Small Animal Surgery

Key Learning Objectives:

• Revise asepsis, sterilisation and appropriate antibiosis for surgical cases
• Expand your knowledge of instrumentation and instrument handling
• Become more familiar with the uses of suture, needles, staples and clips
• Understand the principles of wound healing  and how this applies to your clinical cases
• Re-visit the principles of wound management and get up-to-date with what is available now

Key Learning Objectives:

• Develop your skills in managing renal surgery
• Extend your knowledge of obstructive diseases of the urinary tract from ureters to urethra to enhance your day-to-day management of urolithiasis
• Improve your awareness of the myriad of surgical options for urinary incontinence that are available now including colposuspension, TVT and urethral occluders
• Advance your familiarity of surgery of the male reproductive system – from prostatic omentalisation to penile and preputial procedures
• Extend the range of procedures you can offer for the female reproductive system beyond ovariectomy and ovariohysterectomy

Key Learning Objectives:

• Become familiar with the surgical approaches to salivary gland disease
• Consider oesophageal disease and when surgery may be appropriate
• Gastrotomy and gastrectomy: there is more to surgery of the stomach than just GDV
• Advance your knowledge of small intestinal disease and how your decision-making can reduce complications
• Review and revise ruptures and hernias

Key Learning Objectives

• Improve your knowledge of large intestinal surgery and the differences between cats and dogs
• Familiarise yourself with surgical approaches to the rectum and anus
• Explore the options for liver surgery – suture, staples or electrosurgery
• Review biliary tract surgery – anatomy and surgical options
• Consolidate your knowledge of pancreatic surgery
• Splenectomy – does it need removing and if so, which technique and what are the alternatives to removal?

You will practise the following surgical procedures under supervision by the speaker:

Key Learning Objectives:

• Wound closure
  • Increase your options for skin reconstruction through tension relieving techniques
• Pedicle flaps
  • Become braver with pedicle flaps: advancement, rotational and transposition to help close the larger or trickier defects
• Muscle and omental flaps
  • Develop your familiarity with using muscle in defects by practising the external abdominal oblique muscle flap
  • Become familiar with the role of omental transposition in wound healing
• Skin grafts
  • Understand skin grafts: full thickness and stamp and how to maximise their chances of success

You will practise the following surgical procedures under supervision by the speaker:

Key Learning Objectives:

• Oesophageal foreign bodies
  • Maximise good outcomes for oesophageal foreign bodies by minimising the risks and complications through appropriate knowledge of anatomy, surgical technique and peri-operative care
• Gastric dilation volvulus
  • Investigate which gastropexy you might choose
• Nephrectomy and nephrotomy
  • Perform a ureteronephrectomy for when the whole kidney needs removing
  • Develop your familiarity with partial nephrectomy for saving every precious nephron
  • Investigate possible indications for nephrotomy
• Urethrostomy
  • Practise urethrostomies at a variety of anatomical locations so you can select the right one for your patient

Key Learning Objectives

• Nephrectomy / Nephrotomy
• Renal biopsies
• Cystotomy/ Nystectomy
• Urethrostomy (parascrotal in the dog and perineal in the cat)
• Cystostomy tube placement
• Urohydropulsion

Key learning objectives:

• Become secure doing surgery of the lips, cheeks and tongue
• Improve your approach to surgical treatment of palatal abnormalities
• Maxillectomy and mandibulectomy: when and where to cut
• Become more familiar with pharyngeal surgery and your options for tonsillar surgery
• Make a considered choice for your patients between lateral wall resection, vertical canal ablation, ventral bulla osteotomy and total canal ablation/lateral bulla osteotomy
• Revise the options for surgical treatment of aural haematoma

Key learning objectives:

• Revise conditions of the nasal planum of the young and old to guide you when to operate
• The nasal sinuses – when does surgical access become necessary?
• Brachycephalic airway disease - a myriad of abnormalities
• Perfect your knowledge of the larynx to allow you to successfully treat a wide variety of surgical conditions - paralysis, collapse, trauma, stenosis and neoplasia
• Familiarise yourself with tracheotomy, tracheostomy, tracheal avulsion, collapse, resection/anastomosis, trauma, foreign bodies and neoplasia

Key learning objectives:

• Perfect your approach to peritonitis by going into the detail of the pathophysiology, clinical signs, diagnosis and treatment options
• By the end of this module you will have discovered the thrills of thoracic surgery and maybe even have answered some big questions:
  • Big dog / little dog: who wins?
  • Thoracostomy for pneumothorax, pyothorax and chylothorax – which tube?
  • Thoracotomy – which side and which rib space?
  • Lung Lobectomy – how many lobes can you take?
  • PDA – is this still a surgical condition?
  • Pericardectomy – how much should you take?
  • PRAA – why does a regurgitating patient need a thoracotomy?
  • Chylothorax – can you find the thoracic duct?
  • Chest wall diseases – how far can you advance the diaphragm?

Key learning objectives:

• Revise the underlying principles of oncologic surgery to inform your surgical approaches to the most common tumours seen in practice
• Bring yourself up-to-date on all the treatment options for mast cell tumours
• Become comfortable with maxillectomy and mandibulectomy so you can approach oral tumours with more confidence
• Familiarise yourself with gastrointestinal tumours so you can optimise your patient’s outcome
• Recognise the differences between dogs and cats by learning about feline-specific tumours

Key learning objectives:

•  Total ear canal ablation and lateral bulla osteotomy 
  • Explore the anatomy of the external ear canal 
  • Choose and practise how to use your instruments 
  • Identify top tips to avoid complications intraoperatively and post-operatively
• Ventral bulla osteotomy 
  • Revise the approach to the bulla 
  • Identify which surgical methods maximise your success
• Thyroid surgery 
  • Thyroidectomy in the dog for carcinoma can be an exercise in dissection – become more familiar with potential pitfalls 
  • Thyroidectomy in the cat is a common procedure in small animal practice – minimise complications by improving your technique
• Unilateral arytenoid lateralisation
• These cases can decompensate suddenly – ensure your knowledge of the surgical anatomy is perfected during this wet lab

Key learning objectives:

• Thoracotomy - A successful thoracotomy is all in the planning: Pre-operative assessment and preparation, intra-operative anatomy and surgical technique and post-operative care all work together to optimise outcomes
• Lung lobectomy – Partial and complete lobectomy: choosing which technique to perform and reducing the risk of air leakage post-operatively
• Pericardectomy – Understand the pros and cons of subtotal pericardectomy
• Patent ductus arteriosus (PDA) – These young patients require careful pre-operative management, controlled anaesthesia, precise surgical anatomical knowledge and technique, as well as appropriate post-operative care

Key learning objectives:

• Understand how to perform the initial assessment of the fracture patient
• Be familiar with the descriptions and applications of fracture classification
• Apply the principles of fracture repair and decision making in fracture repair to your cases
• Appreciate the variety of methods available for fracture fixation and implants, including plating and external fixation devices

Key learning objectives:

• Understand the principles of fracture reduction, including both closed and open techniques
• Be familiar with the options for bone grafting including both cancellous and cortical grafts
• Describe the stabilisation of specific fractures of the fore and hindlimb
• Discuss the clinical approach to the following complications: Delayed union/Non-union/Mal-union/Osteomyelitis

During this practical session you will perform the following procedures: Key learning objectives:

• Radial Fracture
  • Surgical repair using a bone plate and screws
• Humeral Fracture
  • Surgical repair using an intramedullary pin and a bone plate and screws
• Femoral Fracture
  • Surgical repair using an intramedullary pin and a bone plate and screws

During this practical session you will perform the following procedures: Key learning objectives:

• Radial Fracture
  • Surgical repair using a bone plate and screws
• Humeral Fracture
  • Surgical repair using an intramedullary pin and a bone plate and screws
• Femoral Fracture
  • Surgical repair using an intramedullary pin and a bone plate and screws

You will practise the following surgical procedures under supervision by the speaker.

Key learning objectives:

• Cancellous bone grafting
  • Harvest cancellous bone from the proximal humerus
• Review external fixation equipment
  • Familiarise yourself with the pins, bars and clamps
• Tibial Fracture
  • Surgical repair with a type II linear frame
• Comminuted Radial Fracture
  • Surgical repair with a type Ib linear frame

Key learning objectives:

• Luxation, osteochondrosis, dysplasia, excision arthroplasty and fractures of the shoulder
• Luxations, developmental disease, un-united anconeal process and fractures of the elbow
• Developmental carpal disease, carpal hyperextension and arthrodesis, luxations and fractures of the carpus and foot Growth plate disorders

Key learning objectives:

• Conditions of the hip, including dysplasia, luxations, arthroplasty and total hip replacement
• Pelvic fractures
• Femoral fractures
• Conditions of the stifle, including patellar luxation, osteochondrosis, fractures and cruciate rupture
• Conditions of the hock, including osteochondrosis, luxation and fractures

You will practise the following surgical procedures under supervision by the speaker:

Key learning objectives:

• Perform a caudolateral and craniomedial approach to the shoulder joint

• Perform a biceps tenotomy

• Revise various elbow joint procedures

• Perform a medial and lateral approach to the elbow joint

• Perform a subtotal coronoidectomy

• Apply a lag screw fixation to fix the Ununited Anconeal Process (UAP)

• Execute a proximal/distal ulna osteotomy

You will practice the following surgical procedures under the supervision by the speaker:

Key learning objectives:

• Perform a craniodorsal approach to the hip

• Identify all the steps to correctly perform a femoral head ostectomy (FHNO)

• Approach to the stifle joint laterally

• Execute lateral fabello-tibial sutures

• Perform recession trochleoplasties

• Describe the key stages involved in a tibial tuberosity transposition procedure

Key learning objectives:

• Integrate the principles of lesion localisation to your spinal cases via a systematic neurological examination and its’ interpretation
• Understand the application of neurodiagnostics
• Appreciate the approach to and management of paraplegia and tetraplegia
• Be familiar with the clinical approach to neurological emergencies, including cranial trauma and status epilepticus

Key learning objectives:

• Revise the surgical options for spinal surgery according to site
• Cervical spine
  • Ventral slot procedure
• Thoracolumbar spine
  • Hemilaminectomy
• Lumbosacral spine
  • Dorsal laminectomy
• CSF tap and Myelography
  • Identify the appropriate landmarks for acquiring CSF samples and obtaining diagnostic myelograms

Observe a demonstration of the above procedures performed by the speaker in the wet lab.