Cadaveric evaluation of fluoroscopy‐assisted placement of one‐lung ventilation devices for video‐assisted thoracoscopic surgery in dogs

Abstract

Objective To evaluate the feasibility of fluoroscopy‐assisted placement of one‐lung ventilation (OLV) devices in dogs. Study design Experimental study. Sample population Canine cadavers (n = 8) weighing between 20.2 and 37.4 kg. Methods Thoracoscopic access with a two‐port approach was established to evaluate bilateral lung ventilation patterns. Advancement of a left‐sided Robertshaw double‐lumen endobronchial tube (DLT) and the EZ‐blocker (EZ) were evaluated under direct fluoroscopic guidance. Each dog also underwent bronchoscopy‐assisted placement of an Arndt endobronchial blocker (EBB). Time to initial placement, success of creating complete OLV (after initial placement attempt and after up to two repositionings), and ease of placement score were recorded. Device position was evaluated bronchoscopically after each fluoroscopy‐assisted placement attempt. Results Time to initial placement was significantly shorter for EZ than for DLT and EBB. The rate of successful placement after up to two repositioning attempts was 87.5%, 87.5%, and 100.0% on the right and 87.5%, 100.0%, 100.0% on the left for DLT, EZ, and EBB, respectively, and was not different between devices. Ease of placement scores were significantly higher for DLT compared with EZ and EBB on both the left and the right sides. Conclusion Fluoroscopy‐assisted placement of DLT and EZ appears feasible in canine cadavers. EZ‐blocker placement was efficient and technically easier than DLT, but positioning must be adapted for dogs. Bronchoscopy‐assisted placement of EBB remains highly successful. Clinical significance Fluoroscopy‐assisted placement of EZ and DLT is a useful alternative to bronchoscopy‐assisted placement of these OLV devices.

Thoracoscopic treatment of persistent right aortic arch in dogs with and without one lung ventilation

“…This was not attempted in this study because of the small size of the patients. Other types of blockers that do not require a bronchoscope are available but were not used in this study 22 . These blockers offer an alternative for very small dogs.…”

“…Other types of blockers that do not require a bronchoscope are available but were not used in this study. 22 These blockers offer an alternative for very small dogs. In two dogs, the endobronchial blocker dislodged early during the procedure.…”

Evaluation of long‐term outcome after lung lobectomy for canine non‐neoplastic pulmonary consolidation via thoracoscopic or thoracoscopic‐assisted surgery in 12 dogs

“…In some cases, PEEP, at 2‐5 cm H 2 O, was used to improve oxygenation during thoracoscopy. Establishment of OLV was either performed blindly, with bronchoscopic assistance or using a fluoroscopic‐assisted technique 16 . The cuffs of the (EZB) or double‐lumen endobronchial tube (DLT) were inflated with air and complete OLV was confirmed via visual inspection thoracoscopically.…”

“…Establishment of OLV was either performed blindly, with bronchoscopic assistance or using a fluoroscopic-assisted technique. 16 The cuffs of the (EZB) or double-lumen endobronchial tube (DLT) were inflated with air and complete OLV was confirmed via visual inspection thoracoscopically. Technical difficulties or failure to establish OLV were recorded.…”

Effects of combined one-lung ventilation and intrathoracic carbon dioxide insufflation on intrathoracic working space when performing thoracoscopy in dogs

“…humans and are not adapted to all breeds of dogs because the trachea of dogs is longer and wider than that of humans. 19,20 In many dogs, the right anterior lobe bronchus is located cranial to the tracheal bifurcation, and inflating the cuff of the blocking equipment obstructs the bronchus in this lobe, which is not ideal. Also on the left side, the primary bronchus is shorter than the cuff of the blocking equipment, which may result in additional lung blockage.…”