Bilateral medial iliac lymph node excision by a ventral laparoscopic approach: technique description

Abstract

The aim of this study was to describe a ventral laparoscopic technique for bilateral medial iliac lymphadenectomy in dogs. Twelve intact male purpose-bred research dogs, weighing less than 15 kg, were positioned in dorsal recumbency, and a 3-portal technique was used. Bilateral dissection was performed with vessel-sealing devices while tilting the surgical table by up to 30° towards the contralateral side of the target medial iliac lymph node (MILN) without changing the surgeon’s position. Using a ventral laparoscopic approach, bilateral MILNs were identified and excised in all dogs. The mean times for unilateral and bilateral MILN dissections were 9.7 ± 3.8 and 21.0 ± 6.0 min, respectively. The mean times for the right and left MILN dissections were 10.8 ± 4.3 and 9.8 ± 2.5 min, respectively. The mean total surgery time was 43.7 ± 7.7 min. In total, 26 MILNs were dissected. Several complications, including mild to moderate capillary hemorrhage from perinodal fat and vessels (controlled laparoscopically), mild spleen trauma caused by the first trocar insertion and capsular damage of MILNs, were observed. However, there were no other major complications. All MILN samples were evaluated and deemed suitable for histopathologic diagnosis. Laparoscopic excision of MILNs is a useful method of excisional biopsy for histopathologic diagnosis. Using this ventral laparoscopic approach with the 3-portal technique, bilateral MILN dissection suitable for obtaining histopathologic samples could be achieved in a short time in dogs weighing less than 15 kg.

CT variants of the caudal vena cava in 121 small breed dogs

“…Recently, retroperitoneal access procedures have been attempted in veterinary medicine . The CVC, aorta, and renal vessels can be used as anatomic landmarks in retroperitoneal laparoscopy .…”

“…The CVC, aorta, and renal vessels can be used as anatomic landmarks in retroperitoneal laparoscopy . Awareness of the CVC location is also crucial to prevent hemorrhage in ultrasound‐guided fine needle aspiration of medial iliac lymph nodes and resection of masses near the CVC tributaries . In particular, awareness of a left‐sided CVC can prevent mistaking the left‐sided CVC for other structures when performing interventional procedures and interpreting CT images .…”

“…Recently, retroperitoneal access procedures have been attempted in veterinary medicine. 24,[26][27][28][35][36][37] The CVC, aorta, and renal vessels can be used as anatomic landmarks in retroperitoneal laparoscopy. 26 Awareness of the CVC location is also crucial to prevent hemorrhage in ultrasound-guided fine needle aspiration of medial iliac lymph nodes and resection of masses near the CVC tributaries.…”

“…However, other studies showing different consequences for the identical CVC malformation indicate the potential for risks induced by CVC variations . Access to the retroperitoneal space containing major vessels and their tributaries has recently been attempted during surgery or interventional radiology in dogs . Abdominal CT has become ubiquitous, including CT angiography to visualize complex vessels .…”

“…16,25 Access to the retroperitoneal space containing major vessels and their tributaries has recently been attempted during surgery or interventional radiology in dogs. 14,[26][27][28] Abdominal CT has become ubiquitous, including CT angiography to visualize complex vessels. 29 We have often encountered CVC variants on contrastenhanced CT images in our practice; however, no previously published studies in dogs were found describing the prevalence of diverse CVC variations and their characteristics on CT.…”