Veterinary Surgery August 2026 – Soft Tissue: Hemorrhage Control in Maxillofacial Surgery & Rethinking Articulating Laparoscopic Instruments

In this episode of the Simini Small Animal Surgery Podcast, we explore the soft tissue research from the August 2026 issue (Issue 6) of Veterinary Surgery, where two studies examine how surgical access and instrumentation can influence safety, efficiency, and technical performance. One study maps new approaches for common carotid artery ligation during complex maxillofacial procedures, potentially allowing surgeons to improve hemorrhage control while performing regional lymphadenectomy through the same surgical field. The second asks whether the additional freedom provided by an articulating laparoscopic needle driver actually makes suturing easier during total laparoscopic gastropexy.In this episode:✅ Blatt et al. used CT imaging and cadaveric dissections to evaluate lateral and ventral approaches for temporary or permanent common carotid artery (CCA) ligation at the level of the medial retropharyngeal lymph node (MRLN). Both approaches provided consistent access to the artery, with the mandibular salivary gland serving as a reliable surgical landmark, and could be combined with mandibular and medial retropharyngeal lymphadenectomy through the same surgical field. Importantly, skull conformation influenced the depth of dissection: in brachycephalic dogs, the lateral approach required a depth of approximately 45 mm compared with 29 mm for the ventral approach. The technique could provide surgeons with a valuable strategy for achieving preemptive vascular control during maxillectomy and other procedures where severe hemorrhage can compromise visualization and patient safety. The discussion also considers surgical site management at closure, particularly when combining vascular control and lymph node staging creates a deeper operative field. The episode examines the role of reinforcing lavage protocols in procedures where contamination and biofilm may remain important concerns despite successful mechanical and oncologic surgery. ✅ Gibson et al. conducted a prospective clinical trial comparing a mechanical articulating laparoscopic needle driver with standard rigid laparoscopic instrumentation during total laparoscopic gastropexy (TLG) in 17 large-breed dogs. Despite offering additional degrees of freedom, the articulating instrument was actually slower, requiring a median of eight minutes per suture line compared with six minutes using the standard rigid driver. Surgeons also reported significantly greater mental demand, effort, and frustration with the articulating device, while technical performance was lower. The likely limitation was mechanical: articulation improved access and needle orientation but reduced needle-grasping strength, creating more tissue drag when passing the needle through the transversus abdominis and gastric seromuscular layers. Importantly, both instruments successfully completed the procedures with few and low-grade adverse events, suggesting the issue is one of efficiency and learning curve rather than safety. Together, these studies reinforce an important principle of surgical innovation: new technology and new approaches are only valuable when they make surgery safer, more practical, or more effective. Greater complexity does not automatically mean better performance. 🎓 Journal Articles DiscussedBlatt et al. — Surgical approach for common carotid ligation at the level of the medial retropharyngeal lymph node in dogs: A comparative cadaveric studyGibson et al. — Comparison between a laparoscopic articulating needle driver with standard laparoscopic instrumentation for total laparoscopic gastropexy in dogs📚 From the August 2026 Issue (Issue 6) of Veterinary Surgery 🎁 Want to learn more about Simini Protect Lavage or request a sample?Learn More: www.simini.comRequest a Sample: https://www.simini.com/evaluation-kit