pad【69†Veterinary Surgery†L1-L20】

🔍 Key Findings

Study type: Cadaveric stifle arthroscopy in large breed dogs (n=12 joints from 6 dogs)
Goal: Describe and assess the proximal lateral portal for insertion of a Ventura stifle thrust lever (VSTL)
Main results:

  • No damage to the long digital extensor tendon (LDE) with this portal
  • VSTL could be placed without removing the arthroscope
  • Portal creation time ~37 seconds (faster than previously reported)

Cartilage impact:

  • Superficial iatrogenic articular cartilage injury (IACI) present in all specimens
  • No difference in IACI between 5- and 10-minute lever durations
  • Zone 4 (lateral femoral condyle) had significantly more damage than zones 1–3 (p < .05)

Conclusion: Portal was safe, repeatable, minimally invasive, and did not increase cartilage damage with up to 10-minute lever use

Lotsikas

Veterinary Surgery

3

2025

Proximal lateral insertion portal of an intra-articular arthroscopic stifle lever: A cadaveric study

2025-3-VS-lotsikas-5

Article Title: Proximal lateral insertion portal of an intra-articular arthroscopic stifle lever: A cadaveric study

Journal: Veterinary Surgery

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In Kokkinos 2025 et al., on THR age effects, what best describes the clinical recommendation based on the study findings?

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Correct. Due to higher complication rates in young dogs, surgeons are advised to exercise caution in elective early-age THR.
Incorrect. The correct answer is Early-age THR should be approached with caution.
Due to higher complication rates in young dogs, surgeons are advised to exercise caution in elective early-age THR.

🔍 Key Findings

  • Study population: 116 dogs underwent cementless THR; grouped by age:
    • Group A: ≤6 months (n = 27)
    • Group B: >6 to ≤12 months (n = 41)
    • Group C: >12 months (n = 48)
  • Overall perioperative complication rate: 31.9% (37/116)
    • Group A: 22.2%
    • Group B: 26.8%
    • Group C: 41.7%
  • No significant difference in total complication rate by age (p = .207), though older dogs (Group C) had numerically higher rates.
  • Luxation was significantly more common in dogs >12 months:
    • Group C: 14.6% vs. Group A (0%) and Group B (2.4%) → p = .049
  • Most common complications: luxation (9.5%) and intraoperative fissure or fracture (9.5%)
  • Time under anesthesia and surgery duration were not associated with complication risk (p = .297 and p = .781)
  • No infections or aseptic loosening observed during the 8-week follow-up.

Kokkinos

Veterinary Surgery

3

2025

The influence of age at total hip replacement on perioperative complications in dogs

2025-3-VS-kokkinos-5

Article Title: The influence of age at total hip replacement on perioperative complications in dogs

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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In Cola 2024 et al., on laparotomy-assisted endoscopy, what was the overall success rate of LAER in avoiding full conversion to enterotomy or gastrotomy?

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Correct. LAER was completely or partially effective in 35/40 cases (88%).
Incorrect. The correct answer is 88%.
LAER was completely or partially effective in 35/40 cases (88%).

🔍 Key Findings

  • LAER was effective (partial or complete) in 35/40 cases, regardless of FB location or type.
  • Intestinal wall damage significantly increased the likelihood of conversion to enterotomy (p = .043).
  • LAER led to significantly shorter hospitalization (median 48 h vs 72 h; p = .006).
  • Patients in the LAER group required less postoperative analgesia (median 36 h vs 48 h; p < .001).
  • Faster return to spontaneous feeding was seen in LAER group (median 24 h vs 36 h; p = .012).
  • No significant difference in complication rate or postoperative ileus between LAER and enterotomy groups.
  • Sharp, linear, or multiple FBs did not significantly affect LAER effectiveness.
  • Conversion to surgery was required in 5/40 LAER attempts, mostly due to immovable FBs or intestinal damage.

Cola

Veterinary Surgery

7

2024

Laparotomy‐assisted endoscopic removal of gastrointestinal foreign bodies: Evaluation of this technique and postoperative recovery in dogs and cats

2024-7-VS-cola-4

Article Title: Laparotomy‐assisted endoscopic removal of gastrointestinal foreign bodies: Evaluation of this technique and postoperative recovery in dogs and cats

Journal: Veterinary Surgery

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In Von Pfeil 2024 et al., on acute ulnar shortening in dogs, which imaging modality was emphasized as superior for dynamic assessment of joint congruity?

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Correct. Arthroscopy allowed dynamic assessment, preferred over static imaging.
Incorrect. The correct answer is Arthroscopy.
Arthroscopy allowed dynamic assessment, preferred over static imaging.

🔍 Key Findings

  • All dogs (11/11) showed improved radiohumeral articulation postoperatively, confirmed arthroscopically.
  • Median shortening: radioulnar (3.2 mm), humeroradial (1.8 mm), humeroulnar (1.2 mm).
  • Median lameness score improved from 2/4 to 1/4 by final follow-up.
  • Bone healing achieved in a median of 8 weeks (range: 4–14 weeks).
  • No major complications; minor issues included 1 screw loosening and 1 superficial infection.
  • Subjective function was graded full in 4 dogs, acceptable in 7.
  • Arthroscopy enabled accurate dynamic joint assessment, preferred over static radiographs.
  • Use of both orthopedic wire and plating provided secure fixation and improved outcomes.

Von Pfeil

Veterinary Surgery

3

2024

Outcomes of 11 dogs with short radius syndrome treated with acute arthroscopically assisted ulnar shortening

2024-3-VS-pfeil-2

Article Title: Outcomes of 11 dogs with short radius syndrome treated with acute arthroscopically assisted ulnar shortening

Journal: Veterinary Surgery

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In Aertsens 2025 et al., on thoracic lift technique, which device was used to create the chest wall lift in the second cat?

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Correct. A bent 2 mm Steinmann pin was inserted at the 8th intercostal space and suspended to elevate the thoracic wall in Cat 2.
Incorrect. The correct answer is Bent Steinmann pin.
A bent 2 mm Steinmann pin was inserted at the 8th intercostal space and suspended to elevate the thoracic wall in Cat 2.

🔍 Key Findings

Case 1: Chest wall lift improved oxygenation (PaO₂ increased from 179.4 to 306.3 mmHg) and enabled thoracoscopic-assisted lobectomy in a cat with pleural effusion and pulmonary carcinoma.
Case 2: Chest wall lift using a Steinmann pin allowed 3-port thoracoscopic lobectomy for a bronchial foreign body; no complications observed.
Both cats: Lift increased working space and eliminated need for thoracotomy; no device-related complications.
Pretied ligating loops (PLL) were effective for hilar vessel ligation—preferred over staplers or self-locking ligatures in feline thorax.
Conclusion: Thoracic lift is a novel, minimally invasive method enhancing thoracoscopic procedures in small patients, particularly cats.

Aertsens

Veterinary Surgery

4

2025

Chest wall lift for thoracoscopic lung lobectomy: Technique and results in two cats

2025-4-VS-aertsens-2

Article Title: Chest wall lift for thoracoscopic lung lobectomy: Technique and results in two cats

Journal: Veterinary Surgery

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Quiz Results

Topic: Surgical Techniques & Planning
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