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Occlusion of the Thoracic Duct Using Ultrasonically Activated Shears in Six Dogs
Author(s) -
Leasure Christopher S.,
Ellison Gary W.,
Roberts John F.,
Coomer Alastair R.,
Choate Christina J.
Publication year - 2011
Publication title -
veterinary surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.652
H-Index - 79
eISSN - 1532-950X
pISSN - 0161-3499
DOI - 10.1111/j.1532-950x.2011.00903.x
Subject(s) - medicine , thoracic duct , occlusion , histopathology , intercostal space , thoracoscopy , thoracotomy , pneumothorax , catheter , video assisted thoracoscopic surgery , lymphatic system , surgery , radiology , pathology
Objective To assess the feasibility of sealing the thoracic duct ( TD ) in dogs using ultrasonically activated shears via thoracoscopy. Study Design In vivo experimental study. Animals Mature dogs ( n = 6). Methods Dogs were anesthetized without pulmonary exclusion and positioned in left lateral recumbency. Lymphangiography was performed to identify TD anatomy. Methylene blue was injected into the lymphatic catheter to identify the TD and its branches. Under thoracoscopic guidance (right dorsal 8–10th intercostal spaces), the TD was sealed with an ultrasonic device and lymphangiography was repeated. If the flow of contrast continued beyond the occlusion site, additional attempts to seal the duct were made. Dogs were euthanatized, the TD was excised and fixed in formalin for histopathology. Results Thoracoscopic identification of the TD was possible in 5 dogs. Three dogs required conversion to a thoracoscopic‐assisted approach and 3 dogs required resealing of the TD closer to the diaphragm. Thoracic duct occlusion ( TDO ) was ultimately achieved in all 6 dogs based on follow‐up lymphangiography. TDO by tissue coagulation was confirmed by histopathology. Conclusions Thoracoscopic identification and occlusion of the TD using ultrasonically activated shears with bilateral lung ventilation is technically feasible in normal dogs and provides a less invasive alternative to open thoracotomy procedures.