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:

• 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?

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

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

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 

Key learning objectives:

• Become secure doing surgery on 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 a 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

• 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 and total 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

• 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 maximize 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:

• Consider the conditions of the shoulder including luxation, osteochondrosis and dysplasia and excision arthroplasty surgery
• Revise the conditions of the elbow including luxations, IOHC, elbow dysplasia, developmental disease and ununited anconeal process
• Understand developmental carpal disease, carpal hyperextension and arthrodesis and luxations of the carpus and foot
• Discuss growth plate disorders

Key learning objectives:

• Discuss the pros and cons of the myriad of surgical options for the ruptured cruciate
• Consider alternative causes of stifle dysfunction than the cranial cruciate ligament
• Revise the underlying causes of patellar luxation when choosing a surgical approach
• Perfect your knowledge of hock anatomy and the conditions that affect the joint including osteochondrosis and luxation
• Review the conditions that affect the hip including dysplasia & luxation and familiarise yourself with a variety of procedures described to treat them
• Understand the pros and cons of total hip replacement

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 surgical procedures

Key Learning Objectives:

• Shoulder Joint
  • Revise the surgical approaches to the joint and perform a bicipital tenotomy
• Elbow Joint
  • Elbow dysplasia is a widespread and complex disease – review which surgical approaches to the joint are most appropriate for your individual cases
• Carpus
  • Sometimes a salvage procedure is the only option – meticulous technique will enhance your ability to perform carpal arthrodesis

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

Key Learning Objectives:

• Hip joint
  • Sometimes the best option is to perform a femoral head and neck ostectomy and good technique should allow a quick return to weight bearing
• Stifle joint I
  • Extracapsular repair of cranial cruciate ligament disease can still be a valid treatment provided you prioritise thorough meniscal inspection
• Stifle joint II
  • Surgical correction of a luxating patella by tibial tuberosity transposition will benefit many of your small dog patients
• Tarsus
  • Arthrodesis of the hock can be the only option – choose whether to perform a partial or pantarsal arthrodesis

Key Learning Objectives

• Application of cerclages and tension band fixations
• Application of positional and lag screws
• Tibial fractures
  • Medial approach to the tibia
  • Application of a bone plate
• Radial fractures
  • Cranio-medial / lateral approach to the radius
  • Application of a bone plate
• Femoral fractures
  • Lateral approach to the femur
  • Application of a bone plate and an intramedullary pin (plate and rod)

Key Learning Objectives

• Recognise the most important features to correctly approach humeral fractures.
  • Approach the humeral shaft laterally.
  • Apply a bone plate and an intramedullary pin (plate and rod)
• Perform a dorsal approach to the carpal joint.
• Perform a carpal arthrodesis
• Perform a medial and lateral approach to the tarsal joint.
• Perform a tarsal arthrodesis.

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:

• 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:

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

• 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