Background Finding compatible feline blood donors can be challenging. Canine blood has been occasionally used when compatible feline blood was not available in emergency situations. Objectives The study goals were to describe the effects of xenotransfusion in two anemic cats receiving canine blood because of discordant blood types and acute transfusion reaction, respectively, and to report in vitro heterotyping and – crossmatching results between canine and feline blood samples. Material and Methods Blood samples from patients and other cats and dogs were typed, crossmatched, and assessed for alloantibodies using gel, card, and immunochromatographic strip techniques. Results Cat 1 was found to have type AB blood. Cat 2, which experienced an acute transfusion reaction, had type A blood. Neither had detectable alloantibodies against feline RBC. Both cats transiently improved after transfusion with canine blood, however, acute intravascular hemolysis occurred and the PCV rapidly declined. Blood typing post xenotransfusion with DEA 1 strips revealed a positive control band that was absent in feline blood, thus allowing for the identification of transfused canine RBC. Longitudinal assessment revealed that canine RBC could no longer be detected 4 days after xenotransfusion. Major crossmatching (feline plasma with canine RBC) resulted in both positive and negative reactions, depending on the cat. Minor crossmatching results showed mostly incompatibility. Conclusion While both cats survived xenotransfusion, the positive control band on the DEA 1 strip revealed that transfused canine RBC were short-lived, and intravascular hemolysis occurred. Crossmatch results between cats and dogs showed varied incompatibilities, and may not predict transfusion reactions.
Objective: To compare the effects of 2 training curricula on laparoscopic skills and performance of simulated surgery in veterinary students.Study design: Prospective study.Sample population: Veterinary students (n 5 33) with no prior hands-on experience in minimally invasive surgery.Methods: Basic laparoscopic skills (BLS) were assessed based on 5 modified McGill inanimate system for training and evaluation of laparoscopic skills. Motion metrics and an objective structured assessment of technical skills (OSATS) were used to evaluate surgical skills during a simulated laparoscopic cholecystectomy performed in an augmented reality simulator. Students were randomly assigned to either skill-based (group A) or procedural-based (group B) training curriculum. Both tests were performed prior to and after a 10-session training curriculum.Results: Post-training BLS results were improved in both training groups (P < .001). Seven participants completed both presimulated and postsimulated laparoscopic cholecystectomy, preventing paired analysis. Based on motion metrics analysis, participants completed tasks in a shorter time (P 5 .0187), and with better economy of movement (P 5 .0457) after training. No difference was detected in OSATS before and after training.Conclusion: Both training curricula improved BLS, but significant differences were not detected between the procedural-based training program and basic skills training alone in veterinary students. Motion metrics such as time, economy of movement, and instrument path were superior to an OSATS, when assessing surgical performance. Further studies are needed to compare the effects of different simulators on the training of veterinarians with diverse laparoscopic surgical experience. | I NT ROD UCTI ONMinimal invasive surgery (MIS) results in less pain and faster recovery for animal patients 1-5 but requires different surgical skills than traditional open surgery. 6,7 Surgeons need to overcome the fulcrum effect, adjust hand-eye coordination, altering the approaching angle of instruments, and adjust to a more restricted field of view. 8 The surgical mantra "see one, do one, teach one" is not suitable in laparoscopic surgery. 9 In the past 2 decades, interest in simulation training and assessment has grown, to surmount the training obstacle in MIS, in animals and man. [8][9][10][11][12][13][14] Simulation aims to replicate clinical situations, ranging from low fidelity simulated basic skills training, to very realistic surgical simulations in high fidelity models. Accordingly, health educators in human medicine have adopted simulation as a viable educational method to teach and practice a diverse range of clinical skills. Live animal or cadaver models are high fidelity and useful training and assessment tools, 13,28 but are sparsely available, very expensive, and the ethical concern of training in live animals remains an important aspect. A recent study showed the value of motion metrics in evaluation of laparoscopic skills in veterinary medicine, 29 yet the effe...
Our results provide construct validity and concurrent validity for motion analysis metrics for an augmented reality system, whereas a virtual reality system was validated only for the time score.
Objective To compare airway leak pressures after sealing peripheral lung biopsy sites with a resorbable ligation device (LigaTie) or thoracoabdominal (TA) staples. Study design Ex vivo study. Animals Four normal caprine cadavers. Methods Twelve lung lobes were harvested from 4 goats immediately after euthanasia. Each lobe was inflated to 20 cm H2O to test for leaks prior to biopsy. Pressure was then maintained at 10 cm H2O. Biopsy samples were obtained 3 cm from the periphery with a resorbable ligation device or a TA stapler (n = 6 per group). After biopsy, inflation pressure was slowly increased to 40 cm H2O while lungs were submerged in water. The pressure at which bubbles were first seen was recorded as the airway leak pressure. The length, width, volume, and weight were recorded for each biopsy sample. Results Five of 6 LigaTie biopsy sites sustained the maximum pressure of 40 cm H2O without leaking. One site leaked at 24 cm H2O. The TA‐stapled sites sustained airway pressure to median 25.5 cm H2O (interquartile range, 23.5–26 cm H2O), and none of them reached the maximum pressure (P = .015). There were no differences in biopsy length, volume, or weight between groups. Conclusion Biopsy sites sealed with LigaTie withstood higher airway pressure without leaking compared with TA‐stapled biopsy sites in normal cadaveric specimens. Clinical significance The LigaTie may be an alternative technique for sealing peripheral lung biopsy sites.
OBJECTIVE To develop and evaluate a high-fidelity simulated laparoscopic ovariectomy (SLO) model for surgical training and testing. DESIGN Evaluation study. SAMPLE 15 veterinary students (novice group), 5 veterinary surgical interns or residents (intermediate group), and 6 veterinary surgeons (experienced group). PROCEDURES Laparoscopic surgery experience was assessed by questionnaire and visual analog scales. Basic laparoscopic skills were assessed with a commercial training model. A commercial canine abdomen model was customized with a high-fidelity simulated canine female genital tract. Each subject's SLO performance (laparoscopic entry, dissection along marked planes, and left ovariectomy) was evaluated by measurement of surgical time and errors (splenic puncture and deviation from dissection marks) and with global and operative component rating scales. Construct and concurrent validity were assessed by correlation of SLO results with self-estimated measures of experience level and with basic laparoscopic skills test results, respectively. Face validity was assessed with a questionnaire completed by intermediate and experienced group participants. RESULTS 13 participants (3/15, 5/5, and 5/6 in the novice, intermediate, and experienced groups, respectively) completed SLO within the preset time. No difference in errors was found among groups. Completion time was significantly correlated with self-estimated experience level (r = −0.626), confirming construct validity, and with basic laparoscopic skills scores (r = −0.552) and global (r = −0.624) and operative component (r = −0.624) rating scale scores, confirming concurrent validity. Overall mean face validity score was low (64.2/100); usefulness of the model for surgical training received the highest score (8/10). CONCLUSIONS AND CLINICAL RELEVANCE Results suggested the SLO model may be a useful surgical training tool. Further studies are needed to confirm usefulness of the model in veterinary laparoscopy training.
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