Search

Medical records were reviewed for cats that underwent surgical treatment of traumatic ureteral rupture (TUR) using urinary diversion procedures between 2012 and 2019.Five cats had presented with injuries associated with road traffic accidents. These included three cats with abdominal hernias that required surgical management. At a median of 15 days after the accident, cats represented with lethargy, the presence of an abdominal mass or with lower urinary tract symptoms and in all cats contrast diagnostic imaging showed proximal unilateral TUR with associated para-ureteral urinoma. Four cats received subcutaneous ureteral bypass (SUB) device placement and one had ureteral anastomosis over a stent. Unilateral cyst-like retroperitoneal fluid consistent with para-ureteral urinoma was observed in all cats and a diffuse retroperitoneal haematoma was noticed in four cats. No immediate major complications occurred, and all cats had post-operative serum creatinine concentration within the reference interval. The cat that had received a ureteral stent subsequently required placement of a SUB following stent encrustation 15 months after surgery. Median follow-up time was 34 (min 28, max 58) months and renal function was normal in all cats at the last follow-up.Urinary diversion procedures provided long-term stable renal function following proximal TUR in these five cats. Delayed, subtle non-specific clinical signs subsequent to high-energy blunt trauma causing abdominal hernia and associated diffuse retroperitoneal haematoma, should raise suspicion of TUR.AFAST: Abdominal focused assessment with sonography for trauma; SUB: Subcutaneous ureteral bypass; TUR: Traumatic ureteral rupture.

OBJECTIVES Acquired oesophageal strictures remain challenging to manage in canine and feline patients. The aims of this study were to describe the treatment, complications, short-term outcome and long-term follow-up of benign oesophageal strictures treated by balloon dilatation or stenting in dogs and cats and to describe adjunctive techniques to minimise the complication rate of stent placement. MATERIALS AND METHODS Retrospective analysis of medical records of dogs and cats with benign oesophageal stricture diagnosed under endoscopy between 2002 and 2019. RESULTS Eighteen dogs and nine cats were included, representing 39 strictures. Balloon dilatation was used as first-line therapy, with a good outcome in 59% of cases. Stents were placed in eight cases due to stricture recurrence; 88% had a long-term satisfactory outcome. Short-term complications occurred in six of eight cases; migration and aberrant mucosal reaction were uncommon. In three cases, progressive mesh cutting during follow-up reduced discomfort and trichobezoars formation and improved long-term stent tolerance. Overall median survival time was 730 days. CLINICAL SIGNIFICANCE Long-term prognosis of balloon dilatation as a first-line therapy for esophageal strictures and of stenting as a rescue therapy was considered satisfactory. Although discomfort associated with stenting was frequent, tolerability might be improved by per-endoscopic adjunctive techniques.

INTRODUCTION The present case describes the treatment of a mucoepidermoid carcinoma in a 13-year-old female sterilized European domestic cat, using lung lobectomy and -accompanying mitoxantrone chemotherapy. Six, 14, 19 and 27 months after the initial treatment tomodensitometric and radiographic examinations showed no abnormalities. However, the cat had to be euthanized 27 months after the lung lobectomy due to a soft tissue sarcoma in the interscapular area.

Dogs (n = 6) suffering from elbow-associated lameness for a median of 3.5 (min 2, max 12) months duration requiring arthroscopic exploration according to imaging results were prospectively included in this study.Dogs that met the inclusion criteria were of various breeds with a median body weight of 18 (min 13.2, max 34.5) kg and median age at presentation of 11 (min 6, max 96) months. Results of imaging modalities (radiographs and/or computed tomography (CT)) were consistent with developmental elbow disease in all of the dogs.Feasibility of the needle arthroscopy procedure was first assessed in a preliminary cadaveric study. Disease-free cadaveric forelimbs (n = 12) were collected from adult dogs (n = 6) euthanised for reasons unrelated to the present study. Elbow exploration was performed, beginning with needle arthroscopy (1 mm, 0° angle scope) followed by standard arthroscopy (2.4 mm, 30° angle scope) through a medial approach. The ease of introduction, range of motion and the quality of visualisation were assessed subjectively and the presence of iatrogenic introduction lesions and extent of field of vision (assessed by the number of anatomical structures visualised) were scored and statistically compared. Needle arthroscopy allowed inspection of all structures at risk for medial/caudal compartment disease in all joints considering the occasional need for multiple portals. In the clinical setting, elbow exploration was found to be similar to that in cadaver joints in 4/6 dogs. The lower quality of vision provided by needle arthroscopy was a limitation of the technique, and 2/6 clinical cases required conversion to standard arthroscopy for full visualisation of the joint. No introduction lesions were noted with needle arthroscopy in either the cadaveric or clinical studies.Needle arthroscopy allowed safe visualisation of all of the structures of the medial and caudal compartment in disease-free cadaveric elbows, suggesting that needle arthroscopy is an appropriate technique for diagnosis and assessment of lesions of developmental elbow disease. However, the low quality of vision provided by the 1 mm scope, and the small diameter of the sleeve, which limited fluid inflow, combined with fragility of the device were major drawbacks that prevented consistent full exploration of the joint and detailed lesion assessment in clinical situations. Improvement of the device is thus necessary before use of the technique in clinical practice can be recommended.CCD: Caudal compartment disease; CT: Computed tomography; DED: Developmental elbow disease; DJD: Degenerative joint disease; LCL: Lateral collateral ligament; LCP: Lateral coronoid process; LHC: Lateral part of the humeral condyle; MCD: Medial compartment disease; MCL: Medial collateral ligament; MCP: Medial coronoid process; MHC: Medial part of the humeral condyle; MRI: Magnetic resonance imaging.

A 2-year-old spayed female Maine Coon presented with urinary incontinence and recurrent urinary tract infection since 2 months of age. Clinical examination was unremarkable. Ultrasonography, CT and cystourethroscopy revealed urogenital abnormalities consistent with genitourinary dysplasia. Urethral pressure profilometry suggested urethral sphincter mechanism incompetence. Surgical placement of an artificial urethral sphincter occluder was performed. Mild decrease of urinary incontinence was observed 6 weeks postoperatively. Inflation of the occluder under urethral pressure profilometry was subsequently performed and resolved the incontinence. This is the first report to describe the use of urodynamic testing at the time of inflation of an artificial urethral sphincter occluder to adjust the degree of urethral occlusion.

Resume Propos La dysphagie cricopharyngee (DC) est secondaire a une alteration du sphincter œsophagien proximal (SOP), qui n’est plus capable de se relâcher correctement pour permettre la deglutition. C’est une affection rare qui est le plus souvent primaire avec une origine congenitale idiopathique. Les chiens atteints de DC primaire presentent des signes des le sevrage. Cette affection se traduit par des signes respiratoires et nutritionnels pouvant mener a la mort. L’examen de choix pour confirmer le diagnostic est la videofluoroscopie. Une intervention chirurgicale ayant pour objectif le relâchement du SOP peut etre indiquee pour pallier l’anomalie fonctionnelle, lorsque le traitement de la cause n’est pas suffisant. Actualites et points forts Le relâchement du SOP peut etre realise soit par une myotomie soit par une myectomie du muscle cricopharyngien. Les deux techniques sont associees a un bon pronostic en cas d’atteinte primaire. Le pronostic est plus reserve lors de DC acquise avec un risque de morbimortalite postoperatoire augmente. Les principales complications sont d’ordre local, respiratoire et des recidives cliniques avec la necessite de reprise chirurgicale. Perspectives et projets Une etude avec un nombre de cas important est necessaire afin de comparer les resultats des deux techniques. L’utilisation de la toxine botulique pourrait devenir un moyen pour determiner l’indication chirurgicale en cas d’atteinte acquise.

Resume Une chatte europeenne de 4 ans est presentee pour des regurgitations post-prandiales, une dysorexie et des episodes de « gagging » (reflexe physiologique caracterise par des efforts expulsifs visant a empecher tout corps etranger d’entrer dans le pharynx/larynx/trachee) evoluant depuis 48 heures. Une œsophagoscopie met en evidence une stenose œsophagienne cervicale proximale importante. Trois dilatations per-endoscopiques par ballonnet, en 5 jours, permettent une resolution des signes cliniques. Neanmoins, les controles endoscopiques, realises la semaine qui suit, mettent en evidence une persistance de la stenose. Un stent œsophagien, auto-expansible, en nitinol est alors mis en place, permettant la resolution des symptomes. Deux complications mineures ont pu etre observees au cours du suivi avec la formation d’un abces en regard de l’ancien point d’attache du stent (1 mois apres sa pose) et une obstruction du stent par un trichobezoard (2 mois apres sa pose). Toutes deux sont traitees efficacement et les mesures hygieniques instaurees par la suite ont permis une remission clinique a long terme.

Objectives The main purpose of this study was to determine the reproducibility and accuracy of a three-dimensional (3D) bone model printed on a desktop 3D-printer based on fused deposition modelling (FDM) technology with polylactic acid (PLA) and the effect of autoclave sterilization on the printed models. Methods Computed tomographic images of the tibia were obtained from 10 feline cadavers, used to create a bone surface-rendering file and sent to the 3D printing software. Right and left tibias were each printed five times with the FDM desktop 3D printer using PLA plastic material. Plastic models and cadaveric bones were measured with a profile projector device at six predetermined landmarks. Plastic bones were then sterilized using an autoclave before being re-measured applying the same method. Analyses of printed model size reliability were conducted using intra-class correlation coefficients (ICC) and Bland–Altman plots. Results The ICC always showed an almost perfect agreement when comparing 3D-printed models issued from the same cadaveric bone. The ICC showed moderate agreement for one measurement and strong/perfect agreement for others when comparing a cadaveric bone with the corresponding 3D model. Concerning the comparison of the same 3D-printed model, before and after sterilization, ICC showed either strong or perfect agreement. Clinical Significance Rapid-prototyping with our FDM desktop 3D-printer using PLA was an accurate, a reproducible and a sterilization-compliant way to obtain 3D plastic models.

A 7-year-old, 34-kg, neutered male Labrador retriever was presented with a 1-year history of intermittent sneezing with occasional left-sided epistaxis. CT revealed a mass in the left nasal cavity. Histopathological analysis of rhinoscopy-guided tissue biopsies was consistent with chronic necrotic and ulcerative rhinitis. Surgical debridement by ventral rhinotomy was subsequently performed and histopathological diagnosis was leiomyoma. Complete resolution of the nasal discharge and reduced sneezing frequency were observed after surgery. Fourteen months postoperatively, CT detected no regrowth of the mass.

Ti6Al4V is commonly used for orthopedic applications. This study was designed to test the potentially added benefit of Ti6Al4V functionalized with a bioactive polymer poly(sodium styrene sulfonate) both in vitro and in vivo. Cell-based assays with MC3T3-E1 osteoblast-like cells were used to measure the cell adhesion strength, cell spreading, focal contact formation, cell differentiation and the mineralization of extracellular matrix on grafted and ungrafted Ti6Al4V discs in combination with FBS and collagen type I. Bone morphogenetic protein-2 (BMP-2) was also included in the cell differentiation assay. Results showed that the grafted surface combined with collagen I gave superior levels in every parameter tested with cell-based assays and was almost equivalent to BMP-2 for cell differentiation. In vivo testing was conducted in rabbits (n=42) with cylinders of grafted and ungrafted Ti6Al4V implanted in defects made to the femoral and lateral condyles and animals that were maintained to 1, 3 and 12months. Hydroxyapatite coated Ti6Al4V cylinders were included as a clinical reference control. Osseointegration was assessed post-mortem using histomorphometric analysis conducted on resin sections of explanted undecalcified bone. Two histomorphometric parameters, that of bone-to-implant contact and the bone area, were analyzed by a trained observer blinded to sample identity. Results showed osseointegration on grafted Ti6Al4V was marginally better than both ungrafted and hydroxyapatite coated Ti6Al4V. Overall, the study found that the grafted Ti6Al4V significantly promoted all aspects of osteogenesis tested in vitro and, although in vivo outcomes were less compelling, histomorphometry showed osseointegration of grafted Ti6Al4V implants was equivalent or better than controls.

Since the early 1990s, minimally invasive surgery, specifically laparoscopy, has been widely adopted as an alternative to laparotomy in human surgery and has become a standard of care for the treatment of many conditions. The advantages of laparoscopy are now obvious for people. Numerous studies have demonstrated that laparoscopic procedures result in shorter hospital stays and improved surgical outcomes when compared with open abdominal surgery. In veterinary medicine, there is a similar paradigm shift from open surgery to minimally invasive surgery, except that the widespread use of the technique has lagged the human field by 10 to 15 years. Over the past decade, the development and implementation of laparoscopy in veterinary surgery has accelerated, particularly for one of the most common procedures performed in veterinary practice, and for which owners are seeking a less invasive option: elective canine ovariectomy.1,2 The first canine laparoscopic sterilisation procedure was reported by Wildt and Lawler in 1985.3 Since then, laparoscopic ovariectomy techniques have been extensively developed and different methods have been described. Laparoscopic ovariectomies are now routinely performed and have become the most popular, if not the most commonly performed, minimally invasive soft tissue procedure in veterinary medicine in several countries.4,5 To date, despite the lack of comparative blinded trials, the advantages of laparoscopy are indisputable.6 Indeed, many reports describe fewer perioperative complications, reduced postoperative pain, less surgical stress and an increase in postoperative activity levels in dogs undergoing laparoscopic ovariectomy compared with open procedures.7-10 Additional advantages of laparoscopic ovariectomy include excellent visibility of the genitourinary tract, including the ovarian vessels and other viscera. …

Resume Un chien Malinois mâle de 3 mois, presentant de l’incontinence urinaire et de la dysurie depuis l’adoption, est refere pour l’exploration d’une suspicion de malformation congenitale. Les examens d’imagerie (echographie, cystographie et examen tomodensitometrique) mettent en evidence une cavite en relation avec la vessie, compatible prioritairement avec un diverticule vesical. Lors de la chirurgie, la visualisation de l’abouchement des ureteres oriente plutot vers un diverticule uretral. Sa resection de presque 90 % associee a une uretroplastie ont permis une resolution des signes cliniques. Un mois apres l’intervention, une resurgence de l’incontinence, d’intensite moindre qu’en preoperatoire est notee associee a la persistance d’une dilatation uretrale moderee. Ce cas rare est l’occasion de presenter une affection peu connue ainsi que son diagnostic et sa prise en charge.

Resume Une ureterocele correspond a une dilatation kystique de la portion distale, intravesicale et sous-muqueux, de l’uretere. Cet article presente un cas d’ureteroceles ectopiques bilaterales chez une jeune chienne atteinte d’incontinence urinaire, traitee par ureterocelectomie partielle bilaterale. S’il s’agit d’un cas rare, la presentation clinique est classique. Pour differencier cette affection d’une ectopie ureterale intramurale, le recours a l’imagerie, et notamment a l’echographie, est necessaire. La technique chirurgicale, simple, utilisee pour ce cas est peu rapportee dans la litterature. Elle decoule d’autres techniques decrites et de la presence ou non d’anomalie observee lors de la chirurgie, et a permis une resolution parfaite de l’incontinence urinaire de la chienne.

A 15-year-old neutered female domestic shorthair cat was presented for weight loss, polydipsia/polyuria, and lethargy. A large fluctuant mass was palpated in the ventral right cervical region. Biochemistry results were consistent with primary hyperparathyroidism. Parathyroid hormone level in the fluid was higher to that observed in the plasma, consistent with a cystic parathyroid lesion. Right parathyroidectomy and thyroidectomy were performed without complications. Ionized calcium normalized within a few hours. Histopathology yielded a diagnosis of cystic parathyroid adenoma. Follow-up showed complete recovery of clinical signs and normalization of ionized calcium. This case shows an uncommon presentation of feline primary hyperparathyroidism secondary to a cystic parathyroid adenoma and is, to our knowledge, the first case presented with a large palpable mass in which parathyroid hormone concentration was measured. This report highlights the value of selective hormonal analyses of the cystic fluid to confirm the origin of the cystic lesion pre-operatively.Keywords: Adenoma, Calcium, Cyst, Hyperparathyroidism, Parathyroid hormone.

Resume Les troubles digestifs chroniques sont un motif de consultation frequent chez les carnivores domestiques. De nombreux examens complementaires sont a la disposition des veterinaires afin d’etayer les hypotheses diagnostiques telles que les analyses sanguines, l’imagerie medicale, l’endoscopie et la chirurgie. La prise en charge de ces troubles digestifs doit etre systematisee afin de reduire les hypotheses diagnostiques au fur et a mesure. L’echographie abdominale est un outil de premiere intention, incontournable dans l’exploration des troubles digestifs chroniques. Le praticien doit veiller a respecter la bonne sequence des examens, ne pas surinterpreter une presentation clinique ou une image echographique, voire un aspect macroscopique. La lymphangite lipogranulomateuse est une inflammation des vaisseaux lymphatiques et des tissus avoisinants qui peut etre observee chez les patients souffrant de lymphangiectasie et d’enteropathie exsudative. L’objectif de ce travail est de mettre l’emphase sur l’importance d’une approche diagnostique systematique et de faire le point actuel sur la lymphangite lipogranulomateuse, affection rare qui doit etre listee dans le diagnostic differentiel des masses intestinales. Nous rapportons ici le cas d’un bouledogue francais de 6 ans presente pour troubles digestifs chroniques, avec une lesion ileale focale a l’echographie et dont l’analyse histologique a mis en evidence une lymphangite lipogranulomateuse.

Objectives This article aimed to describe olecranon fracture in dogs and cats and their stabilization with tension band wiring or plate osteosynthesis, and to evaluate complications associated with each technique. Methods Medical records of cats and dogs that had been surgically treated for olecranon fractures with either tension band wiring or plate osteosynthesis were retrospectively reviewed. The surgical technique, complications and long-term outcomes were assessed. Results Forty-one olecranon fractures were included. Fractures were articular, comminuted and open in 90, 31 and 27% of cases, respectively. Tension band wiring and plate osteosynthesis were performed in 22 and 19 fractures, respectively. Complications occurred more commonly after tension band wiring (74%) compared with plate osteosynthesis (27%) (p = 0.002) and these were probably related to it being used in comminuted fractures (p = 0.01) or to errors in technique. Minor complications included Kirschner wires migration (n = 5), pain (n = 3), osteomyelitis (n = 3), skin breakdown (n = 3) and seroma (n = 1). Implant failure requiring further fixation (n = 4) was observed only in the tension band wiring group. Other major complications included skin wound debridement and closure (n = 1) and chronic lameness requiring implant removal (n = 7). Long-term functional outcomes were excellent regardless of the technique used. Clinical Significance Plate osteosynthesis should be performed for olecranon fracture repair if technically feasible.

During minimally invasive spinal surgery, correct identification of the affected intervertebral disc space is critical. Percutaneous palpation is commonly used, but results may be unreliable. Fluoroscopy is the gold standard but can be cumbersome and exposes operators to ionizing radiation. Spinal ultrasound has been described in veterinary medicine and could be a feasible alternative. This prospective, methods comparison study mimicked a minimally invasive spinal surgery in 10 canine cadavers and compared the accuracy of ultrasound and percutaneous palpation for thoracolumbar intervertebral disc space identification, using fluoroscopy as the reference standard. For each experiment, a disc space was randomly chosen. Identification was then attempted using both percutaneous palpation and ultrasound. For ultrasound, a linear probe was used to guide the operator to the correct location. The time necessary to perform each method was recorded. Accuracies for each method were calculated and statistically compared. Effects of body condition score, location of the targeted thoracolumbar intervertebral disc space and learning curve for each method were also evaluated. Ultrasonographic identification was more accurate (96.7% vs. 76.7%; P < 0.03) but took longer (147 s vs. 29 s; P < 0.0001) than percutaneous palpation. Findings from this cadaver study indicated that percutaneous palpation alone had low accuracy for correctly identifying a targeted thoracolumbar intervertebral disc space and supported the use of ultrasound as a method for improving the accuracy. Future studies are needed to assess the method in clinical cases, especially in obese dogs and/or those in which the targeted site is distant from palpable anatomical landmarks.

Objectives To compare the therapeutic potential of tissue-engineered constructs (TECs) combining mesenchymal stem cells (MSCs) and coral granules from either Acropora or Porites to repair large bone defects. Materials and Methods Bone marrow-derived, autologous MSCs were seeded on Acropora or Porites coral granules in a perfusion bioreactor. Acropora-TECs (n = 7), Porites-TECs (n = 6) and bone autografts (n = 2) were then implanted into 25 mm long metatarsal diaphyseal defects in sheep. Bimonthly radiographic follow-up was completed until killing four months post-operatively. Explants were subsequently processed for microCT and histology to assess bone formation and coral bioresorption. Statistical analyses comprised Mann-Whitney, t-test and Kruskal–Wallis tests. Data were expressed as mean and standard deviation. Results A two-fold increaseof newly formed bone volume was observed for Acropora-TECs when compared with Porites-TECs (14 sd 1089 mm3 versus 782 sd 507 mm3; p = 0.09). Bone union was consistent with autograft (1960 sd 518 mm3). The kinetics of bioresorption and bioresorption rates at four months were different for Acropora-TECs and Porites-TECs (81% sd 5% versus 94% sd 6%; p = 0.04). In comparing the defects that healed with those that did not, we observed that, when major bioresorption of coral at two months occurs and a scaffold material bioresorption rate superior to 90% at four months is achieved, bone nonunion consistently occurred using coral-based TECs. Discussion Bone regeneration in critical-size defects could be obtained with full bioresorption of the scaffold using coral-based TECs in a large animal model. The superior performance of Acropora-TECs brings us closer to a clinical application, probably because of more suitable bioresorption kinetics. However, nonunion still occurred in nearly half of the bone defects. Cite this article: A. Decambron, M. Manassero, M. Bensidhoum, B. Lecuelle, D. Logeart-Avramoglou, H. Petite, V. Viateau. A comparative study of tissue-engineered constructs from Acropora and Porites coral in a large animal bone defect model. Bone Joint Res 2017;6:208–215. DOI: 10.1302/2046-3758.64.BJR-2016-0236.R1.

Resume Nous decrivons le cas d’un chat presente pour distension et douleur abdominale avec une hyperthermie moderee, deux semaines apres le traitement fructueux d’une hernie diaphragmatique traumatique. Les premieres investigations paracliniques ont confirme la presence d’une insuffisance renale moderee associee a un epanchement retroperitoneal et peritoneal dont l’analyse biochimique etait compatible avec un uroperitoine. Une urographie intraveineuse a permis de confirmer la presence d’une breche ureterale unilaterale gauche. Une approche chirurgicale a ete envisagee mais les techniques conventionnelles comme l’ureteronephrectomie et l’anastomose termino-terminale semblaient inappropriees dans ce cas ou preserver une fonction renale deja moderement alteree est d’importance, et compte tenu de l’etendue et du caractere proximal de la breche. Ainsi une technique plus recente et « conservative de la fonction renale » moins invasive etait a privilegier. Les lesions ureterales n’ont pas permis la reparation de l’uretere ni la pose d’un stent ureteral, c’est pourquoi une derivation pyelo-vesicale extra-ureterale a ete mise en place. Le suivi post-operatoire immediat et a long terme (11 mois) revele une excellente recuperation clinique et biologique avec une fonction renale normale.

Resume Les ureterolithiases obstructives felines sont des affections graves necessitant une prise en charge rapide, cependant, le traitement chirurgical est toujours associe a une morbi-mortalite importante. L’utilisation de stents pyelo-vesicaux semblerait permettre de diminuer cette morbi-mortalite. Le but de cette etude est de decrire la technique, la mise en place de stents et le suivi postoperatoire de chats atteints d’obstruction ureterale. Neuf stents multifenestres de 2,5 Fr, a extremites « queue de cochon », ont ete mis en place de maniere normograde, par laparotomie et sous controle fluoroscopique chez 7 chats. Une resection-anastomose ureterale a ete effectuee dans 3 cas de stenose, et une papillotomie dans 2 cas. Tous les animaux ont survecu a l’intervention et ont eu une amelioration notable de leur fonction renale. Les complications observees ont ete de la dysurie (n = 2), une infection urinaire (n = 1) et une obstruction de stent necessitant son retrait (n = 3). Cinq chats sont vivants a 410 ± 166 [123–580] jours. L’utilisation de stents apparait alors comme une option chirurgicale interessante lors d’ureterolithiases, notamment multiples, cependant, la presence d’une stenose ureterale peut limiter l’interet de cette technique qui doit dans tous les cas etre associee a un suivi regulier.

SummaryObjective: To report our clinical experience in the surgical treatment of feline thora-columbar vertebral fracture-luxations using optimal safe implantation corridors as previously described in vitro.Study design: Retrospective clinical study.Materials and Methods: Medical records and radiographs of cats with vertebral fracture- luxations stabilized by screws and polymethylmethacrylate (PMMA) using optimal safe implantation corridors between 2009 and 2011 were reviewed. For each patient the data included: signalment, cause of vertebral fracture-luxations, presence of concurrent injuries, pre- and postoperative neurological grade, surgical treatment, imaging findings, and clinical outcome with short-term (2 weeks) and long-term (12 months) follow-up.Results: Eight cats with vertebral fracture-luxations involving the lumbar (L)(n = 5), the thoracic (T) spinal segments (n = 2), or the thoraco-lumbar junction (n = 1) were included in the study. Screws and PMMA were used bilaterally in five cats and unilaterally in three cats. No surgical intra-operative complications using the defined corridors were recorded. Implant failure followed by spontaneous recovery was recorded in one case. Two cats died in the postoperative period (≤4 days). The short-term and long-term clinical outcome was excellent in four out of eight cats and satisfactory in two out of eight cats.Conclusion and Clinical relevance: This pilot study demonstrates the clinical applicability of optimal safe implantation corridors for stabilization of feline thoraco-lumbar vertebral fracture-luxations with screws and PMMA. This technique can be used with limited risks of iatrogenic injuries for stabilization of vertebral fracture-luxation localized between T11-L4.

OBJECTIVES To evaluate a rational decision-making approach based on preoperative computed tomography for surgical planning in dogs and cats with recurrent draining tracts. METHODS Retrospective evaluation of case records of animals that underwent preoperative computed tomography for surgical treatment of thoracic/abdominal recurrent draining tracts. Cases were classified according to whether a source of inflammation and/or infection, in particular foreign bodies, was identified (group 1), suspected (group 2) or neither identified nor suspected (group 3) at computed tomography. Surgery consisted of removal of the source of inflammation and/or infection (group 1), debridement or abscess drainage (group 2) or en bloc resection of diseased tissues (group 3). Clinical outcome was evaluated at least 12 months after surgery. RESULTS A source of inflammation and/or infection was found in 100% (8 of 8), 41% (7 of 17) and 25% (3 of 12) of cases in groups 1, 2 and 3, respectively. Recurrent draining tracts resolved in 100% (8 of 8), 94% (16 of 17) and 92% (11 of 12) of cases in groups 1, 2 and 3, respectively. CLINICAL SIGNIFICANCE The proposed strategy provided a 95% (35 of 37) cure rate, after a single procedure in 81% (30 of 37) of cases. Recovery of a foreign body at surgery was not a prerequisite for the resolution of the recurrent draining tracts.

SummaryObjective: To define the implantation corridors in feline thoraco-lumbar vertebrae (T10-L7) using computed tomography (CT) for optimal safe placement of the implants (screws/pins) in spinal column stabilization.Study design: Computed tomographic study.Materials and methods: Computed tomography images of feline spinal column (n = 10) were used to define the optimal safe implantation corridors (OSIC) in the transverse plane. The OSIC were defined as corridors allowing the greatest amount of bone purchase with safe margins for implantation of the bicortical implants. They were characterized by their insertion point, optimal angle (from the midsagital plane), maximum and minimum safe angles (from the same insertion points), length, and width.Results: The OSIC are located within the vertebral bodies. Insertion points were situated at the level of the vertebro-costal joint or the base of the transverse process of the vertebral body for thoracic and lumbar vertebrae, respectively. The mean optimal angle of the OSIC was 90.2° with a maximum deviation angle from optimal angle of 10° dorsally and 8.8° ventrally in thoracic vertebrae, and 90.5° with a maximum deviation angle from the optimal angle of 8.4° dorsally and 7.6° ventrally in lumbar vertebrae.Conclusion and clinical relevance: Corridors drilled in the vertebral body perpendicular to the midsagital plane (90°) or with a small angle (≤10°) of deviation from the optimal angle provide an optimal safe placement of bicortical implants. However, perpendicular implant placement may not always be feasible due to surrounding soft tissue structures.

Objectives To compare the therapeutic potential of tissue-engineered constructs (TECs) combining mesenchymal stem cells (MSCs) and coral granules from either Acropora or Porites to repair large bone defects. Materials and Methods Bone marrow-derived, autologous MSCs were seeded on Acropora or Porites coral granules in a perfusion bioreactor. Acropora-TECs (n = 7), Porites-TECs (n = 6) and bone autografts (n = 2) were then implanted into 25 mm long metatarsal diaphyseal defects in sheep. Bimonthly radiographic follow-up was completed until killing four months post-operatively. Explants were subsequently processed for microCT and histology to assess bone formation and coral bioresorption. Statistical analyses comprised Mann-Whitney, t-test and Kruskal–Wallis tests. Data were expressed as mean and standard deviation. Results A two-fold increaseof newly formed bone volume was observed for Acropora-TECs when compared with Porites-TECs (14 sd 1089 mm3 versus 782 sd 507 mm3; p = 0.09). Bone union was consistent with autograft (1960 sd 518 mm3). The kinetics of bioresorption and bioresorption rates at four months were different for Acropora-TECs and Porites-TECs (81% sd 5% versus 94% sd 6%; p = 0.04). In comparing the defects that healed with those that did not, we observed that, when major bioresorption of coral at two months occurs and a scaffold material bioresorption rate superior to 90% at four months is achieved, bone nonunion consistently occurred using coral-based TECs. Discussion Bone regeneration in critical-size defects could be obtained with full bioresorption of the scaffold using coral-based TECs in a large animal model. The superior performance of Acropora-TECs brings us closer to a clinical application, probably because of more suitable bioresorption kinetics. However, nonunion still occurred in nearly half of the bone defects. Cite this article: A. Decambron, M. Manassero, M. Bensidhoum, B. Lecuelle, D. Logeart-Avramoglou, H. Petite, V. Viateau. A comparative study of tissue-engineered constructs from Acropora and Porites coral in a large animal bone defect model. Bone Joint Res 2017;6:208–215. DOI: 10.1302/2046-3758.64.BJR-2016-0236.R1.

Resume Le projet « Ligart » a pour objectif de proposer une nouvelle generation de ligament artificiel « bioactif » et « biointegrable » pour la reconstruction du ligament croise anterieur (LCA) du genou des patients victimes de ruptures du LCA, souvent consecutives a un effort violent. Dans ce projet, la prothese ligamentaire en poly(terephtalate d’ethylene glycol) LARS est « revetue » par greffage chimique d’un polymere « bioactif » et « biomimetique » destine a « masquer » l’origine synthetique du ligament dans le but de controler la reponse de l’hote-secretion collagenique, activite cellulaire des fibroblastes, reponse inflammatoire. Un tel ligament est alors considere comme « biointegre, c’est-a-dire integre par le systeme vivant » : il favorise la repousse fibroblastique organisee le long des fibres constitutives de la partie intra-articulaire du ligament ce qui ameliore sensiblement la tenue mecanique de la prothese, il diminue sensiblement la reaction inflammatoire et previent les synovites aigues abondamment decrites dans le cas des ligaments synthetiques de toute premiere generation. Cinquante-six brebis ont ete implantees avec des ligaments « bioactifs » et commerciaux et l’evaluation des reponses biologiques (histologie, biologie moleculaire, MEB) et biomecaniques (etude cinematique [flexion–extension], laxite, rupture,) a ete realisee apres trois et 12 mois d’implantation. Les resultats montrent que le greffage du polymere bioactif ameliore sensiblement la reponse biologique a trois et 12 mois. Les implantations en therapeutiques dans un essai preclinique sont en cours de realisation chez le chien et des essais chez l’homme vont pouvoir debuter.

Summary Objectives: To investigate the feasibility of a minimally invasive video-assisted (MIVA) cervical ventral slot (VS) in dogs without the use of fluoroscopy, and to report our initial clinical experiences in dogs. Methods: Two surgical approaches to an inter-vertebral disk space (IVDS) were performed in eight intact canine cadavers to determine the feasibility of MIVA-VS using the Destandau Endospine™ Device a (DED) without fluoroscopic guidance. In a subsequent clinical study, 10 client-owned dogs admitted for a Hansen type 1 disk extrusion underwent a MIVA-VS. Recorded data in both studies included: incision lengths, correct targeting of the IVDS, technical problems encountered during the procedure, and potential damage to major anatomical structures. In the 10 clinical cases, duration of the procedure and clinical outcome at five and 12 days, and after a minimum of three months were also recorded. Results: Correct exposure of the targeted IVDS was achieved in all cases. There was no major iatrogenic damage. Mean skin incision length was 39 mm and mean surgery time was 52 minutes. The technique provided increased illumination and magnification of the surgical field. Recovery was uneventful in all cases. Clincial relevance: The present study provided evidence that MIVA-VS using the DED was feasible and a relatively fast and safe procedure for the treatment of cervical disk herniation. Advantages of the technique seemed to include shorter incisions, less dissection and improved visibility.

Reaction of the electron-rich derivative cis-[Pt(Me)2(DMSO)2] with 2,2′-bipyridine (L) affords the mononuclear “rollover” N′,C(3) cyclometalate [Pt(L-H)(Me)(DMSO)] (1a) or the unusual dinuclear species [Pt2(μ-L-2H)(Me)2(DMSO)2] (2a), depending on the Pt/L molar ratio. The latter complex, 2a, can be obtained either directly from cis-[Pt(Me)2(DMSO)2] or by a two-step process through complex 1a. The synthesis of 2a implies a double C−H bond activation, with loss of two molecules of methane: the 2-fold deprotonated 2,2′-bipyridine links two [Pt(Me)(DMSO)] fragments, acting as a π-delocalized C,N∧N,C eight-electron donor. From 1a and 2a displacement of DMSO with two-electron-donor ligands such as PPh3, (b), CO (c), and 3,5-Me2py (d) gives two series of complexes, 1b−d and 2b−d, respectively. Reaction of 1a and 2a with HCl affords the corresponding chlorides [Pt(L-H)(Cl)(DMSO)] (3a) and [Pt2(μ-L-2H)(Cl)2(DMSO)2] (4a), from which complexes 3b−d and 4b,d can be obtained by substitution of DMSO. The crystal struct...

The synthesis of C-2 cyclopalladated derivatives of 1,3-bis(2-pyridyl)benzene (N-CH-N) has been achieved for the first time through a transmetalation reaction. C-2 mono- and dinuclear complexes have been obtained by reaction of Pd(OAc)2 and the organomercury(II) compound [Hg(N-C-N)Cl] (1) as precursors. The new species 2−11 were characterized in solution and, in the case of [Pd(N-C-N)Cl] (2) and [Pd2(N-C-N)2(OAc)]2[Hg2Cl6] (11) as well as of [Hg(N-C-N)Cl] (1), in the solid state. The X-ray crystal structures unambiguously show the pincer behavior of the N-C-N ligand in the palladium species and the linear coordination C−Hg−Cl in the mercury precursor. Displacement of the coordinated halide gives cationic species such as [Pd(N-C-N)(H2O)][BF4] (5) or, in the absence of donor solvents or anions, the dinuclear halide-bridged species [Pd2(N-C-N)2(μ-X)][BAr‘4] (X = Cl (6), Br (7), I (8); Ar‘ = 3,5-(CF3)2-C6H3). For comparison purposes [Pd(N-C-N)(OAc)] (9) and [Pd2(N-C-N)2(μ-OAc)][BAr‘4] (10) were also prepared....

Introduction Les calculs ureteraux sont, devant les stenoses, les calculs hematiques et les neoplasies, la cause la plus frequente d’obstruction ureterale chez le chat et leur incidence est en augmentation constante et reguliere depuis une quinzaine d’annees. Cette entite reste un defi diagnostique et therapeutique pour le clinicien. Si de recentes publications apportent des elements de reponse sur la prise en charge therapeutique en particulier chirurgicale, ils persistent de nombreuses inconnues sur l’epidemiologie, tout particulierement en France, et sur le diagnostic et la validite des traitements medicaux entrepris [1] , [2] , [3] , [4] . Materiel et methodes Il s’agit d’une etude retrospective par analyse des cas presentes dans notre hopital. Les donnees epidemiologiques, cliniques et paracliniques ont ete enregistrees. Les traitements medicaux et leur efficacite ont ete etudies en comparaison aux animaux traites chirurgicalement par ureterotomie ou chirurgie mini invasive (stent ureteral ou chambre de derivation extra ureterale). Les donnees epidemiologiques ont ete compares a une population temoin constituee de chats presentes (n = 7600) dans notre structure pendant la meme periode. Resultats Le nombre de chats presentant des lithiases ureterales augmente sur la periode d’etude. Cinquante-cinq pour cent (n = 39/71) des chats presentes sont des europeens, 18 % (n = 13) des Sacres de Birmanie, 8 % (n = 5) des Siamois et 6 % (n = 4) des Maine Coon. Les races sacree de Birmanie et Siamois sont significativement associees au risque de presenter des calculs ureteraux. L’odds ratio est de 13,97 [7,46;26,18] pour le Sacre de Birmanie, il est de 3,25 [1,39;7,58] pour le Siamois. Les femelles sont significativement predisposees par rapport aux mâles. Les symptomes les plus frequemment rapportes (dans plus de 75 % des cas) sont : dysorexie et abattement. Pres de la moitie des chats presentent une nephromegalie et une asymetrie est perceptible par le clinicien dans 27 % des cas. Seulement 17 % des chats presentaient une douleur abdominale. Tous les animaux ont eu une analyse d’urine a l’admission. La densite urinaire moyenne est de 1,024 ± 0,012 [1,008–1,051]. La presence de sang dans les urines est rapportee sur 37 prelevements (faits par cystocentese). Des cristaux d’oxalate de calcium et des bacteries sont visualises sur respectivement 8 et 6 prelevements. L’uroculture est positive chez 11 chats, Escherichia coli est la bacterie la plus frequemment retrouvee (8 cas sur 11). Soixante-seize pour cent des chats presentent des calculs unilateraux. 60 % dans calculs sont dans le tiers proximal, 13 % dans le tiers median et 27 % dans le tiers distal. Tous les calculs analyses, par spectrophotometrie infrarouge, sont de nature oxalo-calcique. Les localisations d’autres calculs concomitants sont : pyeliques (n = 31), vesicales (n = 8) et uretrale (n = 1). Quarante-huit pour cent des animaux ont recu seulement un traitement medical contre 52 % d’entre eux qui ont ensuite subi une intervention chirurgicale. Le traitement medical a ete associe a une levee de l’obstruction ureterale pour 17 % des animaux et a une amelioration clinique sans migration des calculs pour 10 % des chats traites. Il existe une association significative entre la valeur de la creatinine plasmatique et la duree d’hospitalisation. Les valeurs de creatinine apres un traitement medical restent significativement plus elevees en sortie d’hospitalisation et a 6 et 12 mois apres l’hospitalisation en comparaison au traitement chirurgical. Au total 16 animaux sont morts sur la periode d’etude. Discussion et conclusion Pour la premiere fois, a notre connaissance nous rapportons une association entre la race Sacree de Birmanie et les calculs ureteraux. Le risque apparait ainsi tres eleve dans cette race de developper des lithiases ureterales et invite a la mise en place d’etude prospective. Les predispositions raciales etaient deja rapportees pour le Siamois et le Persan. Les donnees cliniques de cette etude sont similaires aux publications precedentes soulignant en particulier la faible frequence de la douleur abdominale dans un contexte ou en comparaison a la medecine humaine ou canine, elle etait attendue. La presence d’une anomalie a la palpation renale n’est pas constante, la presence de cristaux d’oxalate de calcium dans les urines est tres rare soulignant le defi diagnostique de cette entite dans l’espece feline. Le traitement medical s’il semble moins efficace au long cours pour diminuer la creatinemie est associee a une levee de l’obstacle ou a une amelioration de la fonction renale dans pres d’un tiers des cas.

The diphenyl ditelluride PhTeTePh reacts with [Ir6(CO)15]2- (in refluxing tetrahydrofuran) or Ir6(CO)16 (in toluene) yielding [Ir6(CO)14(μ-TePh)]- or [Ir6(CO)13(μ-TePh)2], respectively. Analogous mono- and disubstituted iridium compounds were prepared with other diaryl disulfides or diselenides. Electrochemical experiments confirm the different reactivity of PhTeTePh and PhSSPh showing that the ditelluride adds to the electrogenerated transient radical [Ir6(CO)15]-• and the disulfide to [Ir6(CO)15]0. The two clusters consists of octahedra of iridium atoms with one or two edges bridged by phenyltellurolate ligands. The Ir−Ir bonds trans to the TePh unit are remarkably short.

Introduction Les calculs ureteraux sont la cause la plus frequente d’obstruction ureterale chez le chat et pres de 98 % de ces calculs sont des oxalates de calcium. La nature de ces calculs empeche leur dissolution medicale et la morbi-mortalite associee a une obstruction ureterale justifie la mise en œuvre d’un traitement precoce et agressif afin de lever cette obstruction et de limiter la diminution permanente et importante du debit de filtration glomerulaire. Le traitement medical, reposant essentiellement sur une diurese forcee, ne permet une levee de l’obstruction que dans moins de 17 % des cas. L’exerese chirurgicale des calculs est donc souvent de rigueur, mais la presence de multiples calculs, le taux eleve de recidives et de complications ont conduit au developpement de techniques alternatives de mise en place de derivations pyelo-vesicales extra-ureterale (SUB). Le but de cette etude est de decrire les resultats et les complications observes lors de mise en place de SUB chez des chats atteints d’obstructions ureterales. Materiel et methode Tous les chats presentes pour obstruction ureterale, objectivee par echographie et/ou pyelographie entre janvier 2013 et janvier 2016 et traites par SUB ont ete inclus. Des examens radiographiques, echographiques et sanguins ont ete realises de maniere systematisee. La procedure a consiste en la mise en place par laparotomie d’un SUB (Norfolk Vet Products, Etats-Unis). Pour cela, un guide metallique (0,035″) est passe du pole caudal du rein jusque dans la cavite pyelique. Une sonde de nephrostomie (7 Fr) est montee sur le guide jusque dans la cavite pyelique. Une sonde de cystotsotmie (6,5 Fr) est positionnee a l’apex de la vessie, puis les deux sondes sont reliees en sous-cutanee, apres tunnelisation de la paroi abdominale, par une chambre de derivation. La permeabilite de la derivation et le bon positionnement des sondes sont controles par injection au sein de la chambre de derivation. Dans tous les cas, les lithiases ureterales sont laissees en place. Un rincage du SUB a ete realise 3 mois apres l’intervention, puis tous les 6 a 12 mois. Le signalement des animaux, les parametres biologiques pre et postoperatoires, ainsi que les incidents, accidents et complications et le devenir des chats ont ete etudies. Resultats Vingt-huit chats presentes pour obstruction ureterale, âges de 7,1 ± 3,7 [2–14] ans en moyenne et pesant 3,7 ± 1,1 [2,1–7,0] kg, ont ete traites par mise en place de SUB ; de maniere unilateral chez 26 chats et bilateral chez 2 chats. Les valeurs de creatinine et d’uree preoperatoires etaient respectivement de 59,7 ± 43,0 [11–136] mg/L et 1,5 ± 0,9 [0,4–3,5] g/L. Une infection du tractus urinaire (ITU) a ete objectivee chez 18 % des animaux. Aucun accident peroperatoire n’a ete rapporte. Une sonde de nephrostomie a ete considere comme imparfaitement placee et repositionnee le lendemain de la chirurgie. Les valeurs de creatinine, et d’uree 48 a 96 heures apres l’intervention etaient respectivement de 26,3 ± 12,8 [7–56] mg/L et 0,9 ± 0,6 [0,2–2,7] g/L. Le taux de survie perioperatoire est de 90 %. Trois animaux ont presentes une obstruction du SUB dans les 2 semaines a 4 mois suivant l’intervention, soit par hematome pyelique traite par rincage (2 cas), soit par coude de la nephrostomie traitee par reprise chirurgicale. Une pollakiurie et/ou hematurie macroscopique, sans ITU ont ete rapportees dans 20 % des cas et traitees par administration de corticoides. Une ITU a ete detectee chez 32 % des animaux au cours du suivi postoperatoire. Sur les animaux sortis d’hospitalisation, le taux de survie a 6 mois est de 83 %. Discussion Historiquement, les calculs ureteraux associes a une insuffisance renale sont traites par ureterotomie, resection-anastomose ou reimplantation ureterale. Le taux de complications majeures (fuite, stenose) de ces techniques (le plus souvent unilaterale, sur un seul site d’obstruction et sans rupture) est de 6 a 30 % et la mortalite perioperatoire de 18 a 21 %. Recemment le traitement par stent a ete decrit, mais de nombreux cas d’obstruction de stents ont conduit au developpement d’une technique de derivation pyelo-vesicale extra-ureterale. Cette technique permet de maniere moins invasive une levee rapide de l’obstruction quel que soit le nombre de calcul. Les frequences de complications et de mortalite rapportees dans cette etude sont inferieures a ceux decrit avec les techniques chirurgicales conventionnelles ou avec la mise en place de stent ureteraux. Neanmoins, les complications ne sont pas rares et comprennent de la dysurie, des obstructions (moins de 10 %) et des infections (7 a 30 %). Conclusion L’utilisation de SUB lors d’obstruction ureterale chez le chat apparait donc comme une option interessante. Neanmoins, compte tenu des complications, un suivi clinique, biologique et echographique regulier apparait indispensable. Des etudes sur un plus grand nombre de cas sont necessaires pour preciser les indications, limites et benefices de cette technique.

Unusual platinum(II) trimetalated derivatives have been synthesized and characterized by reaction of cis-[Pt(R)2(DMSO)2] (R = Me, Ph) and 6-phenyl-2,2‘-bipyridine. The behavior of the substituted 2...

The cluster [FeIr 4 (CO) 13 ] 2- is obtained by decarbonylation of [FeIr 4 (CO) 15 ] 2- , either at room temperature or by moderate heating of a solution of the complex. The salt [PPh 4 ] 2 °FeIr 4 (CO) 13 ].C 4 H 8 O crystallizes in the triclinic space group P1

In the ethene/CO copolymerization catalyzed by palladium derivatives, species arising from ethene insertion into the palladium−acyl bond have been shown to play a key role. We report here the synthesis, spectroscopic characterization, and X-ray structure of the complex (HL = 6-Me-2,2‘-bipyridine, Ar‘ = 3,5-(CF3)2C6H3), 4, the first one having an ancillary N,N ligand to be characterized in the solid state.

The addition of a methanolic solution of cimetidine (1) to a methanolic solution of M2+ cations (M = Co, NJ, Cu, Zn) affords the cationic complexes [M(1)2]2+. In the case of M = Cu the addition of KOH in the reaction medium at 60 °C gives the [Cu(2′)]+ cation, where 2′ is an anionic ligand resulting from deprotonation of a cimetidine molecule modified by methanolic solvolysis of the nitrilic function. The X-ray structure characterization of [Cu(2′)]X·0.5H2O has been performed for X = ClO4− (5) and I− (6). Compound 5 is monoclinic, space group C2/c with a=20.732(8), b=7.471(3), c=23.734(5) A, β 100.76(3)°, Z=8, R=0.034, Rw=0.045 for 1767 reflections with I>3σ(I). Compound 6 is monoclinic, space group C2/c with a=20.736(3), b=7.426(3), c=22.786(2) A, β=99.65(1)°, Z=8, R=0.029, Rw=0.045 for 2498 reflections with I>3σ(I). In both compounds the 2′ anion acts as a tetradentate ligand coiled around the almost square planar metal center. Quantomechanical semiempirical calculations (CNDO/ 2) have been carried out on simple models of 2′, 5 and 6.

The neutral cluster [Ir6(CO)15(AuPPh3)21 has been obtained by reaction of [IrdC0)15I2- with [AuPPh3]+. The iridium atoms of the cluster define an octahedral frame capped by one gold-phosphine group. The second AuPPh3 unit spans one Ir-Au edge. The metal skeleton of C1 symmetry is coordinated by twelve terminal and three edge-bridging carbonyl groups. The dianionic [IrdcO)14(Hgc1)21~- has been prepared from [Irs(C0)15l2- and Hg2C12, HgC12 + Hg, or HgClz in the presence of Na2C03. The metallic framework forms an octahedron of iridium atoms bearing, on four non-adjacent faces, two ,u3-HgC1 fragments and two ,u3-C0 groups. The chemical shift of the lg9Hg NMR was found at +1508 ppm.

The aim of this case series was to describe a novel technique of single-incision laparoscopic ovariectomy in dogs using the SILS Port (Covidien), a single-port multiple-access device, in 40 client-owned dogs. A single 3 cm incision was made caudal to the umbilicus and the SILS Port device was bluntly introduced. Three cannulae were inserted in the SILS Port through the access channels. In the first 20 cases, a transabdominal suspension suture was used to transfix the ovaries. In all cases, ovariectomy was performed using a standard straight non-roticulated laparoscopic grasper and a vessel sealer/divider device. Mean (sd) duration of the ovarian resection was 25.1 (6.1) minutes (range 16 to 39 minutes). In five dogs (with transabdominal suspension suture), minor bleeding in the mesovarium or in the spleen was observed. Since the SILS Port allows simultaneous use of two instruments and a telescope through a single incision, the suspension suture is not mandatory. The lack of a transabdominal suspension suture increased collision between instruments and the telescope, but triangulation capabilities remained sufficient to achieve visualisation, sufficient manoeuvrability and safe vessel sealer/divider device application. The time to perform ovarian resection remained unaltered with or without suspension suture and regardless of the fat score of the ovarian ligament. Complications were less frequent without a suspension suture.