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Laparoscopy and Thoracoscopy in the Dog and Cat
ISBN : 9781957260846 Author/s : Andrea M. Pievaroli, Roberto Properzi, J. Brad Case, Francesco Collivignarelli Release date : July 2023 Pages : 696 Binding : Hard cover Dimensions : 22 X 28 Language : English
After the introduction in the 1980s of minimally invasive surgery in human medicine, laparoscopic and thoracoscopic surgery started to take hold also in veterinary medicine. Thanks to its reduced invasiveness and its fast post-operative recovery, minimally invasive surgery started to expand so quickly that nowadays it has become the preferred technique for many surgical procedures. Laparoscopy and Thoracoscopy in the dog and cat is a comprehensive book that describe all the minimally invasive surgical procedures. The description of the various surgical steps is accompanied by a wide iconography, each chapter in fact illustrates with drawings and pictures the arrangement of the surgeons in the operating room and the positioning of portals to perform laparoscopic or thoracoscopic procedures. The book is also enriched by personal experiences of international authors who shared procedures still not described in the literature making the volume a must have practical book for practitioners aswell as experienced surgeons. For a better understanding the book includes videos of the described procedures available through QR codes on vetminimallyinvasivesurgery.edrapublishing.com.
Contents
Section I. GENERAL PRINCIPLES 1. HISTORY OF VETERINARY MINIMALLY INVASIVE SURGERY Beagle ovariohysterectomy model Open approach to the abdomen Trocar and clip applier testing Expansion of preclinical research and development Early knowledge dissemination Early clinical application Veterinary Endoscopy Society Advances in education Natural orifice transluminal endoscopic surgery (NOTES) Single-incision laparoscopic surgery Future of minimally invasive surgery in animals
2. LOW-IMPACT SURGERY
3. EQUIPMENT FOR MINIMALLY INVASIVE SURGERY Imaging systems Light sources Light transmitting cables Camera control units and camera heads Insufflators Documentation units Surgical monitors Instrumentation Electrosurgery units and vessel-sealing technology Accessory devices Surgical tables and racks Other accessory units and devices for laparoscopy and thoracoscopy
4. OPERATING ROOM AND HYGIENE MEASURES Considerations for a minimally invasive operating room Basic ergonomic considerations Operating room checklist Preparation for open surgery Hybrid rooms Hygiene measures Cleaning of hands
5. ERGONOMICS IN LAPAROSCOPY AND THORACOSCOPY Domains of ergonomics Operating room setup Factors linked to musculoskeletal disorders
6. PRINCIPLES OF TRIANGULATION IN LAPAROSCOPY AND THORACOSCOPY Mechanical constraints Visual restrictions Optimal position of the rigid endoscope (T1) Optimal position of operative instruments (T2, T3) Relationship between the endoscope and the working instruments
7. SINGLE-INCISION (SINGLE-PORT) LAPAROSCOPIC TECHNIQUE Principles of single-port surgery Instrumentation Optics Single-port access methods Equipment-specific access methods A. Insertion techniques for specifically manufactured single‐port devices B. Insertion technique of standard trocars for single‐port entry C. Innovative adaptations of existing equipment
8. LAPAROSCOPIC INTRACORPOREAL AND EXTRACORPOREAL SUTURING Ergonomics Instruments and equipment Training in laparoscopic suturing Suture materials Types and patterns of laparoscopic suturing Laparoscopic intracorporeal suturing Laparoscopic extracorporeal suturing Additional suturing and knot tying techniques Robotic, articulated, and mechanical devices How many turns and throws do I need? Knot security in laparoscopic surgery What is the best knotting configuration?
9. LEARNING AND ADVANCING MINIMALLY INVASIVE SURGERY SKILLS Basic psychomotor skills Laparoscopic entry and basic procedure practice Performing basic procedures in live animals Advanced procedure training
10. INDOCYANINE GREEN INITIAL APPLICATIONS OF FLUORESCENCE-GUIDED SURGERY Fundamentals of NIR/ICG Imaging technology Procedure principles Clinical applications Case examples
Section II. LAPAROSCOPY 11. ANESTHESIA IN LAPAROSCOPIC SURGERY Anesthetic management Postoperative management Complications Clinical cases 11.1 Hypotension and bradycardia at pneumoperitoneum induction in a female dog Samuele Venuta
12. PATIENT POSITIONING, ACCESS, PORT PLACEMENT, AND PNEUMOPERITONEUM IN LAPAROSCOPY Patient positioning Laparoscopic access and port placement Pneumoperitoneum
13. COMPLICATIONS IN LAPAROSCOPY Anatomical knowledge Closed entry with the Veress needle technique Open entry techniques Laparoscopic access complications Intraoperative complications and conversion to open techniques Postoperative complications
14. EXPLORATORY AND DIAGNOSTIC LAPAROSCOPY Patient preparation and positioning Operating room layout Port placement A. Abdominal exploration B. Liver and gallbladder evaluation and biopsy C. Kidney and adrenal gland evaluation and biopsy D. Pancreas evaluation and biopsy E. Spleen evaluation and biopsy F. Lymph node evaluation and biopsy G. Gastrointestinal tract evaluation and biopsy Postoperative management Clinical cases 14.1 Cisterna chyli ablation 14.2 Laparoscopic intraperitoneal foreign body retrieval (two-port technique) 14.3 Laparoscopic exploration in a cat 14.4 Laparoscopic treatment of hemoabdomen 14.5 Minimally invasive abdominal approach to subcostal foreign body removal 14.6 Laparoscopic repositioning of a ventriculoperitoneal shunt catheter 14.7 Laparoscopic liver biopsy
15. LAPAROSCOPIC OVARIECTOMY Described surgical procedures Patient preparation and positioning Operating room layout A. Two-port ovariectomy B. Three-port ovariectomy C. Single-port laparoscopic ovariectomy Postoperative management Clinical cases 15.1 Ovariectomy by transvaginal total NOTES. 15.2 Two-port laparoscopic ovariectomy in the cat 15.3 Laparoscopic ovariectomy in a dog with type III sclerosing encapsulating peritonitis 15.4 Laparoscopic ovariectomy in large- and giant-breed dogs 15.5 Two-port laparoscopic ovariectomy without ovary suspension suture in a female dog 15.6 Laparoscopic ovariectomy in an African lioness (Panthera leo) using a single-port multiple-access device 15.7 LESS ovariectomy using a simple handmade access device
16. LAPAROSCOPY FOR OVARIAN REMNANT SYNDROME Described surgical procedures Patient preparation and positioning Operating room layout Port placement Procedure Postoperative management Clinical cases 16.1 Ovarian remnant syndrome after laparoscopic ovariectomy in a cat 16.2 Ovarian remnant syndrome in a dog
17. LAPAROSCOPIC OVARIOHYSTERECTOMY Described surgical procedures Patient preparation and positioning Operating room layout A. Two-port ovariohysterectomy B. Three-port ovariohysterectomy Laparoscopic ovariohysterectomy for ovarian or uterine pathologies Postoperative management
18. LAPAROSCOPIC CRYPTORCHIDECTOMY Patient preparation and positioning Operating room layout A. Two-port laparoscopic cryptorchidectomy B. Single-port laparoscopic cryptorchidectomy Postoperative management Clinical cases 18.1 Testicular torsion in a cryptorchid dog 18.2 Laparoscopic cryptorchidectomy
19. LAPAROSCOPIC-ASSISTED CYSTOSCOPY AND PERCUTANEOUS SUPRAPUBIC CYSTOSCOPY Patient preparation and positioning Operating room layout A. Laparoscopic-assisted cystoscopy B. Percutaneous suprapubic cystoscopy or percutaneous cystolithotomy (PCCL) C. Single-port percutaneous cystolithotomy Postoperative management Clinical cases 19.1 Percutaneous cystoscopic cystolithotomy in a Yorkshire Terrier 19.2 Laparoscopic-assisted cystostomy in a Chihuahua
20. LAPAROSCOPIC CYSTOTOMY Patient preparation and positioning Operating room layout Port placement Procedure Postoperative management
21. LAPAROSCOPIC CYSTOPEXY Described surgical procedures Patient preparation and positioning Operating room layout Port placement Procedure Postoperative management
22. LAPAROSCOPIC-ASSISTED VASOPEXY Patient preparation and positioning Three-port laparoscopic-assisted vasopexy Postoperative management Clinical cases 22.1 Laparoscopic reversible neutering in a dog
23. LAPAROSCOPIC URETERONEPHRECTOMY Roberto Properzi Described surgical procedures Patient preparation and positioning Operating room layout Port placement Procedure Postoperative management Clinical cases 23.1 Laparoscopic omentalization of a renal cyst 23.2 Laparoscopic perinephric pseudocyst resection 23.3 Laparoscopic renal cyst deroofing, fulguration, and omentalization
24. CURRENT CONCEPTS IN MINIMALLY INVASIVE NEPHROLITHOTOMY Described surgical procedures Patient selection Equipment Operating room layout Modified surgical-assisted nephrolithotomy technique Postoperative management Clinical cases 24.1 Nephron-sparing nephrotomy to remove large uroliths in dogs 24.2 Nephron-sparing nephrotomy for the treatment of Dioctophyme renale parasitosis
25. LAPAROSCOPIC APPROACH TO URETEROLITHIASIS Patient preparation and positioning Operating room layout Port placement Procedure Postoperative management Clinical cases 25.1 Ureterotomy for stone removal
26. LAPAROSCOPIC NEOURETEROCYSTOSTOMY Described surgical procedures Patient preparation and positioning Operating room layout Port placement Procedure Postoperative management Clinical cases 26.1 Laparoscopy-assisted cutaneous ureterostomy (LACU) in a canine patient with prostatic carcinoma
27. LAPAROSCOPIC ARTIFICIAL URETHRAL SPHINCTER (AUS) IMPLANTATION Patient preparation and positioning Operating room layout Port placement Procedure Postoperative management
28. LAPAROSCOPIC PROSTATECTOMY Felipe Lillo, Francesco Collivignarelli Described surgical procedures Patient preparation and positioning Operating room layout Port placement Procedure Postoperative management
29. LAPAROSCOPIC OMENTALIZATION OF PARAPROSTATIC CYSTS Patient preparation and positioning Operating room layout Port placement Procedure Postoperative management Clinical cases 29.1 Omentalization of a prostatic abscess 29.2 Omentalization of a paraprostatic cyst in a dog
30. LAPAROSCOPIC GASTROPEXY AND LAPAROSCOPIC-ASSISTED GASTROPEXY Described surgical procedures A. Intracorporeal laparoscopic gastropexy I B. Intracorporeal laparoscopic gastropexy II C. Laparoscopic-assisted gastropexy D. Single-port laparoscopic-assisted incisional gastropexy Postoperative management Clinical cases 30.1 Total laparoscopic sutureless gastropexy with absorbable straps in dogs 30.2 Intracorporeally sutured laparoscopic gastropexy using an abdominal wall incision made at right angles to the rotation direction of the suturing needle 30.3 Laparoscopic gastropexy in a dog 30.4 Total laparoscopic gastropexy (two-port technique using Endostitch) 30.5 Treatment of lower esophageal sphincter incompetence in a cat using total laparoscopic gastropexy
31. LAPAROSCOPIC-ASSISTED GASTROTOMY Patient preparation and positioning A. Two-port laparoscopic-assisted gastrotomy B. Single-port laparoscopic-assisted gastrotomy Postoperative management
32. SINGLE-PORT LAPAROSCOPIC-ASSISTED INTESTINAL SURGERY Patient preparation and positioning Operating room layout Port placement Procedure Postoperative management
33. LAPAROSCOPIC-ASSISTED COLOPEXY Patient preparation and positioning Operating room layout A. Two-port laparoscopic-assisted colopexy B. Three-port laparoscopic-assisted colopexy and vasopexy Postoperative management Clinical cases 33.1 Totally laparoscopic colopexy in a cat 33.2 Laparoscopic colopexy and ovariectomy in a dog
34. LAPAROSCOPIC LIVER SURGERY Patient preparation and positioning Operating room layout A. Right medial hepatectomy in a cat using a bipolar sealing device B. Laparoscopic partial left lateral hepatectomy C. Laparoscopic partial left medial hepatectomy Postoperative management Clinical cases 34.1 Laparoscopic excisional liver biopsy in a dog 34.2 Laparoscopic excision of a hepatic cyst and omentopexy in a Persian cat
35. LAPAROSCOPIC MICROWAVE ABLATION OF THE LIVER Described surgical procedures Patient preparation and positioning Operating room layout Port placement Procedure Postoperative management
36. LAPAROSCOPIC CHOLECYSTECTOMY Patient preparation and positioning Operating room layout Port placement Procedure A. Dissection from the cystic duct B. Dissection from the apex of the gallbladder C. Intraoperative cholangiogram Postoperative management Clinical cases 36.1 Single-port laparoscopic cholecystectomy technique in dogs 36.2 Laparoscopic cholecystectomy and intraoperative bile duct flushing for extrahepatic biliary obstruction in a dog 36.3 Cholecystectomy and bile duct flushing 36.4 Laparoscopic cholecystectomy in a dog using the subserosal layer dissection technique 36.5 Cholecystectomy 36.6 Cholecystectomy by three-port access and “cold” dissection 36.7 Cholecystectomy in a dog 36.8 Laparoscopic cholecystectomy in a dog 36.9 Fundus-first cholecystectomy
37. LAPAROSCOPIC TREATMENT OF EXTRAHEPATIC PORTOSYSTEMIC SHUNT A. Laparoscopic treatment of extrahepatic portosystemic shunt with cellophane band B. Laparoscopic treatment of extrahepatic portosystemic shunt with ameroid constrictor Clinical cases 37.1 Splenocaval shunt 37.2 Laparoscopic attenuation of a splenophrenic shunt in a dog 37.3 Laparoscopic attenuation of a splenocaval shunt in a dog 37.4 Laparoscopic attenuation of a left intrahepatic portosystemic shunt in a cat 37.5 Laparoscopic portosystemic shunt attenuation in a dog
38. LAPAROSCOPIC PANCREATIC SURGERY S. A. van Nimwegen, F. O. Buishand, J. Kirpensteijn Described surgical procedures A. Three-port pancreatic biopsy B. Three-port excision of pancreatic lesions, excluding lesions in the distal left pancreatic lobe C. Three-port excision of pancreatic lesions in the distal left pancreatic lobe D. Laparoscopic approach for insulinoma going beyond the pancreas Postoperative management Clinical cases 38.1 Pancreatectomy in a case of insulinoma 38.2 Laparoscopic right lateral pancreatic lobectomy in a dog 38.3 Laparoscopic omentalization of a pancreatic cyst in a cat
39. LAPAROSCOPIC SPLENECTOMY Patient preparation and positioning Operating room layout Port placement A. Multiport laparoscopic splenectomy B. Single-incision laparoscopic splenectomy C. Laparoscopic-assisted splenectomy D. Hand-assisted splenectomy Postoperative management Clinical cases 39.1 Laparoscopic splenectomy in a small dog 39.2 Splenectomy 39.3 Laparoscopic splenectomy for hemangiosarcoma
40. LAPAROSCOPIC ADRENALECTOMY Francesco Collivignarelli, Felipe Lillo Endocrine testing Diagnostic imaging Described surgical procedures A. Adrenalectomy in sternal recumbency B. Adrenalectomy in lateral recumbency Postoperative management C. Retroperitoneal adrenalectomy Clinical cases 40.1 Right laparoscopic adrenalectomy 40.2 Laparoscopic right adrenalectomy for adrenal adenocarcinoma in a dog 40.3 Right adrenalectomy in a Yorkshire Terrier dog 40.4 Left adrenalectomy in a dog 40.5 Laparoscopic right adrenalectomy
41. LAPAROSCOPIC DIAPHRAGMATIC HERNIORRHAPHY Described surgical procedures A. Three-port laparoscopic diaphragmatic herniorrhaphy B. Three-port gasless laparoscopic diaphragmatic herniorrhaphy Postoperative management Clinical cases 41.1 Diaphragmatic hernia in a cat
42. LAPAROSCOPIC HIATAL HERNIORRHAPHY Described surgical procedures Patient preparation and positioning Operating room layout Port placement Procedure Postoperative management
43. LAPAROSCOPIC INGUINAL HERNIORRHAPHY Described surgical procedures Patient preparation and positioning Operating room layout Port placement Procedure Postoperative management Clinical cases 43.1 Laparoscopic-assisted percutaneous herniorrhaphy in dogs using the PIRS technique and laparoscopic ovariectomy Przemysław Przadka, Bartłomiej Liszka, Agnieszka Antończyk, Zdzisław Kiełbowicz, Dariusz Patkowski 43.2 Laparoscopic-assisted percutaneous inguinal herniorrhaphy F. Martínez Gomariz, C. Sánchez, J. D. Carrillo
44. LAPAROSCOPIC PERINEAL HERNIORRHAPHY Patient preparation and positioning Operating room layout Port placement Procedure Postoperative management
45. LAPAROSCOPIC PERITONEOPERICARDIAL HERNIORRHAPHY Patient preparation and positioning Operating room layout Port placement Procedure Postoperative management Clinical cases 45.1 Laparoscopic treatment of peritoneal- pericardial diaphragmatic hernia in a puppy dog 45.2 Laparoscopic repair of pericardial diaphragmatic hernia in a dog
Section III. THORACOSCOPY 46. ANESTHESIA IN THORACOSCOPY Indications for thoracoscopic procedures Patient selection Preoperative work-up Patient stabilization Patient preparation and positioning Anesthesia Analgesia Visualization of the surgical field and lung separation Pathophysiology of one-lung ventilation Management of ventilation Complications during one-lung ventilation Monitoring 3 Postoperative complications Postoperative management
47. PATIENT POSITIONING, ACCESS, AND PORT PLACEMENT IN THORACOSCOPY Patient positioning Thoracoscopic access and port placement
48. CONTRAINDICATIONS AND COMPLICATIONS IN THORACOSCOPY Strategic avoidance of complications Most frequent complications Monitoring for complications
49. EXPLORATORY AND DIAGNOSTIC THORACOSCOPY A. Thoracoscopic exploration B. Thoracic biopsy Postoperative management Clinical cases 49.1 Thoracoscopy in combination with digestive endoscopy for the diagnosis of intrathoracic neoformations 49.2 Gunshot wound to the chest cavity in a dog
50. THORACOSCOPIC PERICARDIECTOMY A. Pericardial window in dorsal recumbency B. Pericardial window in lateral recumbency C. Subtotal pericardiectomy Postoperative management Clinical cases 50.1 Two-port thoracoscopic pericardiectomy as a novel technique in flat-chested dogs with reduced thoracic working spaces 50.2 Thoracoscopic subphrenic (subtotal) pericardiectomy
51. THORACOSCOPIC THORACIC DUCT LIGATION FOR TREATMENT OF CHYLOTHORAX Described surgical procedures Patient preparation and positioning Operating room layout Port placement Procedure Postoperative management Clinical cases 51.1 Bilateral en bloc thoracic duct ligation in combination with pericardiectomy by video-assisted thoracoscopic surgery for idiopathic chylothorax in a dog 51.2 Thoracoscopic thoracic duct ligation for idiopathic chylothorax 51.3 Thoracic duct ligation and pericardiectomy in a cat with chylothorax 51.4 Thoracoscopic thoracic duct ligation and methylene blue coloration of mesenteric lymph nodes to confirm occlusion 51.5 Endoscopic-assisted surgery for idiopathic chylothorax in a domestic shorthair cat 51.6 Chylothorax associated with a peritoneopericardial diaphragmatic hernia in a dog
52. THORACOSCOPIC APPROACH TO THE MANAGEMENT OF PYOTHORAX Operating room layout Port placement Procedure Postoperative management
53. THORACOSCOPIC LUNG LOBECTOMY Patient preparation and positioning Operating room layout A. Thoracoscopic lung lobectomy B. Thoracoscopically assisted lung lobectomy Postoperative management Clinical cases 53.1 Hilar lung lobectomy 53.2 Video-assisted thoracoscopic surgery pulmonary lobectomy 53.3 Thoracoscopic lung lobectomy for lung lobe torsion Roberto Bussadori, Deborah De Bastiani 53.4 Thoracoscopic lobectomy of the right middle lung lobe in a dog
54. THORACOSCOPIC APPROACH TO VASCULAR RING ANOMALIES Described surgical procedures Patient preparation and positioning Operating room layout Port placement Procedure Postoperative management Clinical cases 54.1 Thoracoscopic approach combined with esophagoscopy for the surgical correction of a persistent right aortic arch
55. THORACOSCOPIC APPROACH TO MEDIASTINAL MASS EXCISION Patient preparation and positioning Operating room layout Port placement Procedure Postoperative management Clinical cases 55.1 Thoracoscopic mediastinal lymph node excision 55.2 Thoracoscopic treatment in a cat with thymoma-associated exfoliative dermatitis 55.3 Thoracoscopic resection of a cranial mediastinal mass in a dog 55.4 Thoracoscopic excision of a mediastinal ectopic thyroid carcinoma
56. THORACOSCOPIC AURICULECTOMY Described surgical procedures Patient preparation and positioning Operating room layout Port placement Procedure Postoperative management Clinical cases 56.1 Thoracoscopic right auricular tumor excision using a four-port technique 56.2 Surgical variation on auricular mass removal technique
57. THORACOSCOPIC FOREIGN BODY REMOVAL Diagnosis Preoperative considerations Patient preparation and positioning Operating room layout Port placement Procedure Postoperative management
58. THORACOSCOPIC PLACEMENT OF EPICARDIAL PACEMAKERS Patient preparation and positioning Operating room layout Port placement Procedure Postoperative management
59. THORACOSCOPIC-ASSISTED PLEURAL PORT PLACEMENT A. Pleural port placement following pericardiectomy B. Pleural port placement for the management of malignant thoracic effusion Postoperative management Clinical cases 59.1 Pleural port implantation for the management of malignant pleural effusion due to metastatic mammary carcinoma in a dog
Author
Andrea M. Pievaroli Andrea M. Pievaroli graduated in 1992 from Università degli Studi in Milan.Since 1993 he has worked in Rome in a private referral clinic, mainly dealing with soft tissue surgery, minimally invasive surgery and orthopedics. He spent periods at the College of Veterinary Medicine of Michigan State University (USA), the College of Veterinary Medicine of Texas A&M University (USA), and the Animal Medical Center (NY, USA). Since 2000 he is particularly experienced in minimally invasive endoscopic surgery (Laparoscopy and Thoracoscopy), cystoscopy and other endoscopic techniques. He is an instructor for minimally invasive endoscopic courses and has presented at national and international congresses and events. He is a member and liaison of VES (Veterinary Endoscopy Society) and secretary of SICMIV (Italian Society of Veterinary Mini-Invasive Surgery).
Roberto Properzi Roberto Properzi is the author of several scientific articles, mainly in the surgical field. He has presented numerous dissertations at specialized international conferences organized by VES, SICV, SIOVET, SICEV, SLEV, ASAEE and EVENDOC. He participated in four courses in Caceres (Spain) at the CCMIJU (Jesus Uson Minimally Invasive Surgery Center), in June 2009 and January 2011 as a student, in 2018 and 2022 as an instructor. He was a lecturer at the Master of Surgery in the years 2021-2022, at the Faculty of Veterinary Medicine of Teramo. He mainly practices orthopedic and minimally invasive surgery and is particularly keen on laparoscopy, thoracoscopy and arthroscopy. He is an associate member of the following organizations: VES, ASAEE, EVENDOC, MINIMAL, SIOVET, SICV, SICMIV, SITOV, ESVOT, SLEV and SICEV. His hobbies are both the mountain, where he practices ski mountaineering and the sea, which sets sail with his motorboat. He loves beautiful company too.
J. Brad Case J. Brad Case is a Professor of Small Animal, Minimally Invasive and Soft Tissue Surgery at the University of Florida. He obtained his DVM degree from The University of California, Davis. He did an internship in medicine and surgery at Texas A&M University. He then went on to complete a surgery residency and Master’s degree at Colorado State University. He has been a surgeon at the University of Florida since 2011. During this time, he has trained multiple surgery residents and minimally invasive surgery fellows. He has developed a vascular interventional service after training with University of Florida interventional radiologists. His translational research has been funded by the NIH and the Society of Thoracic surgeons which has led to the development of devices and procedures intended for use in humans with cardiovascular disease.
Francesco Collivignarelli Francesco Collivignarelli graduated at the University of Perugia and started a Master’ s degree in Oncology and Oncologic Surgery at the University of Pisa and and a PhD from the University of Teramo. He did an Internship in Soft Tissue Surgery at University of Bristol Prof. Peter Holt (ECVS). After that he gained a fellowship in Oncologic Surgery at University of Torino under the supervision of Prof. Paolo Buracco (ECVS). He is the coauthor and collaborator of the book Advances in Small Animal Care vol.1 (Elsevier 2020). And also the author and coauthor of many scientific studies and scientific papers. He is often invited as guest speaker at national and international meetings. Since 2020° is the contract Professor at Master of Small Animal Surgery University of Teramo. He i s also a Lecturer at the Master of Diagnostic Image University of Teramo (2020 to date).Currenly is working as surgeon at Teaching Hospital at University of Teramo, and at AniCura at Policlinico Roma Sud. His field of interest are sentinel lymph node, minimally invasive surgery, oncologic surgery, cardiovascular surgery, oromaxillofacial oncologic surgery. He is the secretary of AIVPA, SICEV Italian associations for small animal. Professional CCR Diver
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