Ex Vivo Evaluation of Canine Lung Biopsy Techniques

Objective An ex vivo comparison of thoracoscopic lung biopsy techniques in dogs. Study Design Experimental. Sample Population Cadaveric canine lung lobes. Methods Lungs were inflated to 10 cmH 2 O. After collecting biopsies 3 cm from the edge of lung lobes, leak pressures were recorded as inflation pressure was increased to 40 cmH 2 O. Pre‐tied loop ligature, square knot (SQ), modified 4S Roeder knot (M4SR) with glycomer 631 and polyglactin 910 size 0 and 2‐0 were used in addition to EndoGIA 45–2.5 mm (Covidien, Norwalk, CT) and a vessel sealant device (VSDS single and VSDD double seal). Six biopsies were performed with each of these modalities. Results Median airway pressure at which leakage occurred was 28 (20–34) cmH 2 O for EndoGIA 45; 33 (14–40) for VSDD; and 33 (10–40) for VSDS while other groups reached a median pressure of 40 cmH 2 O ( P  < .0001). Leakage occurred at 20 cmH 2 O in 1 sample with the EndoGIA and the VSDS, and in 2 with the VSDD while leakage did not occur in any other group ( P  = .36). Leakage occurred at 30 cmH 2 O in 1 specimen each of the 0‐polyglactin SQ, 2‐0 glycomer 631 M4SR, 2‐0 polyglactin M4SR, and 2‐0 Surgitie (Covidien, Norwalk, CT); 2 with the VSDS; and 3 with the EndoGIA and the VSDD while leakage did not occur in any other group ( P  = .26). Conclusions All tested techniques seemed safe except the vessel sealant device since it did not consistently seal every biopsy and leaked at pressures <20 cmH 2 O.