NOTES in small animal practice

First day (theory and dry lab)

Goals and objectives. 

9.00-9.15 Introduction. NOTES is a new concept of abdominal surgery in small animal practice. From the history to future. Clients preferences for NOTES. Medical preferences for NOTES.  (Alex)

Part 1. 

Mastering the primary skills of minimally invasive Pure and Hybrid Transvaginal (TV) SPAY endosurgery in dogs and cats.Introduction to skills of Transvaginal endoscopic ovario- and ovariohysterectomy. Mastering the art of modern endoscopic equipment application performing LAP SPAY surgery in dogs and cats, tips and tricks for TV approach etc.  Skills training – dissection, approximation of tissue, fixation, exposition, hemostasis, ligation techniques during TV laparoscopy.

9.15-10.00 NOTES. Transvaginal endosurgery.  Theory and Instrumentation.

Features of TV SPAY surgery, advantages and benefits.  Endoscopic equipment for TV accesses (rigid and flexible Transvaginal endosurgery).

Sequential algorithm – from access until the finished endosurgery.

Selection and preparation of the patient. Pure and Hybrid Transvaginal approach.  Surgical intervention: intervention implementation, viewing of the abdominal cavity. Mobilization of tissues and surgical hemostasis. Resection and removal of organs (ovary, ovary with uterus). Control of hemostasis and postoperative period. Complications in the analysis of 200 patients dogs, 20 patients cats. (Alex)

10.00-11.00 Dry lab virtual clinical demonstration and works on simulator. Work in groups. SPAY TV surgery in dogs and cats.  Testing of the primary skills of endoscopic treatment with modern tools and equipment. The primary virtual manual training. (Alex, Antoine)

11.00-11.30 Coffee brake.

Part 2.

 11.30-13.00 NOTES . GI endosurgery.  Theory and Instrumentation.  Basic principles of endoscopic dissection in the submucosal layer. Minimally invasive transluminal surgery on the esophagus, stomach, rectum and colon.

Oesophagus: Endosurgery of neoplasia, hemostasis, stricture, rupture.

Stomach: Endosurgery of neoplasia, hemostasis of erosion and ulcer, closer defects, hiatal hernia.

Ructum and colon: Endosurgery of neoplasia, hemostasis, closer defects.

Clinical cases demonstration.

Complications. (Antoine)

13.00-14.45 Lunch

14.45-15.00 Dry lab virtual clinical demonstration and works on simulator. Work in groups. Testing of manual skills on equipment. (Antoine, Alex)

Part 3.

15.00-15.30 NOTES. Introduction in GI endosurgery in the thorax and abdominal cavity.

Indications, application recommendations. Equipment required for transesophageal, transgastric, transcolonic NOTES. Step by step NOTES algorithm to thorax, abdominal cavity. Closing defects. Complications. (Alex, Antoine)

Clinical cases of NOTES:

• Transesophageal thoracoscopy;
• Transgastric ovariectomy;
• Transgastric cholecystectomy;
• Transgastric gastropexy in dogs;
• Transanal laparoscopy.

15.30-16.00

Hands-on training on equipment. (Alex, Antoine)

Second day (wet lab)

 Part 1.

9.00-10.45 NOTES. TV endosurgery. Life pig training on groups. Instructor’s demonstration. Hands – on under instructor supervision.  (Alex, Antoine)

10.45-11.00 Coffee break

Part 2.

11.00-13.00 NOTES. GI endosurgery. Life pig training on groups.  On the cranial and caudal GI tract. Submucosal dissection. Instructors demonstration.  Work on groups. “Hand-eye” visual-tactile coordination tests of mentors. (Antoine, Alex)

13.00-14.00 Lunch

Part 3.

14.00-15.30 NOTES. Life pig training on groups. Transesophageal thoracoscopy. Transgastric, transcolonic laparoscopy. From approach to closing deffects.

15.30-16.00 Discussion. Certificates award. (Alex, Antoine)

Sincerely, Organizers