Combined thoracoscopic-assisted and laparoscopic approach for the surgical treatment of chylothorax in dogs: a cadaver study

摘要

This study describes and assesses the technical feasibility of a combined thoracoscopic-assisted and laparoscopic technique for thoracic duct identification and ligation, subtotal pericardectomy and thoracic omentalisationin dogs. The technique was applied to two canine cadavers. Mesenteric lymph node injection, thoracoscopic-assisted thoracic duct ligation, subtotal pericardectomy, and thoracoscopic and laparoscopic-assisted thoracic omentalisation, were performed in two canine cadavers positioned in left lateral recumbency. A combination of thoracic portals, a mini-thoracotomyand anabdominal portal were used. Access via the laparoscopic portal allowed amesenteric lymph node to be identified and injected with patent blue tissue dye using a spinal needle. The omentum was grasped using an endoscopic Babcock forceps and passed though a transdiaphragmatic portal into the thorax. The coloured thoracic duct was identified, dissected and ligated using a thoracoscopic-assisted technique. Thoracoscopic-assisted subtotal pericardectomy was then performed. A minimally invasive, combined thoracoscopic-assisted and laparoscopic combination of mesenteric lymph node injection, thoracic duct ligation, subtotal pericardectomy and thoracic omentalisation is technically feasible in canine cadavers. Further studies are warranted to demonstrate its feasibility in live dogs with chylothorax. Aust Vet Practit 2011;41(4):172-176