Standing surgery among equine board certified surgeons: Survey regarding current use and trends

Abstract

BackgroundPublications about equine standing surgery are flourishing, however, information regarding its use and prevalence among surgeons is still limited.ObjectivesTo determine the current use and recent trends for equine standing surgery among board certified surgeons and to identify the main reasons and limitations for performing a procedure standing.Study designCross‐sectional survey.MethodsA 139‐item questionnaire was sent by email to 733 large animal surgery Diplomates (ACVS and ECVS) from November 2020 to February 2021. The survey collected demographic information and general data regarding standing surgery before being divided into seven identical sections for each body system, involving 36 standing procedures.ResultsThe survey response rate was 29.7% (218/733). Most respondents (58.9%, 126/214) had performed standing surgery for <10 years regardless of length of time they were board certified (48.2% board certified <10 years and 51.8% >10 years). Most respondents (range: 50.0%–92.9%, mean 69.5%) changed from performing 14/36 surgeries under general anaesthesia (GA) to standing within the previous 10 years and had always performed 8/36 surgeries standing (51.6%–73.9%, mean 61.4%) regardless of board certification time. Surgeons board certified <10 years ago performed more often 3/36 listed procedures standing than those board certified >10 years ago (p < 0.05). Avoiding GA (179/218) and/or reducing procedure cost (111/218) were the two main reasons to perform standing surgeries whereas the horse's behaviour (183/218) and/or the patient size/age (94/218) were the two main limiting factors.Main limitationsLow response rate. Results biased towards the opinion of a subgroup of surgeons, those performing standing surgery. Some standing procedures were not included in the survey.ConclusionsThe use of standing surgery is well established among board certified surgeons and progressively increasing, especially in the last 10 years and among recent Diplomates. With increased training and awareness, more Diplomates may be encouraged towards performing standing surgeries.

Standing Surgical Management of Splint Bone Fractures in 13 Horses: A Comparison to Management Under General Anaesthesia

“…[13][14][15][16][17][18][19]25 Surgical site contamination is reported as a top concern to perform a procedure standing. 12 In our study, new surgical site infections did not develop after surgery, suggesting that the relatively minimal measures used to prevent contamination were sufficient. Also, the standing technique could shorten the convalescence period (1 vs. 3 months) when compared to conservative treatment, making it an attractive choice for the commonly seen simple, uncontaminated fracture of the middle or distal third of the bone, However, contamination concerns and surgeon safety may limit its widespread use for MCII/MTII fractures, hindlimbs or fractures requiring internal fixation.…”

“…Case selection based on age/size and behaviour are key aspects for standing procedures. 12 Screening for behavioural problems prior to the procedure may help to minimize undesired reactions and harm to the patient or to the surgical team. In this study, none of the horses in the standing group had an undesired behaviour during surgery indicating appropriate patient selection and analgesia.…”

“…[12][13][14][15][16][17][18][19] However, personnel safety is still a concern during standing procedures and case selection is key to ensure it. 12 Partial ostectomy of MCII/MTII or MCIV/MTIV is one of those procedures performed currently standing and 46% of board certified equine surgeons questioned in a recent survey performed it standing. 12 However, the aforementioned percentage also indicates that standing splint bone surgery is still not widespread among surgeons regardless of its advantages over conservative treatment in selected cases.…”

“…10,11 To avoid general anaesthesiarelated complications and to reduce cost while potentially preserving safety for the horse, many surgical procedures are now being performed standing. [12][13][14][15][16][17][18][19] However, personnel safety is still a concern during standing procedures and case selection is key to ensure it. 12 Partial ostectomy of MCII/MTII or MCIV/MTIV is one of those procedures performed currently standing and 46% of board certified equine surgeons questioned in a recent survey performed it standing.…”

A review on sinoscopy in the horse: Traditional and minimally invasive techniques and sinoscopic treatment of paranasal disease

“…While many practices may not count with paediatric endoscopes due to their price and limited use, most clinics currently have laser equipment to perform different surgical procedures. An alternative to paediatric endoscope is the endoscope used for the MIST which is affordable (approximately 600$) and compatible with the console used for the increasingly popular standing needle arthroscopy (Bonomelli et al 2022).…”