Simini Surgery Review: Small Animal Edition

In this episode of the Simini Small Animal Surgery Podcast, we explore the soft tissue research from the August 2026 issue (Issue 6) of Veterinary Surgery, where two studies examine how surgical access and instrumentation can influence safety, efficiency, and technical performance. 

One study maps new approaches for common carotid artery ligation during complex maxillofacial procedures, potentially allowing surgeons to improve hemorrhage control while performing regional lymphadenectomy through the same surgical field. The second asks whether the additional freedom provided by an articulating laparoscopic needle driver actually makes suturing easier during total laparoscopic gastropexy.

In this episode:

✅ Blatt et al. used CT imaging and cadaveric dissections to evaluate lateral and ventral approaches for temporary or permanent common carotid artery (CCA) ligation at the level of the medial retropharyngeal lymph node (MRLN). Both approaches provided consistent access to the artery, with the mandibular salivary gland serving as a reliable surgical landmark, and could be combined with mandibular and medial retropharyngeal lymphadenectomy through the same surgical field. Importantly, skull conformation influenced the depth of dissection: in brachycephalic dogs, the lateral approach required a depth of approximately 45 mm compared with 29 mm for the ventral approach. The technique could provide surgeons with a valuable strategy for achieving preemptive vascular control during maxillectomy and other procedures where severe hemorrhage can compromise visualization and patient safety. 

The discussion also considers surgical site management at closure, particularly when combining vascular control and lymph node staging creates a deeper operative field. The episode examines the role of reinforcing lavage protocols in procedures where contamination and biofilm may remain important concerns despite successful mechanical and oncologic surgery. 

✅ Gibson et al. conducted a prospective clinical trial comparing a mechanical articulating laparoscopic needle driver with standard rigid laparoscopic instrumentation during total laparoscopic gastropexy (TLG) in 17 large-breed dogs. Despite offering additional degrees of freedom, the articulating instrument was actually slower, requiring a median of eight minutes per suture line compared with six minutes using the standard rigid driver. Surgeons also reported significantly greater mental demand, effort, and frustration with the articulating device, while technical performance was lower. The likely limitation was mechanical: articulation improved access and needle orientation but reduced needle-grasping strength, creating more tissue drag when passing the needle through the transversus abdominis and gastric seromuscular layers. Importantly, both instruments successfully completed the procedures with few and low-grade adverse events, suggesting the issue is one of efficiency and learning curve rather than safety. 

Together, these studies reinforce an important principle of surgical innovation: new technology and new approaches are only valuable when they make surgery safer, more practical, or more effective. Greater complexity does not automatically mean better performance. 

🎓 Journal Articles Discussed

• Blatt et al. — Surgical approach for common carotid ligation at the level of the medial retropharyngeal lymph node in dogs: A comparative cadaveric study
• Gibson et al. — Comparison between a laparoscopic articulating needle driver with standard laparoscopic instrumentation for total laparoscopic gastropexy in dogs

📚 From the August 2026 Issue (Issue 6) of Veterinary Surgery 

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In this episode of the Simini Small Animal Surgery Podcast, we explore the orthopedic research from the August 2026 issue (Issue 6) of Veterinary Surgery, where two studies focus on restoring normal biomechanics in challenging orthopedic cases, from feline corpus ilium fractures to canine patellar luxation associated with abnormal tibial torsion. 

One study compares a modified clamp rod internal fixation system with conventional locking plates for feline ilial fractures, while the second examines proximal tibial detorsional osteotomy as a way to correct the underlying rotational deformity responsible for patellar maltracking.

In this episode:

✅ Saylak et al. conducted a prospective clinical study of 36 cats with corpus ilium fractures, comparing conventional locking plates with a modified clamp rod internal fixation (MCRIF) system. All fractures ultimately healed, but the MCRIF group demonstrated better radiographic healing at 45 days, less pelvic canal narrowing, and no screw loosening, compared with a 22.2% screw-loosening rate in the locking plate group. The adjustable clamp design allowed screws to be placed at a precise 90-degree angle to the cortex, maximizing screw purchase in the narrow, relatively spongy feline ilium. The rod also functioned as a rigid bridge, maintaining anatomic alignment without drawing the fragments inward toward a flat plate, potentially reducing the risk of clinically significant pelvic canal narrowing. 

The discussion also highlights the importance of surgical site management at closure in complex orthopedic procedures involving greater tissue manipulation and implanted hardware. The episode examines how reinforcing the lavage protocol may help address bacterial contamination that mechanical fixation alone cannot control. 

✅ Petazzoni et al. reported outcomes following proximal tibial detorsional osteotomy (PTDO) in dogs with patellar luxation associated with abnormal tibial torsion. Across 53 stifles, the procedure restored normal patellar tracking in 96% of cases, with 96% also achieving full or acceptable limb function. Rather than simply repositioning the tibial tuberosity, PTDO addresses the underlying rotational deformity of the proximal tibia. The technique is mechanically demanding because of persistent traction from the patellar tendon, making rigid fixation and precise plate contouring essential. Although the overall complication rate was 33%, major complications occurred in only 11% of cases and were predominantly implant-related, emphasizing that successful correction depends heavily on meticulous mechanical execution. 

Together, these studies reinforce a fundamental principle of small animal orthopedics: successful fixation is not simply about holding bone together. It is about identifying and correcting the mechanical problem that caused instability or malalignment in the first place. 

🎓 Journal Articles Discussed

• Saylak  et al. — Locked plate versus modified clamp-rod internal fixation for feline corpus ilium fractures: A comparative clinical study
• Petazzoni et al. — Clinical outcomes and complications after proximal tibial detorsional osteotomy for patellar luxation in dogs: A multicenter retrospective study

📚 From the August 2026 Issue (Issue 6) of Veterinary Surgery 

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In this episode of the Simini Small Animal Surgery Podcast, we explore the soft tissue research from the July 2026 issue (Issue 5) of Veterinary Surgery, where two studies demonstrate how precision—both in surgical technique and preoperative diagnosis—can significantly improve patient outcomes. 

One study objectively compares the physiologic effects of laparoscopic versus open elective ovariectomy, while the second examines the diagnosis and surgical management of dogs with multiple congenital extrahepatic portosystemic shunts, highlighting why meticulous imaging review is critical before entering the operating room.

In this episode:

✅ Calabria et al. compared laparoscopic (LAP) and open (OPEN) elective ovariectomy in 26 healthy anestrous dogs, measuring inflammatory and oxidative stress biomarkers before and after surgery. Although laparoscopic procedures required a median of 35 minutes compared with 25 minutes for open surgery, the minimally invasive approach produced a significantly milder inflammatory response, with interleukin-6 (IL-6) returning to baseline by postoperative day seven. Likewise, markers of oxidative stress (d-ROMs) showed only a transient increase following laparoscopy, whereas dogs undergoing open surgery demonstrated persistently elevated oxidative stress throughout the first postoperative week. The findings provide objective evidence that reduced tissue manipulation outweighs the effects of slightly longer anesthesia time, supporting laparoscopy as the less physiologically traumatic approach. 

✅ Vogel et al. reviewed the clinical presentation, diagnosis, treatment, and long-term outcomes of 15 dogs with two or three congenital extrahepatic portosystemic shunts (MEHPSS). Nearly half of the affected dogs were Miniature Schnauzers, and the most common vascular pattern combined a left gastrophrenic (LGP) shunt with a left gastroazygous (LGA) shunt. Importantly, the study found that the left gastrophrenic shunt was overlooked on the initial CT examination in one-third of cases, emphasizing the need for careful evaluation of the diaphragmatic region before surgery. Despite their complex anatomy, 86% of dogs achieved good or excellent long-term outcomes following standard surgical attenuation, demonstrating that multiple congenital shunts do not necessarily carry a poorer prognosis than solitary shunts when every anomalous vessel is correctly identified and treated. 

Together, these studies reinforce a central message in small animal surgery: better outcomes come from reducing unnecessary physiologic trauma and recognizing anatomic complexity before the first incision is made.

🎓 Journal Articles Discussed

• Calabria et al. — Surgical Impact of Laparoscopic and Laparotomic Elective Ovariectomy on Inflammatory and Oxidative Stress Biomarkers in Dogs
• Vogel et al. — Clinical Presentation, Treatment, and Outcomes for Dogs with Two or Three Congenital Extrahepatic Portosystemic Shunts

📚 From the July 2026 Issue (Issue 5) of Veterinary Surgery

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In this Simini Small Animal Surgery Podcast episode, we continue our soft tissue coverage from the February 2026 issue of Veterinary Surgery with two studies that highlight how outcomes depend not just on technique, but on tissue biology and surgeon-tool interaction.

From large-scale reconstructive flap surgery in cats to laparoscopic instrument design, these papers reveal how both biology and ergonomics can shape surgical success.

In this episode, we talk about:

✅ Cinti et al. — A retrospective study evaluating the lateral caudal axial pattern flap for reconstruction of large caudodorsal defects in cats. Despite a 50% complication rate, all complications were minor (seroma, edema, partial dehiscence), and 0% required revision surgery. Surgeons were able to safely use flaps averaging 61.3% of tail length, demonstrating that feline tail vasculature provides robust and reliable perfusion even under high tension, making this a viable option for massive defects. 

✅ Cormillot et al. — A prospective, randomized crossover study of 120 surgeons evaluating laparoscopic instrument handle size. The study found that hand size strongly predicts optimal handle preference, with surgeons wearing glove sizes ≤6.5 significantly preferring smaller handles, while larger-handed surgeons preferred standard sizes. Poor ergonomic fit led to two-handed instrument use, increased wrist strain, and reduced efficiency, highlighting a major but often overlooked contributor to surgeon fatigue and long-term injury risk. 

Together, these studies emphasize a critical concept: successful surgery depends on both the biology of the patient and the biomechanics of the surgeon.

🎓 Journal Articles Discussed

• Cinti et al. — Outcome and complications of lateral caudal axial pattern flap in 14 cats.
• Cormillot et al. — Surgeon hand size influences laparoscopic finger loop handle preference.

📚 From the February 2026 issue of Veterinary Surgery

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In this Simini Small Animal Surgery Podcast episode, we continue our orthopedic coverage from the May 2026 issue of Veterinary and Comparative Orthopaedics and Traumatology (VCOT) by exploring three studies that reveal how hidden pathology often lies beneath seemingly normal clinical findings. 

From subtle elbow incongruity in medial coronoid disease to standardizing stress radiography for hip dysplasia and identifying silent gastrocnemius tendon injuries in canine athletes, these papers emphasize the importance of looking beyond what is immediately visible.

In this episode:

✅ Scharpf et al. — Used CT imaging to evaluate radioulnar congruity in dogs with medial coronoid disease (MCD). Although the medial compartment often appeared anatomically congruent, the authors identified significant lateral and central radioulnar incongruity, suggesting that many cases of MCD may actually represent a joint-wide biomechanical disorder rather than an isolated medial lesion. These findings help explain why some dogs continue to experience lameness despite technically successful arthroscopic treatment focused solely on the medial compartment. 

✅ Vandekerckhove et al. — Quantified the force required during passive stress radiography to accurately assess canine hip laxity. Under standardized sedation, 90% of hips reached maximal diagnostic laxity at approximately 80.5 Newtons (about 8.2 kg of force). The study provides an objective benchmark that may improve consistency between clinicians while reducing false-negative screening examinations caused by inadequate applied force. 

✅ Vannini et al. — Investigated gastrocnemius tendon origin (TGMO) injuries in actively competing Border Collies. Despite owners reporting no lameness, more than half of the dogs demonstrated pain during palpation, while ultrasonography revealed tendon abnormalities in approximately 85% of cases. The study showed that direct palpation of the lateral fabella was the most clinically useful screening tool, emphasizing that many athletic dogs may develop significant tendinopathy long before overt lameness appears. 

Together, these studies reinforce an essential orthopedic principle: successful diagnosis depends on recognizing pathology before it becomes clinically obvious.

🎓 Journal Articles Discussed

• Scharpf et al. — Assessment of the Conformation of the Radioulnar Joint Comparing Dogs with and without Medial Coronoid Disease
• Vandekerckhove et al. — Quantifying the Stress in Stress Radiography to Determine Sufficient Laxity of the Coxofemoral Joint in Sedated Dogs
• Vannini et al. — Prevalence of Tendinopathy of the Gastrocnemius Muscle Origin in a Cohort of Sound Border Collie

📚 From the May 2026 issue of VCOT

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In this Simini Small Animal Surgery Podcast episode, we begin our orthopedic coverage from the May 2026 issue of Veterinary and Comparative Orthopaedics and Traumatology (VCOT) by exploring three studies focused on making better clinical decisions through objective measurement. 

From synovial biomarkers for joint disease, to surgical stabilization of degenerative lumbosacral stenosis, and evidence-based rehabilitation exercises, these papers demonstrate how data—not assumptions—can improve diagnosis, surgery, and postoperative recovery.

In this episode:

✅ Beer et al. — Evaluated synovial fluid C-reactive protein (CRP) as a diagnostic biomarker for canine joint disease. Dogs with osteoarthritis demonstrated very low synovial CRP concentrations (median 1.2 mg/L), while dogs with immune-mediated polyarthritis (IMPA) and bacterial infective arthritis showed markedly elevated values of approximately 60–65 mg/L. Although CRP reliably distinguished non-inflammatory osteoarthritis from inflammatory joint disease, it could not differentiate septic arthritis from immune-mediated disease, reinforcing the continued importance of synovial cytology, culture, and clinical judgment when evaluating painful joints. 

✅ Van der Brink et al. — Compared standalone intervertebral cages with cages combined with pedicle screw and rod fixation (PSRF) for canine degenerative lumbosacral stenosis. Both techniques achieved similar long-term clinical outcomes, with approximately 64–65% of dogs returning to full function. However, adding PSRF reduced cage subsidence from 75% to 33%, improved radiographic fusion, and decreased temporary neurologic complications by providing greater construct stability during bone healing. 

✅ Ramos et al. — Used inertial motion sensors (IMUs) and surface electromyography (sEMG) to objectively measure muscle activation during rehabilitation exercises on progressively unstable platforms. While unstable "peanut" exercises increased thoracolumbar instability by 42–60%, they unexpectedly reduced activation of the epaxial muscles and biceps femoris, while dramatically increasing rectus abdominis recruitment. The findings suggest rehabilitation equipment should be selected based on which muscles require strengthening, rather than assuming greater instability universally improves core activation. 

Together, these studies reinforce an important clinical principle: better orthopedic outcomes come from measuring the right variables—and understanding what those measurements truly mean.

🎓 Journal Articles Discussed

• Beer et al. — Synovial Fluid C-Reactive Protein as a Biomarker in Osteoarthritis, Immune-Mediated Polyarthritis and Bacterial Infective Arthritis 
• Van der Brink et al. — Comparison of Stand-Alone Cage versus Intervertebral Cage with Pedicle Screw and Rod Fixation in Dogs with Degenerative Lumbosacral Stenosis
• Ramos et al. — The Effect of Progressively Unstable Equipment Used in Canine Fitness and Rehabilitation on Standing Postural Control and Muscle Activity

📚 From the May 2026 issue of VCOT

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In this Simini Small Animal Surgery Podcast episode, we conclude our orthopedic coverage from the March 2026 issue of Veterinary and Comparative Orthopaedics and Traumatology (VCOT) by exploring two studies that emphasize an essential surgical principle: successful orthopedic reconstruction depends on understanding anatomy—not simply repairing bones. 

From complex craniomaxillofacial trauma in cats to an alternative surgical approach for canine total ankle replacement, these papers demonstrate how thoughtful preoperative planning and detailed anatomical knowledge can dramatically improve patient outcomes.

In this episode:

✅ Weichert et al. — A retrospective CT study of 48 cats with craniomaxillofacial trauma following high-rise syndrome or motor vehicle accidents. Although mandibular fractures occurred in 40 cats, the authors found that 75% of patients (36/48) had injuries involving multiple functional systems. Notably, all cases of nasal airway obstruction were associated with oral cavity injuries, while 25 cats sustained fractures of the pterygoid hamular process, creating occult airway compromise despite minimal external soft tissue damage. The findings highlight the importance of CT-based evaluation and comprehensive surgical planning that addresses airway, mastication, vision, and temporomandibular joint function simultaneously. 

✅ Zingel et al. — A cadaveric study evaluating a lateral surgical approach for canine total ankle replacement (CTAR) when the standard medial approach is not feasible. Both approaches achieved excellent implant positioning, with 96% of bone-implant interfaces measuring less than 1 mm. Although the lateral approach increased angular laxity (15.5° vs. 9.5°) and required fibular osteotomy with meticulous protection of the lateral collateral ligament, overall joint stability remained acceptable. The authors conclude that the lateral approach represents a valuable alternative for revision cases or patients with severe medial scarring, while emphasizing the importance of precise center-of-rotation post placement and soft tissue preservation. 

Together, these studies reinforce a central lesson in orthopedic surgery: the best reconstruction begins with understanding anatomy in three dimensions before making the first incision.

🎓 Journal Articles Discussed

• Weichert et al. — Assessment of Fracture Distribution and Involvement of Functional Systems Following Craniomaxillofacial Trauma in 48 Cats
• Zingel et al. — Implantation of a Canine Total Ankle Replacement Prosthesis Using a Lateral Surgical Approach is Accurate and Leads to a Stable Joint 

📚 From the March 2026 issue of VCOT

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In this Simini Small Animal Surgery Podcast episode, we conclude our orthopedic coverage from the March 2026 issue of Veterinary and Comparative Orthopaedics and Traumatology (VCOT) by examining how better surgical instrumentation can improve precision, consistency, and patient safety. 

One study evaluates an ergonomically redesigned cup impactor for canine total hip replacement, while the second demonstrates how patient-specific 3D-printed drill guides may transform feline spinal stabilization.

In this episode:

✅ Mancusi et al. — A cadaveric study comparing a prototype ergonomic acetabular cup impactor with a conventional impactor during Zurich cementless total hip replacement. Among novice surgeons, the prototype significantly improved the angle of lateral opening (ALO), reducing the mean placement from 48.9° with the standard impactor to 43.2°, much closer to the ideal 45° target. However, the improved instrument did not improve cup retroversion, reinforcing that while better tools can reduce mechanical errors, accurate interpretation of anatomic landmarks remains essential for successful THA. 

✅ Rigo et al. — Evaluated patient-specific 3D-printed drill guides for thoracolumbar pedicle screw placement in cats. Across 126 pilot holes, the guides achieved an overall 91.2% safe placement rate, including 100% accuracy within the thoracic spine. Importantly, all breaches occurred laterally, with zero medial breaches or spinal canal violations, demonstrating that patient-specific guides can substantially improve safety while allowing a less invasive dorsal surgical approach. The study also reports the first successful clinical application of this technique in a feline patient, highlighting its potential for future spinal stabilization procedures. 

Together, these studies demonstrate that the future of orthopedic surgery isn't simply better implants—it's smarter instrumentation that helps surgeons consistently perform at a higher level.

🎓 Journal Articles Discussed

• Mancusi et al. — Comparison between Two Zurich Cementless Total Hip Replacement Cup Impactor Types in the Accuracy of Cup Positioning: An In Vitro Study
• Rigo et al. — Feasibility and Accuracy of Pedicle Screws in the Feline Thoracolumbar Spine

📚 From the March 2026 issue of VCOT

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In this Simini Small Animal Surgery Podcast episode, we begin our orthopedic coverage from the March 2026 issue of Veterinary and Comparative Orthopaedics and Traumatology (VCOT) by examining how small technical decisions can profoundly influence orthopedic outcomes—from postoperative care to implant manufacturing and intraoperative accuracy. 

This episode explores whether routine postoperative bandaging is truly beneficial in cats, how 3D-printed locking plates may reshape the future of patient-specific implants, and a novel device designed to improve acetabular cup positioning during canine total hip replacement.

In this episode:

✅ Clayton et al. — A multicenter retrospective study of 152 cats undergoing clean orthopedic procedures evaluated complications associated with postoperative external coaptation. Overall, 68.4% of cats developed bandage-associated complications, and those receiving rigid splints were 3.4 times more likely to experience severe complications than cats managed with soft padded bandages alone. Cases included pressure necrosis, implant exposure, osteomyelitis, and even digit amputation. The findings suggest that when rigid internal fixation provides adequate stability, routine postoperative splinting may introduce unnecessary risk rather than additional protection. 

✅ Kang et al. — Investigated whether locking screw threads can be manufactured directly into 3D-printed titanium plates, eliminating the need for expensive post-machining. When printed in a 0° horizontal orientation, directly printed locking threads achieved push-out strength equivalent to commercially machined plates. However, vertically printed implants demonstrated significant thread defects, and insertion torque proved critical—100% of printed threads failed when tightened to 2.0 Nm, while 1.1 Nm provided reliable fixation. The study highlights how implant manufacturing parameters and surgical technique must evolve together as patient-specific implants become more common. 

✅ Karlin et al. — Evaluated the Cup Position Assessment Device (CPAD), a 3D-printed intraoperative guide designed to objectively measure acetabular cup orientation during canine total hip arthroplasty. Using embedded radiopaque crossbars and intraoperative radiographs, the device measured the angle of lateral opening (ALO) with remarkable accuracy—within approximately 1.1° of the true angle. Although version measurements remain limited by implant overlap on radiographs, the CPAD represents an important step toward objective intraoperative implant positioning and reducing postoperative luxation risk. 

Together, these studies reinforce an important orthopedic principle: better outcomes often come from improving the small details that surround surgery—not just the operation itself.

🎓 Journal Articles Discussed

• Clayton et al. — Incidence of Bandage-Associated Complications in Cats following Clean Orthopaedic Procedures: A Retrospective Study of 152 Cases
• Kang et al. — Feasibility of Integrating Locking Plate System into Additively Manufactured Implants: A Mechanical Comparison of Three-Dimensional-Printed and Machined Locking Hole Threads
• Karlin et al. — In Vitro Evaluation of a Device to Assess Acetabular Cup Position by Sagittal Plane Radiography

📚 From the March 2026 issue of VCOT

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In this Simini Small Animal Surgery Podcast episode, we continue our orthopedic coverage from the January 2026 issue of Veterinary and Comparative Orthopaedics and Traumatology (VCOT) by challenging two common assumptions surrounding timing and surgical planning. 

One study investigates whether orthobiologic injections administered immediately after elbow arthroscopy actually remain inside the joint, while the second demonstrates that double pelvic osteotomy (DPO) plates consistently produce less acetabular rotation than their labeled angle, changing how surgeons should approach implant selection.

In this episode:

✅ Rustemeyer et al. — A cadaveric CT study evaluating contrast retention following elbow arthroscopy. Compared with simple arthrocentesis, elbows undergoing arthroscopy demonstrated immediate postoperative extravasation, resulting in an estimated 64.3% dilution of injected fluid. The findings suggest that orthobiologics such as PRP or stem cell therapies administered immediately after arthroscopy may largely escape into the surrounding soft tissues rather than remaining intra-articular. Delaying injections until portal sealing occurs may substantially improve therapeutic delivery. 

✅ Trommelmans et al. — A CT-based retrospective study measuring the true acetabular rotation achieved during double pelvic osteotomy. Across 49 hips, every plate angle consistently underperformed its nominal correction. Thirty-degree plates produced a median correction of only 23.4°, 25° plates achieved 16.7°, and 20° plates achieved approximately 15°. The study demonstrates that surgeons should anticipate 5–8° of lost rotation due to pelvic elasticity and soft tissue tension, recommending that 7–10° be added to preoperative planning measurements when selecting implant angles. 

Together, these studies emphasize that successful orthopedic surgery depends not only on technical execution, but also on understanding what happens immediately after surgery—and how living tissues respond to implanted hardware.

🎓 Journal Articles Discussed

• Rustemeyer et al. — Extravasation of Intraarticular Fluid Injection Following Canine Elbow Arthroscopy: A Cadaveric Study
• Trommelmans et al. — Effect of Double Pelvic Osteotomy on Dorsal Acetabular Rim Angle Using Computed Tomography in 27 Dogs

📚 From the January 2026 issue of VCOT

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