Small Animal Soft Tissue Surgery

• Explain skin anatomy and vascular supply and select primary, secondary or delayed closure.

• Apply tension-reducing techniques and plan local advancement/transposition flaps, axial pattern flaps and full-thickness skin grafts.

• Manage surgical site infection and delayed or abnormal healing, including pseudo-healing in cats.

• Plan perioperative care and reconstruction around sensitive structures, including when referral is appropriate.

• Apply oncologic surgery principles including margins, tissue planes and vascular control.

• Select appropriate FNA, incisional or excisional biopsy and stage cutaneous and subcutaneous tumours.

• Plan removal and closure of subcutaneous masses and manage mammary tumours in context.

• Use perioperative checklists, closed-loop communication and other non-technical surgical skills.

• Investigate chronic otitis externa using otoscopy, imaging and sampling, and manage common aural disease.

• Explain indications, techniques and complications for lateral wall resection, vertical canal ablation, TECA, pinnectomy and tonsillectomy.

• Assess oropharyngeal injuries and nasopharyngeal polyps and incorporate imaging, nerve blocks and perioperative care into ENT surgical planning.

• Recognise complex cases requiring referral.

• Apply canine and feline neck anatomy to diagnostic and surgical planning for cervical masses.

• Assess and manage feline hyperthyroidism and canine thyroid tumours, including thyroidectomy and referral decisions.

• Diagnose and surgically manage salivary mucoceles.

• Explain oesophagostomy tube placement and temporary tracheostomy, including aftercare and complications.

By the end of Day 1, the learner will be able to:

• Perform secure hand-ties using one- and two-handed techniques (square, surgeon’s, slip knots). 
• Execute the “finger trap” suture effectively for securing tubes and drains. 
• Select appropriate surgical instruments for skin suturing and demonstrate correct handling and needle control. 
• Apply gentle tissue manipulation principles during suturing to minimise trauma and ensure optimal healing. 
• Close large skin wounds using subdermal flap techniques with proper respect for tissue planes and tension lines. 
• Perform tension-relieving techniques including undermining, walking sutures, and tension incisions. 
• Plan and verbally justify reconstructive strategies using advancement and transposition flaps. 
• Demonstrate technical competence in creating and securing local skin flaps. 
• Place and secure a Penrose drain correctly, ensuring optimal placement for drainage. 
• Identify and apply suitable dressings and bandaging strategies, including tie-over dressings for complex wound locations. 
• Perform advanced knot techniques such as sliding knots and the Modified Miller’s knot, ensuring security and precision in deep cavities.

By the end of Day 3, the learner will be able to:

• Perform a lateral wall resection and vertical canal ablation with respect for neurovascular structures and surgical planes. 
• Execute a pinnectomy and tonsillectomy with attention to haemostasis and postoperative considerations. 
• Carry out a soft palate incision and repair procedure, recognising tissue layers and suture techniques required. 
• Administer regional nerve blocks (auriculotemporal, greater auricular) accurately to enhance analgesia for ENT procedures. 
• Interpret radiographic and CT imaging related to otitis, aural masses, and oropharyngeal trauma.

By the end of Day 2, the learner will be able to:

• Perform a regional mastectomy and mammary strip procedure with appropriate vascular control and anatomical awareness. 
• Identify and remove subcutaneous masses with oncologic margins and plan for effective closure. 
• Recognise and articulate key non-technical skills (situational awareness, decision-making, leadership, communication) as critical to surgical success. 
• Apply principles of contextualised care in evaluating and managing mammary tumours with varying clinical presentations. 
• Utilise perioperative checklists and closed-loop communication to enhance surgical team safety and reduce errors.

• Use radiography, ultrasound and CT to assess gastrointestinal abnormalities including obstruction, intussusception and neoplasia.

• Plan and perform exploratory laparotomy, gastrotomy, partial gastrectomy, gastropexy, enterotomy, intestinal biopsy and enterectomy, including augmentation techniques.

• Manage intussusception, mesenteric lymph node biopsy and postoperative complications including peritonitis, ileus and pancreatitis.

• Plan perioperative care, interpret blood gases and electrolytes, select closure materials and recognise cases requiring referral.

• Triage and plan surgery for acute abdominal emergencies.

• Plan splenectomy and surgery of the liver, kidney, adrenal gland and pancreas, using diagnostic imaging to guide operative planning.

• Anticipate haemorrhage, coagulopathy, pancreatitis, peritonitis and other complications.

• Recognise hernia or parenchymal-organ cases requiring referral.

By the end of Day 1, the learner will be able to:

• Perform oesophagostomy tube placement and formulate postoperative nutritional support plans. 
• Execute the emergency placement of a temporary tracheotomy tube and describe key aftercare protocols. 
• Conduct a midline neck exploration, identifying normal anatomy and recognising common abnormalities. 
• Perform mandibular/sublingual sialadenectomy for the treatment of salivary mucoceles, selecting the appropriate surgical approach. 
• Perform thyroidectomy with attention to gland preservation, haemostasis, and postoperative monitoring. 
• Safely isolate and loop a carotid artery, demonstrating fine dissection and vascular handling techniques.

By the end of Day 2, the learner will be able to:

• Perform a complete exploratory laparotomy and systematically evaluate the pancreas, liver, adrenal glands, GI and urinary tracts. 
• Conduct a gastrotomy and a pyloric incisional gastropexy; perform a partial gastrectomy via invagination. 
• Excise and biopsy mesenteric lymph nodes safely, with appropriate anatomical orientation. 
• Close the abdominal wall using correct suture layers and material selection. 
• Perform enterotomy and hand-sutured enterectomy procedures, applying serosal patching and other augmentation techniques where needed. 
• Recognise technical errors in intestinal surgery and respond appropriately to demonstrator feedback during the session. 
• Observe and evaluate stapled enterectomy technique. 
• Perform intestinal biopsy and interpret its role in diagnostic and surgical planning.

By the end of Day 3, the learner will be able to:

• Recall the splenic vascular anatomy and perform both hilar and major vessel ligation splenectomy techniques. 
• Execute liver biopsy using multiple methods (e.g. guillotine, punch, wedge) with minimal tissue trauma. 
• Perform diaphragmatic hernia repair, including air evacuation from the thoracic cavity and closure of the defect. 
• Identify inguinal anatomy and perform a simulated inguinal hernia repair. 
• Perform a tenotomised internal obturator flap for perineal hernia repair and justify flap selection. 
• Carry out an anal sacculectomy, recognising anatomical landmarks and avoiding key complications.

By the end of Day 4, the learner will be able to:

• Consolidate and refine technical execution of procedures covered in Practical Blocks 1 and 2, including: from hand-ties (basic and advanced) through to a range of the more clinically relevant soft tissue surgicla procedures covered to date., skin closures with subdermal flaps, tension-relieving techniques, Penrose drain placement, regional mastectomy, subcutaneous mass excision, lateral wall resection, vertical canal ablation, pinnectomy, tonsillectomy, soft palate incision and repair, oesophagostomy tube placement, emergency tracheotomy, thyroidectomy, neck exploration, salivary gland removal, full exploratory laparotomy, gastrotomy, enterotomy, enterectomy, mesenteric lymph node biopsy, splenectomy, liver biopsy, diaphragmatic hernia repair, inguinal hernia repair, perineal hernia repair, and anal sacculectomy. 
• Integrate flap planning, instrument selection, and gentle tissue handling principles into more advanced surgical contexts. 
• Demonstrate improved fluency in operative flow, efficient instrument use, and anatomical respect across all rehearsed procedures. 
• Repeat complete surgical procedures with minimal supervision, actively correcting prior errors using demonstrator feedback. 
• Maintain consistent aseptic technique, surgical rhythm, and intraoperative decision-making throughout. 
• Reflect on technical progress and set personal goals for continued improvement.

• Explain BOAS pathophysiology and assess the upper airway under anaesthesia.

• Plan surgical correction of stenotic nares and recognise cases requiring referral.

• Explain indications and approaches for common thoracic procedures, including lung lobectomy or biopsy, pericardiectomy, PDA or vascular procedures, thoracic duct ligation, thymectomy, sternotomy and chest wall reconstruction.

• Manage perioperative risks and complications of thoracic surgery.

• Diagnose and surgically manage urolithiasis and urinary obstruction, including cystotomy, urethrotomy, perineal and scrotal urethrostomy.

• Use imaging and urinalysis to plan surgery for obstruction or trauma and manage ectopic ureters and urinary incontinence.

• Perform common reproductive procedures including ovariohysterectomy, castration and cryptorchid surgery, and manage reproductive neoplasia.

• Plan perioperative care, recognise complications and identify cases requiring referral.

By the end of Day 1, the learner will be able to:

• Perform a surgical tracheostomy and describe appropriate postoperative management and complication prevention. 
• Execute a frontal sinusotomy (sinus approach) and identify key anatomical landmarks and surgical risks. 
• Perform wedge rhinoplasty for stenotic nares, demonstrating tissue planning and cosmetic alignment. 
• Place thoracostomy tubes using both trocar and Seldinger techniques, and explain indications and complications. 
• Conduct an ovariectomy or ovariohysterectomy safely, selecting the appropriate technique based on patient factors. 
• Perform cystotomy for removal of uroliths, with appropriate closure and leak testing. 
• Perform urethral catheterisation in male and female dogs, understanding anatomical variations and techniques to minimise trauma.

By the end of Day 2, the learner will be able to:

• Perform nephrectomy, including vascular ligation and ureteral transection, and discuss indications and contraindications. 
• Conduct an episiotomy with attention to reproductive tract and perineal anatomy. 
• Execute a preputial advancement procedure to address preputial displacement or injury. 
• Perform prescrotal urethrotomy in the male dog and describe closure and catheterisation techniques. 
• Place a cystostomy tube and plan for long-term urinary diversion and care. 
• Insert abdominal drains using open or closed methods and justify their use in specific surgical contexts. 
• Surgically approach the prostate gland and discuss common indications such as abscesses, cysts, or neoplasia.

By the end of Day 3, the learner will be able to:

• Perform thyroidectomy in the cat and describe perioperative considerations including hypocalcaemia prevention. 
• Execute feline enucleation and identify differences from the canine approach. 
• Manage feline wounds with appropriate closure techniques and considerations for skin fragility. 
• Perform enterotomy and enterectomy procedures in the cat, with feline-specific handling and repair strategies. 
• Repair diaphragmatic rupture in cats, managing thoracic entry and ensuring secure closure. 
• Diagnose and repair prepubic tendon rupture, including reconstruction techniques and postoperative care. 
• Recognise and adapt surgical plans based on feline anatomical and physiological differences compared to dogs.

• Communicate surgical plans, prognosis, consent, complications and unexpected outcomes using clear language, active listening and emotional intelligence.

• Recognise compassion fatigue and surgical stress and use strategies to support wellbeing and decision-making.

• Practise high-stakes surgical communication and reflect on psychological and ethical aspects of surgical care.