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Optimization of surgical approach for thoracoscopic‐assisted pulmonary surgery in dogs
Author(s) -
Singh Ameet,
Scott Jacqueline,
Case J. Brad,
Mayhew Philipp D.,
Runge Jeffrey J.
Publication year - 2019
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/vsu.13128
Subject(s) - medicine , lung , cannula , cadaveric spasm , thoracoscopy , cadaver , intercostal space , surgery , extracorporeal
Objective To determine the optimal intercostal space (ICS) to perform thoracoscopic‐assisted lung lobectomy. Study design Cadaveric study. Animals Six mature, medium‐sized canine cadavers. Methods Cadavers were placed in right or left lateral recumbency. A 15‐mm thoracoscopic cannula was inserted in the middle third of the 9th or 10th ICS. A wound retraction device was placed into a 7‐cm minithoracotomy incision created in the middle third of the 4th‐7th ICS on the left side and the 4th‐8th ICS on the right side. The pulmonary ligaments were sectioned by using a combined intracorporeal and extracorporeal technique. Each lung lobe was sequentially withdrawn from the wound retraction device at the respective ICS and side. A thoracoabdominal stapler was positioned to simulate lung lobectomy, and the distance from the stapler anvil to the hilus was measured. Results Simulated thoracoscopic‐assisted lung lobectomy performed at left or right ICS 4 and 5, compared with other ICS evaluated, resulted in a significantly shorter median distance from the stapler anvil to the pulmonary hilus of the left cranial and caudal lung lobes and right cranial and middle lung lobes, respectively (all P < .05). Lobectomy at right ICS 5 or 6 resulted in a significantly shorter median distance from the stapler anvil to the pulmonary hilus of the right caudal and accessory lung lobes, respectively (both P < .05). Conclusion These data may inform minithoracotomy positioning to optimize tumor margin excision during thoracoscopic‐assisted lung lobectomy for treatment of pulmonary neoplasia in dogs. Clinical significance Complete lung lobectomy is possible by using the described thoracoscopic‐assisted technique in normal, cadaveric lungs.