From Biovision’s “Views” newsletter (Q1 2015)
WHAT VETS HAVE TO SAY ABOUT:
TRYING SINGLE-PORT LAPAROSCOPIC SPAY AND GASTROPEXY FOR THE FIRST TIME
By Marjorie Wallwey, Biovision Veterinary Endoscopy
Eight of your veterinarian colleagues took part in a Biovision-sponsored hands-on lab at the North American Veterinary Community (NAVC) conference in Orlando, FL. They came from across the country (Minnesota; Florida; New Jersey; and Kentucky) and around the world (United Kingdom; Bermuda; and Trinidad and Tobago). Their practice settings range from a single-doc hospital to a university, and from a 3-doc clinic in a village of 11,000 to an internationally-accredited nonprofit organization that trains and places guide dogs with visually-impaired individuals. What they all had in common was a desire to explore the single-port laparoscopic modality and see whether it lives up to its promise. Spoiler alert: it does, indeed.
First, Some Background
The lab was promoted in NAVC’s conference program. Pre-registration was required, at a cost of $1,150 per participant. Participants were required to read educational material and view procedure videos in advance. In addition, they were required to attend a presentation the night before the wetlab (the presentation recapped the lead instructor’s experience performing 3,000+ lap-assisted OHEs). The lab combined didactic and hands-on settings; after an introductory discussion, participants scrubbed in to perform a laparoscopic-assisted ovariohysterectomy/ovariectomy/prophylactic gastropexy combination and laparoscopic exploratory on live, recoverable dogs. All procedures were performed on patients as part of their preparation for adoption.
Purposely keeping the class size small — with a student-to-instructor ratio of 2:1 — allowed for lots of interaction and individualized instruction. By the end of the session, participants were able to:
- Place a trocar
- Manipulate instruments inside the abdomen
- Use bipolar cautery
- Use the video/visualization tower equipment
- Use CO2 insufflation
- Use a surgical positioning table (Tippy Table) for patient positioning to utilize gravity as a retractor
- Use transabdominal procedures for fixation
Instructors were Ray Cox, DVM and Markee Kuschel, DVM of Deer Creek Animal Hospital and the Center for the Advancement of Rigid Endoscopy (C.A.R.E.) in Littleton, CO, as well as Jim Houchens, DVM of Arvada Veterinary Hospital in Arvada, CO. Drs. Cox and Kuschel pioneered single-port laparoscopic procedures and have made the modality a profitable centerpiece of their practice for nearly 20 years. Dr. Houchens has nearly a decade of experience using the modality. The wetlab included discussion of the science of rigid endoscopy, the economics, and the profitability of incorporating rigid endoscopy into private practice.
What the Participants Had to Say
As part of its standard procedures for hands-on labs, NAVC asked participants to complete evaluations rating aspects of the lab. Five of the 8 participants returned evaluations. Here’s what they had to say about trying single-port laparoscopic spay and gastropexy for the first time.
Please rate the lab instructors:
- Jim Houchens — “Very Good” = 80%; “Excellent” = 20%
- Ray Cox — “Very Good” = 60%; “Excellent” = 40%
- Markee Kuschel — “Very Good’ = 60%; “Excellent” = 40%
Were you able to complete the objectives laid out in the beginning of the lab:
- Yes = 100%
How would you rate the overall experience of the lab:
- “Good” = 60%
- “Excellent” = 40%
Will these new procedures apply to your practice:
- “Agree” = 100%
Considering the price, did you get your money’s worth:
- “Strongly Agree” = 20%
- “Agree” = 80%
Will the procedures/skills learned in this lab:
- Improve your ability to practice? “Yes” = 100%
- Make your practice more professionally rewarding? “Yes” = 100%
And, perhaps most telling of all…
Having experienced this lab, would you attend another NAVC hands-on lab:
- “Yes” = 100%
As the participants discussed, lap-assisted spay and gastropexy are merely the foundational procedures. Once learned, they open up the possibility of a myriad of procedures.