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1.
OBJECTIVE: To evaluate the efficacy of a reusable plastic model mimicking the anatomy and hemodynamics of the canine female genital tract for teaching basic surgical skills and ovariohysterectomy. SAMPLE POPULATION: 40 veterinary students of the class of 1998. STUDY DESIGN: Prospective study. METHODS: Students'confidence level and experience in private practice was evaluated via questionnaire before training. Students in 2 groups performed an ovariohysterectomy on cadavers (group C, n = 20) or on the model (Group M, n = 20) for 2 hours. Students' psychomotor and basic surgical skills were objectively assessed by the following tests: ligation of a foam cylinder, passing a needle through the eyelets of an electronic suture board, and ligating latex tubing. Results were compared before and after training and within and between groups. The ability of students to perform an ovariohysterectomy in a live dog after training was compared between groups with a scoring system. RESULTS: Students in both groups had similar surgical experience and basic skills before training. The results of the psychomotor and basic surgical skills tests were better in group M after training than group C. The improvement of each student in performing these tasks also increased when students were trained with the model. Scores assigned to students performing an ovariohysterectomy in a live dog were higher in group M (31.45 +/- 1.15) than in group C (20.7 +/- 1.42). CONCLUSION: The model was more effective than cadavers in teaching basic surgical skills and ovariohysterectomy in dogs.  相似文献   

2.
Surgical training in veterinary medicine has evolved rapidly over the past several decades. Catalysts for change include pressure from concerned students and the public to reduce the use of live animals in teaching; less-than-effective preparation of students for live surgery experience; an overall reduction in faculty time and effort devoted to skills training; college budgetary reallocations mandating reductions in expensive group laboratory experiences; and more specialized case-load patterns in clinical rotations, which have reduced students' exposure to common surgical conditions. In response to these trends, methods for surgery educators to reduce, refine, and replace live animals in surgery training courses at veterinary schools have received broad attention. When these methods are used effectively in a curriculum, it is no longer necessary to sacrifice animals for adequate student training. This article describes a successful and ethical surgical training program used at the Ohio State University College of Veterinary Medicine (OSU-CVM). This program provides early exposure to skills training using surgical simulators and auto-tutorials, ensures that basic skills are mastered before students are exposed to cadaver practice, and requires application of model-based skills to cadavers, with final matriculation to intensive exposure to multiple live-animal procedures via a collaborative surgery program with a local shelter.  相似文献   

3.
A procedure for imaging the canine tympanic bulla, external ear canal and adjacent structures using currently available ultrasound equipment was established. Lateral and ventral transducer positions were identified for this purpose and a 6.5 MHz curvilinear transducer was considered to be optimal. The sonographic appearance of these structures in cadavers and live dogs unaffected by ear disease is documented. Fluid was introduced into the tympanic bullae of the cadavers and its presence could be identified through the bony wall of the bulla. The ability of ultrasound to differentiate between gas and fluid within the bulla has important clinical implications as this is a common occurrence in dogs with middle ear disease. Ultrasound has several advantages over other imaging modalities and the examination procedure was well tolerated by unsedated dogs.  相似文献   

4.
Objectives: To describe stapled 1‐stage functional end‐to‐end intestinal anastomosis for treatment of small intestinal obstruction in dogs and evaluate outcome when the technique is performed by nonexpert surgeons after limited training in the technique. Study Design: Case series. Animals: Dogs (n=30) with intestinal lesions requiring an enterectomy. Methods: Stapled 1‐stage functional end‐to‐end anastomosis and resection using a GIA‐60 and a TA‐55 stapling devices were performed under supervision of senior residents and faculty surgeons by junior surgeons previously trained in the technique on pigs. Procedure duration and technical problems were recorded. Short‐term results were collected during hospitalization and at suture removal. Long‐term outcome was established by clinical and ultrasonographic examinations at least 2 months after surgery and from written questionnaires, completed by owners. Results: Mean±SD procedure duration was 15±12 minutes. Postoperative recovery was uneventful in 25 dogs. One dog had anastomotic leakage, 1 had a localized abscess at the transverse staple line, and 3 dogs developed an incisional abdominal wall abscess. No long‐term complications occurred (follow‐up, 2–32 months). Conclusion: Stapled 1‐stage functional end‐to‐end anastomosis and resection is a fast and safe procedure in the hand of nonexpert but trained surgeons.  相似文献   

5.
Trigonal-colonic anastomosis for diversion of urine into the colon was performed in 12 clinically normal dogs and in 10 incontinent dogs with diseases of the urinary bladder or urethra. Dogs were studied from 1 to 30 months after surgery. The surgical procedure was technically satisfactory. Fifteen of 22 dogs were studied with intravenous urography, and only 1 case of hydronephrosis was found. Pyelitis was a common histopathologic finding in both groups of dogs. Pyelonephritis developed in 30% of dogs, regardless of duration of anastomosis. Glomerular filtration rate was reduced in all dogs studied, but renal failure was infrequent. Values for blood urea nitrogen and serum inorganic phosphorus were elevated due to intestinal recycling of nitrogenous products and phosphate. Electrolyte imbalances were not a problem, but gastrointestinal disturbances developed in 3 of the 10 diseased dogs. Six of 10 diseased dogs survived from 9 months to more than 3 years. Trigonal-colonic anastomosis appears to be a satisfactory salvage procedure for incontinent dogs with diseases of the urinary bladder or urethra that do not respond to other forms of therapy.  相似文献   

6.
OBJECTIVES: To evaluate the clinical outcome and percentage increase in rima glottidis area achieved using a combined technique of cricoarytenoid and thyroarytenoid cartilage lateralization compared with cricoarytenoid cartilage lateralization alone in live anesthetized dogs clinically affected with bilateral laryngeal paralysis. STUDY DESIGN: Randomized prospective clinical study. ANIMALS: Twenty dogs with bilateral laryngeal paralysis. Methods-Bilateral laryngeal paralysis was diagnosed by direct laryngoscopy. Each dog was allocated randomly to 1 of 2 surgical groups: CAL (cricoarytenoid lateralization) and CTAL (cricoarytenoid and thyroarytenoid lateralization). Photographs were taken of each larynx before and after surgery, the images were digitized, and the preoperative and postoperative areas of each rima glottidis were measured. The percentage increase in rima glottidis area produced by each of the arytenoid lateralization procedures was compared. Follow-up was obtained by telephone survey of owners and referring veterinarians. RESULTS: There was no significant difference in mean (+/- SD) percentage increase in rima glottidis area for the CAL group (241.5 +/- 42.9%) or the CTAL group (236.4 +/- 44.5%). Clinical follow-up (median, 18 months postoperatively) indicated 60% of the dogs were still alive and only 1 dog had died as a result of complications related to surgery. CONCLUSIONS: CTAL for the treatment of canine laryngeal paralysis does not significantly increase rima glottidis area compared with CAL alone. The mean percentage increase in rima glottidis area obtained with both procedures was comparable to previously reported mean increases with CAL in live anesthetized dogs. Both procedures resulted in good long-term clinical outcome. CLINICAL RELEVANCE: CTAL is as effective as CAL in providing an increased rima glottidis for the treatment of bilateral laryngeal paralysis in dogs.  相似文献   

7.
CASE DESCRIPTION-4 dogs were evaluated because of recurrent urinary tract infections. CLINICAL FINDINGS-All dogs had recurrent urinary tract infections and similar clinical signs; 3 dogs had urinary incontinence. Digital vaginal examination revealed vestibulovaginal stenosis in all dogs, which was confirmed by results of contrast vaginourethrography. From image measurements, the vestibulovaginal ratio (ratio of the height of the vestibulovaginal junction to the maximum height of the vagina on a lateral vaginourethrogram) was calculated for each dog. Three dogs had severe stenosis (vestibulovaginal ratio, < 0.20; severe stenosis is defined as a vestibulovaginal ratio < 0.20), whereas the fourth dog had moderate stenosis (vestibulovaginal ratio, 0.24; ratio range for moderate stenosis is 0.20 to 0.25). TREATMENT AND OUTCOME-All dogs were anesthetized for surgical correction of the vestibulovaginal stenosis. Vaginal resection and anastomosis of the stenosis was performed in all 4 dogs, with 1 dog also undergoing episioplasty. Complete resolution of clinical signs was apparent in 3 dogs; 1 dog had postoperative complications including pollakiuria and stranguria, which resulted in rectal and vaginal prolapse. This dog underwent ovariohysterectomy, after which clinical signs resolved. All dogs had resolution of urinary tract infections at the time of follow-up (6 to 8 months after surgery). CLINICAL RELEVANCE-Resection and anastomosis may resolve recurrent urinary tract infections in dogs with severe or moderate vestibulovaginal stenosis. Episiotomy was not necessary for success of surgical treatment, and overall, that procedure increased morbidity, the severity of intraoperative hemorrhage, and duration of surgery.  相似文献   

8.
This study evaluated the safety of preoperative computed tomography angiography (CTA) and its effect on surgical time and clinical outcomes in dogs that underwent surgical correction of a single congenital extrahepatic portosystemic shunt (CEPSS). Patient data were retrospectively collected from medical records and owner communications for 124 dogs with single CEPSS, undergoing preoperative CTA (n = 43) or not (n = 81) which were surgically treated from 2005 to 2014. The frequency of major postoperative complications was 4.7% and 9.9% for the CTA and no CTA groups, respectively (P = 0.49). Mean ± standard deviation (SD) surgical time for the preoperative CTA group was 84 ± 40 min and 81 ± 31 min for the no CTA group (P = 0.28). We conclude that anesthetized preoperative CTA appears to be a safe method for diagnosis and surgical planning in dogs with single CEPSS, and does not appear to affect surgical procedure time, complication rate, or clinical outcome.  相似文献   

9.
For practical, ethical and economic reasons, veterinary surgical education is becoming increasingly dependent on models for training. The limited availability and high cost of commercially produced surgical models has increased the need for useful, low-cost alternatives. For this reason, a number of models were developed to be used in a basic surgical skills course for veterinary students. The models were low fidelity, having limited resemblance to real animals. The aim of the present study was to describe the students' learning experience with the models and to report their perception of the usefulness of the models in applying the trained skills to live animal surgery. One hundred and forty-six veterinary fourth-year students evaluated the models on a four-point Likert scale. Of these, 26 additionally participated in individual semistructured interviews. The survey results showed that 75 per cent of the students rated the models 'useful'/'very useful'. Interviews revealed that tactile, dimensional, visual, situational and emotional features are important to students' perception of a successful translation of skills from models to live animal. In conclusion, low-fidelity models are useful educational tools in preparation for live animal surgery. However, there are specific features to take into account when developing models in order for students to perceive them as useful.  相似文献   

10.
This study determined the effects of intravenous ampicillin, cefazolin, and cefoxitin on blood pressures and heart rates in healthy, anesthetized dogs. Forty dogs were each randomly assigned to a control, ampicillin, cefazolin, or cefoxitin group. Antibiotics or saline was delivered by intravenous bolus prior to surgical stimulation. Heart rate; systolic, mean, and diastolic arterial pressures; oxygen saturation; end-tidal halothane; and end-tidal carbon dioxide (CO2) were recorded before and every minute for 10 minutes after the test drug was administered. No significant differences were recorded between the antibiotic and control groups. The prophylactic use of these antibiotics should be considered safe in healthy, anesthetized dogs.  相似文献   

11.
Epidural injections are commonly performed blindly in veterinary medicine. The aims of this study were to describe the lumbosacral ultrasonographic anatomy and to assess the feasibility of an ultrasound‐guided epidural injection technique in dogs. A cross sectional anatomic atlas of the lumbosacral region and ex vivo ultrasound images were obtained in two cadavers to describe the ultrasound anatomy and to identify the landmarks. Sixteen normal weight canine cadavers were used to establish two variations of the technique for direct ultrasound‐guided injection, using spinal needles or epidural catheters. The technique was finally performed in two normal weight cadavers, in two overweight cadavers and in five live dogs with radiographic abnormalities resulting of the lumbosacral spine. Contrast medium was injected and CT was used to assess the success of the injection. The anatomic landmarks to carry out the procedure were the seventh lumbar vertebra, the iliac wings, and the first sacral vertebra. The target for directing the needle was the trapezoid‐shaped echogenic zone between the contiguous articular facets of the lumbosacral vertebral canal visualized in a parasagittal plane. The spinal needle or epidural catheter was inserted in a 45° craniodorsal–caudoventral direction through the subcutaneous tissue and the interarcuate ligament until reaching the epidural space. CT examination confirmed the presence of contrast medium in the epidural space in 25/25 dogs, although a variable contamination of the subarachnoid space was also noted. Findings indicated that this ultrasound‐guided epidural injection technique is feasible for normal weight and overweight dogs, with and without radiographic abnormalities of the spine.  相似文献   

12.
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13.
OBJECTIVES: To investigate the influence of different approach angles on the amount of nucleus pulposus removed during intervertebral disc fenestration in dogs. METHODS: Twenty cadavers of beagle dogs were randomly divided into four groups: a control group and three treatment groups in which intervertebral fenestration was performed using either a dorsal, dorsolateral or lateral approach between the 12th thoracic and second lumbar spaces. The volume of nucleus pulposus, the weight of the residual nucleus pulposus and the angle of the working sector were measured. The ratio of the residual nucleus pulposus weight to the nucleus pulposus volume was used to evaluate the efficacy of the performed fenestration. Data were analysed with Kruskal-Wallis analysis of variance between groups on ranks with correction for ties and Bonferroni correction for multiple comparisons. Correlation between ratio and working angle was calculated using a Spearman's rank test (P<0.05). RESULTS: The calculated ratio of nuclear weight to volume was significantly less in the lateral approach group than that in the other groups. The working sector was widest in the dorsolateral approach group, but this did not correlate with efficient fenestration. CLINICAL SIGNIFICANCE: Using the lateral approach for intervertebral disc fenestration may increase the efficiency of the fenestration procedure.  相似文献   

14.
The objective of this study was to develop a surgical technique for sensory denervation of the canine elbow joint and to assess the effects of denervation on limb function in normal dogs. Twenty cadavers (40 elbows) were used to characterize innervation and design the surgical protocol which was tested in 13 cadavers (26 normal elbows). The effect of denervation on limb function was assessed in vivo in four dogs with the elbow randomly selected for the procedure. Primary outcome measures were static bodyweight distribution and distal limb mechanical sensory thresholds; secondary outcome measures were subjectively scored lameness, neurological function and pain on manipulation. Histology was performed on all resected tissues to determine whether nerves had been resected. Denervation was achieved by separate medial and lateral surgical approaches. In testing the developed surgical protocol, 111/130 resected samples contained nerve tissue in the healthy cadaveric elbows and 18/20 in the in vivo study. Limb function and sensation were not altered by elbow joint denervation. The protocol developed for denervation of the canine elbow appears feasible and does not result in any sensory or motor deficits of the forelimb.  相似文献   

15.
Forty students were randomly assigned into two study groups (traditional, T; and simulator, S) of 20 students each for a core operative practice laboratory. Students were randomly paired and their group assignment and identity remained anonymous to the evaluators throughout the study. Questionnaires were distributed to students to evaluate prior surgical experience and obtain learning resource use information. Before the evaluation sessions, both groups were given identical learning resource opportunities except students in Group S received hollow organ simulators and practice materials for gastrotomy closure. All students were forewarned that surgical instruction would not be available during the evaluation sessions. In the first live animal evaluation session, all student pairs were videotaped after which stomachs were harvested for gross evaluation of the surgical site. Group T performed an additional gastrotomy for video and gross evaluation 2 weeks later. Questionnaire, and gross and video evaluation results were compared statistically between groups and sessions. The hollow organ model did not suitably simulate live stomach tissue; the material was more fragile and stiff and suture cut-out was a problem even with appropriate suture tension and technique. The model was effective for teaching needle placement, instrument usage, creating proper tissue inversion, and methods to minimize instrument handling of tissue during gastrotomy closure. Prior practice with models did not boost student confidence during their live gastrotomy session. The autotutorials (ATs) were well received by students but did not sufficiently address how to manage mucosal eversion, suture tension, and bleeding encountered during live gastrotomy. AT viewing lime positively correlated with mean total video score for Group T during both sessions. None of the students had prior experience performing hollow organ closure and no significant difference in experience level was evident between groups. Mean closure time was not significantly different between groups for session one (Group T, mean, 31.5 minutes, range, 18.4 to 53.4; Group S, mean, 28.2 minutes, range, 16.8 to 36), but was significantly reduced for session two (Group T, mean, 21.3 minutes, range, 13.9 to 31). This AT/simulator program does not significantly influence students' overall gastrotomy closure technique; gross and video evaluation scores were not significantly different between groups. Without instructor supervision, an additional gastrotomy experience did not improve surgical technique appreciably for Group T; however, these students performed the second procedure with more confidence and speed. Instruction during simulator or live animal practice appears to be necessary to assure adequate skill mastery and to reduce perpetuation of mistakes.  相似文献   

16.
ObjectiveTo investigate the effects of a heat and moisture exchanger (HME) on the temperature and humidity of inhaled gas in isoflurane-anesthetized dogs.Study designProspective, interventional study.AnimalsA total of four experimental dogs and four client-owned dogs weighing 13.9 ± 7.4 kg (mean ± standard deviation).MethodsThe four experimental dogs were anesthetized on two occasions with and without an intact HME at least 1 week apart. The four client-owned dogs were anesthetized once only for a surgical procedure and assigned to the HME group or no-HME group in alternate order, resulting in six dogs for each group. All dogs were premedicated, anesthetized with propofol and intubated. The HME was connected to the endotracheal tube. Anesthesia was maintained with isoflurane. A digital thermo-hygrometer was placed between the endotracheal tube and HME. The temperature and relative humidity of the inhaled gas were measured every 5 minutes for 60 minutes and the absolute humidity was calculated at each time point.ResultsThe temperature and absolute humidity of the inhaled gas was significantly higher at 5–60 minutes after intubation in the HME group than in the no-HME group. Absolute humidity was maintained above 29 mg H2O L−1 in the HME group. No significant time-dependent effects on temperature, relative humidity or absolute humidity of the inhaled gas were observed.Conclusions and clinical relevanceThe temperature and absolute humidity of the inhaled gas were higher when an HME was used during isoflurane anesthesia in dogs. The use of an HME may reduce the risk of dehydration and dysfunction of the airway mucosal epithelium.  相似文献   

17.
The need for alternative methods of teaching veterinary medicine and surgery has increased in recent years because of increasing costs and changing public opinion. For these reasons a hemostasis model was developed that mimics the arteries and veins of the peripheral vascular system, and can be used to teach the basic skills involved in blood vessel ligation and division. This study evaluated the effectiveness of the fluid hemostasis model compared with using live animals for teaching these skills. Forty sophomore veterinary students participated in the study. Two groups of 20 students each received identical instruction in the basic techniques required for vessel ligation and division. The students then completed various exercises using inanimate models to objectively evaluate their psychomotor skills. Both groups then practiced the techniques for equal time periods; one group used the hemostasis model and the other performed a splenectomy on live dogs. After the practice session, the students were videotaped (for later evaluation), as they performed vessel ligations and divisions. The students then repeated the exercises using the inanimate models for evaluation of skills improvement. Questionnaire responses before and after the project were obtained to determine the students' views on the need for inanimate models for teaching purposes. Results of this study indicate that the hemostasis model was as effective as live animals for teaching the basic skills involved in blood vessel ligation. The students' opinions regarding the use of properly designed inanimate models for teaching these skills were dramatically changed.  相似文献   

18.
OBJECTIVE: To evaluate a technique for preservation of organoleptic tissue characteristics (color, odor, texture, and flexibility) in cadavers used for surgical instruction. STUDY DESIGN: Experimental study. ANIMALS: Forty-three canine cadavers. METHODS: Cadavers were preserved with a modified Larssen solution of the Hospital Cochim, Paris and cryopreservation. Tissue handling qualities were evaluated in surgical laboratory sessions. RESULTS: All cadavers kept texture and tissues consistency, especially skin and muscle, similar to those of live animals. Some skin desquamation and pallor of the mucous membranes occurred with repetitive freeze-thaw cycles. CONCLUSIONS: This preservation technique provides acceptable cadaver quality and tissue handling for use in surgical instruction. CLINICAL RELEVANCE: Preparation of patient cadavers by intravascular injection of modified Larssen solution yielded suitable instructional models for surgical training.  相似文献   

19.
OBJECTIVE: To design and create 3 types of arteriovenous fistulas (AVF) in normal dogs, to monitor the dogs for secondary cardiovascular complications, and to verify adequacy of these fistulas for hemodialysis vascular access. STUDY DESIGN: Experimental study. ANIMALS: ur normal adult dogs. METHODS: Cadaveric dissections were performed, and surgical protocols were generated for carotid-jugular (CJ), brachial-cephalic (BC), and distal caudal femoral-lateral saphenous anastomosis (DCFLS) AVF. Each surgical procedure was then performed in 2 live dogs. Echocardiography was performed at days 0, 1, 3, 7, 14, 28, and 56 to evaluate the dogs for evidence of volume overload secondary to AVF formation. Estimation of luminal diameter and confirmation of fistula patency were performed using percutaneous color Doppler ultrasound. At day 56, hemodialysis was performed using each fistula as a vascular access. RESULTS: No significant changes occurred in the echocardiographic variables over time. All fistulas were patent at day 56 with mean luminal diameters of 4.5 mm (CJ), 4 mm (BC), and 1.5 mm (DCFLS). The BC fistula was superior for ease of needle placement and stabilization and provided adequate blood flow for clinical hemodialysis. CONCLUSIONS: Based on this short-term study, arteriovenous fistulas appear to be a safe and effective means for hemodialysis access in dogs. CLINICAL RELEVANCE: The arteriovenous fistulas described provide an alternative to the central venous catheters currently used for chronic hemodialysis access in dogs.  相似文献   

20.
The use of live animals for educational purposes is an old practice that is still employed in teaching and research institutions. However, there are several objections to this practice, whether for ethical or humanitarian reasons. Surgical techniques teaching using anatomical pieces and/or preserved cadavers promotes greater learning efficiency, provides exercise repetition and increases the confidence and satisfaction of the students when compared to the use of live animals. The current work aimed to analyse the feasibility of using fresh swine urinary bladder and small intestines (jejunum), obtained from slaughterhouses, fixed in 99.8% ethyl alcohol (EA) and preserved in sodium chloride hypersaturated solution (SCHS) at 30%, for 7, 14 and 21 days, as an alternative method for surgical skills training (SST). Swine viscera, fixed in EA and preserved in SCHS, presented a realistic appearance, absence of odour and maintained the viable morphological characteristics during the performance of the operative techniques. Preservation solutions had low cost, were easy to acquire and did not offers risks to human health. Therefore, urinary bladders and small intestines fixed in 99.8% EA for 30 days and maintained in 30% SCHS at different periods were demonstrated as a good viable option as a preservation method for surgical skills training.  相似文献   

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