Soft tissue surgery 2 – Advanced Soft Tissue Surgery

Course Introduction

Take your soft tissue surgery to the next level.

STT 2 – Advanced Soft Tissue Surgery is an intensive, hands-on OKEAN programme designed for veterinarians who are ready to move beyond routine soft tissue procedures and develop greater confidence with complex urinary, abdominal and reconstructive surgery in dogs and cats.

Across two highly practical days, participants will work through a carefully selected range of advanced procedures — from urinary tract and bladder surgery to major abdominal procedures, GDV surgery, biliary surgery, diaphragmatic hernia repair, advanced colorectal surgery and challenging perineal hernia reconstruction.

The course focuses on the principles that make advanced surgery successful: case selection, surgical planning, anatomical approach, tissue handling, operative technique, complication avoidance and postoperative decision-making.

Rather than simply demonstrating individual procedures, STT 2 is designed to develop the surgeon’s ability to approach challenging cases systematically and perform technically demanding procedures with greater confidence and precision.

Jackie Demetriou, BVetMed, CertSAS, DipECVS, FRCVS

Jackie Demetriou is an EBVS and RCVS Specialist in Small Animal Surgery and a Fellow of the Royal College of Veterinary Surgeons. She qualified from the Royal Veterinary College in London in 1996 and went on to complete an internship and residency in Small Animal Surgery at the University of Edinburgh. Over the past 20 years, she has worked in both academia and specialist referral practice, including nine years as a Lecturer at the University of Cambridge and her current part-time Chair in Small Animal Soft Tissue Surgery at the University of Nottingham. She also spent 12 years in private referral practice, where she led a large soft tissue surgery team and ECVS residency programme. Jackie has extensive experience teaching surgery to veterinary surgeons, interns and residents in the UK and internationally, and particularly enjoys helping practitioners develop the confidence to manage challenging surgical cases. She has served on the ECVS Examination Committee and Board of Regents and is the author of two textbooks, several book chapters and more than 30 peer-reviewed publications.

Day 1 – Advanced Urinary Surgery

The first day focuses on advanced surgery of the urinary and reproductive tract, including:

• Cystotomy
• Bladder wall resection / partial cystectomy
• Nephrectomy
• Scrotal urethrostomy in dogs
• Perineal urethrostomy in cats
• Colposuspension

Participants will explore the indications, surgical approaches and key technical considerations for each procedure, with particular emphasis on anatomy, tissue handling and avoiding common complications.

Day 2 – Advanced Abdominal & Reconstructive Surgery

The second day concentrates on challenging abdominal and reconstructive procedures:

• Gastrectomy
• GDV surgery and gastropexy
• Cholecystectomy
• Diaphragmatic hernia repair
• Colectomy for megacolon and selected colonic tumours
• Perineal hernia repair using the internal obturator muscle flap
• Perineal hernia repair using the semitendinosus muscle flap

These procedures represent some of the more demanding soft tissue surgical cases encountered in small animal practice and provide participants with practical experience in advanced surgical decision-making and technique.

Course Objectives

By the end of STT 2, participants will be able to:

• Approach complex urinary and abdominal surgical cases in a structured and systematic manner.
• Understand the indications, limitations and appropriate case selection for advanced soft tissue procedures.
• Plan and perform advanced urinary tract surgery, including bladder surgery, nephrectomy and urethrostomy procedures.
• Apply appropriate techniques for partial cystectomy and bladder wall reconstruction.
• Understand the surgical principles of GDV management and perform appropriate gastropexy techniques.
• Perform key advanced gastrointestinal procedures, including gastrectomy and colectomy.
• Apply safe surgical techniques for cholecystectomy and recognise important anatomical and technical considerations of biliary surgery.
• Understand and perform appropriate approaches to diaphragmatic hernia repair.
• Select and perform appropriate reconstructive techniques for perineal hernia, including internal obturator and semitendinosus muscle flaps.
• Develop greater confidence in handling challenging anatomical regions and technically demanding procedures.
• Anticipate and minimise common intraoperative and postoperative complications.
• Apply sound principles of tissue handling, haemostasis, surgical exposure and closure throughout advanced soft tissue procedures.
• Transfer the practical techniques and decision-making skills gained during the course directly into clinical practice.

Who Is This Course For?

STT 2 is intended for veterinarians with previous experience in small animal soft tissue surgery who want to expand their surgical repertoire and become more confident in managing advanced cases.

It is particularly suited to clinicians who already perform routine abdominal and soft tissue procedures and are ready to progress to more complex and technically demanding surgery.

The OKEAN Approach

Advanced cases. Practical techniques. Greater surgical confidence.

STT 2 combines focused surgical teaching with intensive practical training, giving participants the opportunity to understand not only how to perform an advanced procedure, but also when, why and how to approach it safely.

This intensive two-day practical course is designed for veterinarians who want to strengthen their confidence and hands-on skills in the most important emergency soft tissue procedures in dogs and cats.

Emergency surgery demands more than knowing the procedure. It requires the ability to assess the problem, choose the right approach, work efficiently and manage complications when the patient is unstable.

Through extensive practical training, participants will work through a range of procedures encountered in emergency and first-opinion practice — from wound management, drains and airway procedures to gastrointestinal surgery and abdominal emergencies.

The emphasis is firmly on practical surgical technique, decision-making and procedures that can be immediately transferred to clinical practice.

COURSE OBJECTIVES

By the end of the course, participants will be able to:

• Select and place appropriate drainage systems, including Penrose and closed-suction drains.
• Perform essential wound management and debridement techniques.
• Establish temporary airway access through tracheostomy.
• Place thoracic drains safely and effectively.
• Select and place appropriate feeding tubes.
• Perform cystotomy and scrotal urethrostomy.
• Manage urinary obstruction using retrohydropulsion techniques.
• Perform a structured exploratory laparotomy and systematic abdominal exploration.
• Perform gastrotomy, enterotomy and intestinal resection and anastomosis.
• Use serosal patching and omentalisation to support compromised gastrointestinal tissue.
• Perform incisional gastropexy.
• Understand the indications, technique and key considerations for splenectomy.

Jackie Demetriou, BVetMed, CertSAS, DipECVS, FRCVS

Jackie Demetriou is an EBVS and RCVS Specialist in Small Animal Surgery and a Fellow of the Royal College of Veterinary Surgeons. She qualified from the Royal Veterinary College in London in 1996 and went on to complete an internship and residency in Small Animal Surgery at the University of Edinburgh. Over the past 20 years, she has worked in both academia and specialist referral practice, including nine years as a Lecturer at the University of Cambridge and her current part-time Chair in Small Animal Soft Tissue Surgery at the University of Nottingham. She also spent 12 years in private referral practice, where she led a large soft tissue surgery team and ECVS residency programme. Jackie has extensive experience teaching surgery to veterinary surgeons, interns and residents in the UK and internationally, and particularly enjoys helping practitioners develop the confidence to manage challenging surgical cases. She has served on the ECVS Examination Committee and Board of Regents and is the author of two textbooks, several book chapters and more than 30 peer-reviewed publications.

DAY 1 — EMERGENCY PROCEDURES & WOUND MANAGEMENT

A practical day focused on procedures commonly required in emergency and critical-care patients.

Practicals

Drains
Penrose and closed-suction drain placement, selection and management.

Wound Management
Debridement techniques and tie-over dressings for complex wounds.

Temporary Tracheostomy
Practical technique for establishing a temporary airway in emergency patients.

Thoracic Drain Placement
Technique and practical considerations for thoracic drainage.

Feeding Tube Placement
Practical approaches to enteral access in critically ill patients.

Cystotomy & Scrotal Urethrostomy
Essential techniques for emergency urinary tract surgery.

Retrohydropulsion
Hands-on management of urethral obstruction using retrohydropulsion techniques.

DAY 2 — EMERGENCY ABDOMINAL SURGERY

A full practical day dedicated to the surgical management of acute abdominal disease.

Practicals

Exploratory Laparotomy
Develop a systematic approach to entering and assessing the abdomen.

Systematic Abdominal Exploration
Learn a structured examination sequence to minimise missed pathology.

Gastrotomy & Enterotomy
Safe surgical approaches to the stomach and intestine.

Intestinal Resection & Anastomosis
Practical techniques for managing non-viable or severely compromised bowel.

Serosal Patch
Learn when and how to reinforce compromised intestinal segments.

Omentalisation
Use the omentum strategically to support healing and manage contaminated or compromised tissues.

Incisional Gastropexy
Practical technique and key surgical principles.

Splenectomy
Approach to splenic surgery, vascular control and safe removal.

WHY THIS COURSE?

This is a practical, hands-on course for vets who want to improve their confidence with emergency soft tissue surgery in dogs and cats. Over two days, you will practise a range of procedures that are relevant to everyday emergency practice, including drain placement, wound management, temporary tracheostomy, thoracic drains, feeding tubes, cystotomy and emergency laparotomy. The emphasis is on doing the procedures yourself, with guidance throughout, rather than simply watching demonstrations. The aim is to leave the course with practical skills and greater confidence that you can take straight back to your clinic and use when faced with an emergency case.

A 2-Day Practical Surgical Course

COURSE DESCRIPTION

Soft tissue surgery is an essential part of everyday small animal practice, yet many procedures can be challenging without sufficient experience. This 2-day STT 1 practical course is designed for veterinary surgeons with basic surgical experience who want to build confidence in soft tissue surgery, skin reconstruction and abdominal procedures.

The course covers suturing and tension-relieving techniques, reconstructive skin flaps, abdominal exploration, biopsy techniques, gastrointestinal surgery, intestinal anastomosis, omentalisation, serosal patching, cystotomy and feeding tube placement.

2 days | Intensive practical training | Small groups | Supervised surgery

With short theoretical introductions followed by extensive hands-on practice, participants will develop practical surgical skills, learn when to use different techniques and gain confidence in avoiding common complications.

Jackie Demetriou, BVetMed, CertSAS, DipECVS, FRCVS

Jackie Demetriou is an EBVS and RCVS Specialist in Small Animal Surgery and a Fellow of the Royal College of Veterinary Surgeons. She qualified from the Royal Veterinary College in London in 1996 and went on to complete an internship and residency in Small Animal Surgery at the University of Edinburgh. Over the past 20 years, she has worked in both academia and specialist referral practice, including nine years as a Lecturer at the University of Cambridge and her current part-time Chair in Small Animal Soft Tissue Surgery at the University of Nottingham. She also spent 12 years in private referral practice, where she led a large soft tissue surgery team and ECVS residency programme. Jackie has extensive experience teaching surgery to veterinary surgeons, interns and residents in the UK and internationally, and particularly enjoys helping practitioners develop the confidence to manage challenging surgical cases. She has served on the ECVS Examination Committee and Board of Regents and is the author of two textbooks, several book chapters and more than 30 peer-reviewed publications.

COURSE OBJECTIVES

• By the end of the course, participants should be able to:
• Apply the principles of atraumatic tissue handling and good surgical technique.
• Select appropriate suture materials and suture patterns for different tissues and situations.
• Recognise situations where primary wound closure may create excessive tension.
• Use undermining, relaxing incisions and advancement techniques to achieve more effective wound closure.
• Plan and perform basic reconstructive skin flaps.
• Perform V-to-Y advancement, advancement, bipedicle advancement and transposition flaps.
• Understand the design and practical application of the caudal superficial epigastric flap.
• Perform a systematic abdominal exploration.
• Obtain appropriate surgical biopsies from commonly encountered abdominal organs.
• Perform liver, gastrointestinal, lymph node, kidney, pancreas and bladder biopsy techniques.
• Perform enterotomy and enterectomy safely.
• Perform an end-to-end intestinal anastomosis.
• Understand the principles and practical application of omentalisation and serosal patching.
• Perform cystotomy and appropriate bladder closure.
• Place oesophagostomy and gastrostomy feeding tubes.
• Recognise potential complications associated with these procedures and understand how to minimise them.

COURSE TIMETABLE

DAY 1

Suturing, Wound Management & Skin Reconstruction

• Surgical principles – Atraumatic tissue handling – Surgical planning – Suture materials and selection – Principles of wound healing – Dead space and tension management
• Suturing techniques – practical – Basic and commonly used suture patterns – Interrupted and continuous patterns – Appositional closure – Tension-relieving techniques – Practical exercises
• Wound reconstruction – Assessment of skin defects – Undermining – V-to-Y advancement – Single and multiple relaxing incisions – Practical application
• Advancement & bipedicle flaps – practical – Flap planning – Principles of blood supply – Advancement flap – Bipedicle advancement flap – Practical flap creation
• Transposition & caudal superficial epigastric flaps – When to choose a transposition flap – Flap design and planning – Transposition flap – Caudal superficial epigastric flap – Practical reconstruction
• Day 1 review – Common mistakes – Complications – Choosing the appropriate reconstructive technique

DAY 2

Abdominal, Gastrointestinal & Urinary Surgery

• Abdominal exploration – Surgical approach to the abdomen – Systematic abdominal exploration – Assessment of abdominal organs – Surgical decision-making and sampling
• Biopsy techniques – practical – Liver biopsy – Gastrointestinal biopsy – Lymph node biopsy – Kidney biopsy – Pancreatic biopsy – Bladder biopsy
• Gastrointestinal surgery I – practical – Assessment of intestinal viability – Enterotomy – Enterectomy – Principles of intestinal closure
• Gastrointestinal surgery II – practical – End-to-end intestinal anastomosis – Omentalisation – Serosal patch – Avoiding common complications – Practical surgical exercises
• Urinary surgery – practical – Cystotomy – Bladder exploration – Stone retrieval – Principles of bladder closure – Avoiding postoperative complications
• Feeding tube placement – practical – Indications for enteral feeding – Oesophagostomy tube placement – Gastrostomy tube placement – Tube management and potential complications
• Final review & discussion – Putting the techniques into clinical practice – Case-based discussion – Common surgical pitfalls – Questions and discussion