I (Henri Bianucci) have just returned from the annual symposium for the American College of Veterinary Surgeons. Each year the elites from the academic world and private practice converge for three days in a major city to share their experience and research. This event is the artery for gauging the pulse of the field.

Many sessions are running at the same time throughout the day. The amount of information presented is staggering, and it’s literally impossible to attend every presentation. Talks cover wide-ranging topics such as diagnostic imaging, stem cell therapy, cartilage transplants, skin grafts, joint replacement and fracture repair, to name a few. Surgery residents, academicians, and practitioners present their research. The results and conclusions are then questioned, and challenged, in open forums.The net effect can be contentious, vibrant and stimulating.

What began a few decades ago as a small gathering primarily of surgeons from academia has morphed into an international meeting of both surgeons and general practitioners, with attendance in the thousands. The research and findings presented here represent the cutting edge of veterinary surgery. Most of the game-changing surgical breakthroughs have been presented here.

But the dust bin of surgical history is full of past breakthroughs.

What preliminary research deems groundbreaking may be determined ineffective, impractical, or downright dangerous when applied in private practice. The reason, in part, is about the numbers. In simple terms, the number of subjects in a research project is typically dwarfed by the numbers in the general public. This alone can vastly influence results.

Furthermore, a particular technique may be just fine when performed by a relatively small group of highly trained individuals. But, when performed by a wider range of less highly trained individuals, the experiences may range from suboptimal to disastrous. These “breakthroughs” become a flash in the pan, and fade away.

Coinciding with the scientific presentations is a large exhibition hall filled with the major vendors serving the veterinary surgical industry. If the scientific sessions represent the waves in the industry, this room represents the tide. The breakthroughs of yesterday that have survived introduction to the market are all represented here.

From all appearances, the tide in veterinary surgery is a rising one.

The newest ways to stabilize an injured ligament in the knee, which requires sophisticated instrumentation and implants, were represented by multiple companies, each having improved upon the technology in some way over the past few years. Joint replacement options appear to be growing. Hip replacement surgery is the most well- established, and options were on display in multiple sites.

In addition to this was a range of options in the newer, and less widespread, procedures for replacing elbows and knees. The sophistication of these procedures and the required tools and implants are amazing.

Minimally invasive surgical procedures, from all appearances, are continuing to supplant conventional approaches. From thoracic and abdominal surgery, to joint exploration, the wave is definitely toward the use of tiny scopes and instruments. With demand and acceptance growing, these cameras are now on par with those in human operating theaters.

Diagnostic imaging has evolved in an exponential way. The transition from hand-dipped X-ray film development to digital radiography gave an unprecedented capacity to share X-rays. They can be sent easily to a surgeon or a radiologist for instant interpretation.

The imaging revolution has not stopped there. As the ability to perform more intricate procedures has increased, the need for better imaging has followed. When I was in residency fewer than 20 years ago, the university (Virginia Tech) had just acquired a CT scanner, and that was a big deal. Virtually none of the universities had MRI capability.

Now virtually all referral centers have an on-site CT and an MRI. In the exposition hall, companies were displaying mobile CT scanners that can fit on a table top. Small MRI units also were on display. Although the efficiency of these units is still in question, it’s amazing that it is even an option.

My overall impression is that the community of veterinary surgeons is practicing at an unprecedented level. The instruments and techniques have co-evolved with our human counterparts. The surgeons always have been driven to do everything better, but the feeling was somehow different now.

There is a convergence of the pet owner sentiment, economic ability, and medical advancements, which has brought the level of medical care for our pets to an all-time high. Beyond that, and more importantly, there also appears to be a collective will driving improvements, with the pet’s quality of life being the primary consideration.

Dr. Henri Bianucci and Dr. Perry Jameson are with Veterinary Specialty Care LLC. Send questions to petdocs@postandcourier.com.

 

 

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