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BSAVA Congress on Demand – Surgery

  • 14/10/2021 08:51:00
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BSAVA Congress on Demand  – Surgery

With over 30 sessions, surgery is the biggest of our Congress on Demand bundles. On the clinical side, it covers orthopaedics, acute abdomen, urogenital tract surgery and brachycephalics.

It also covers administrative elements such as clinical audits, and explores the human interaction with sessions about getting the best from surgical teams.

Find out what Clare Low (peripatetic surgeon), Charlie Folkes (ECC veterinary surgeon), Kate O’Sullivan (mixed practitioner) and Elle Haskey (veterinary nurse) think of the offering below:

 

Orthopaedics

“Three orthopaedic specialists - Ben Walton from ChesterGates Veterinary Specialists, Amanda Aiken from Anderson Abercromby Veterinary Referrals and Bianca Hettlich - lead us through an interesting collection of orthopaedic lectures,” summarises peripatetic surgeon, Clare Low. 

“Ben starts with a thorough run-through of lameness examination in the dog, always one of my favourite lectures, reminding us all how much information can be gained from a good clinical exam, in tandem with Amanda giving us a refresher on gait analysis. We then move on to some cases with Amanda and Ben.  It’s a fantastic review for all young graduates or those wanting to improve their orthopaedic exam.” 

In the myth-busting session ‘My favourite orthopaedic myths’ Amanda explores those around FHO and cat fractures.

“Cat fractures will heal so long as the two ends of the bone are in the same room – it’s a myth we have all heard,” notes Clare.  “In this session Amanda delves into the available research to try to determine where our infamous cat myth has arisen from, answers questions such as, do cats really have lower complication rates? And are they really healing machines?”

The orthopaedics sessions also include ‘Why is my dog still lame after cruciate repair?’, ‘My pragmatic approach to elbow dysplasia’, and ‘Does my patient need a hip replacement?’

 

Urogenital tract surgery

“These sessions are fact-filled and highly practical,” says Kate, “leaving viewers equipped to do diagnostic work-ups on incontinent and dysuric patients, and follow through with treatment modalities in their clinics.”

“Urogenital conditions can present with diagnostic challenges and Alix McBrearty’s session takes a pragmatic approach,” she says. “History, and clinical picture help to distinguish incontinence from inappropriate urination, and the clinical problem can be subdivided into storage or voiding disorders.”

“Laura Owen and Alasdair Hotston Moore present surgical options for incontinent dogs. A lively discussion follows their individual presentations, highlighting that treatment of ectopic ureter patients is often frustrated by the fact that dogs may have a number of abnormalities in the urogenital tract, and that no two dogs are the same.   I found this discussion particularly interesting, as there is much yet to learn and understand in this area. As a CertSAS and an AP, I deal with these cases in my practice.”

In ‘The burst pipe under the floorboards: how to spot urinary trauma?’ Ed Friend and Laura Owen discuss urinary tract trauma, its diagnosis and management. “Cats feature more in this than in the other presentations, as they are frequently abdominal trauma candidates (and are not frequent incontinence sufferers),” explains Kate. “It is important to identify the level and degree of urinary tract damage, before deciding upon treatment. Techniques for catheterisation of the damaged urethra are discussed, and a temporary cystotomy tube is a suitable option for urinary bypass during tissue healing.”

 

The surgical team: practice and principles

“As a veterinary nurse who never steps foot in theatre and a believer that ‘Narnia” could be through those double doors, I found the surgical sessions on practices and principles refreshing,” says The Royal Veterinary College’s ECC nurse, Elle Haskey. 

“I can see how Halstead’s 7 guiding principles can be applied to the critical care patients I nurse and I have several pages of scribbled notes to take back to the hospital to chat to our team about. We can make more use of checklists, we can review how we carry out skin preparation for patients and we can aim to be better prepared for the procedures that we embark on with our patients, so that we can give them the best chance of a successful outcome.”

In ‘Getting the best out the surgical team’ with Dick White and Alison Young, Elle explains how Dick introduces Halstead’s 7 guiding principles.  “The number one rules is handle tissues that you operate on as if they were part of a butterfly,” she notes.

On Jolle Kirpensteijn’s and Jonathon Bray’s ‘Improving outcomes from lumpectomies’ she says: “They gave practical tips that will no doubt help vets approaching challenging mass removals where minimal tissue tension, preservation of blood supply and accurate tissue apposition play a vital role in the success of cases.”

Many of the take-home messages for Elle came from Alison Young who, she says, empowers the veterinary nurse in their role with surgical cases and management of the surgical environment. “She addresses the importance of strict asepsis – in terms of both the patient and the environment. She gives a wealth of useful advice and pointers on how to improve working ways such as the use of surgical checklists and the importance of preparation,” says Elle.

These themes are explored in further detail with Angela Rayner and Helen Silver in ‘Are safety checklists your new best friend?’ and ‘Clinical audit: an important part of patient safety?’ with Catherine Oxtoby and Pam Mosedale.

Congress on Demand, The Surgery Bundle, is available to buy now from the BSAVA Library.  Click here to find out more.

 

Acute abdomen

“These short lectures take you from beginning to end,” says veterinary surgeon, Charlie Folkes. “There’s something for everyone and they include not only a good revision of the basics but also highlight points we may not have considered in general practice.”

Alison Moores from Anderson Moores Specialists talks through the presentations and triage of acute abdomen cases. Jackie Demetriou from Dick White Referrals covers the immediate management in terms of drugs and diagnostic tests. Jess Herley from Paragon Veterinary Referrals gives a lecture on the use of fluid therapy in these cases while Ian Self from the University of Cambridge highlights the anaesthetic considerations for our acute abdomen patients.

Jackie looks at the surgical management of these cases, including a walk-through for explorative coeliotomy, and Rob White, from the University of Nottingham, gives his top tips for improving outcomes with gastrointestinal surgery. Jackie also focuses on post-operative complications, and Jane Ladlow from Hamilton Specialist Referrals talks specifically about post-operative peritonitis.

“It’s an excellent series of lectures,” notes Charlie.  “Whether you want to recap the basics, or pick up some pointers for better managing your acute abdomen cases, these are the lectures for you. Maybe you will be inspired to develop an “early warning score” system for your practice, based on the NHS one highlighted by Jackie. Perhaps investing in a point of care analyser, measuring serial lactate, or even having a go at diagnostic peritoneal lavage will help take your work up to the next level.”

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