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

Identification of intra-abdominal lymphatics in canine carcasses by laparoscopic fluorescence lymphography with intradermal and intrapopliteal ICG administration

Objective

To evaluate the feasibility of laparoscopic fluorescence lymphography (LFL) using indocyanine green (ICG) via intradermal (ID) or intrapopliteal (IPP) administration in an ex vivo canine model.

Methods

Six thawed adult male dog carcasses were placed in the Trendelenburg position after placing three surgical ports in triangulation. ICG (0.5 mg/ml; 0.05 mg/kg) was administered to five of the carcasses (one carcass was a pilot) via ID in the left torso and IPP (right position, by surgical access) to stain the lymphatic pathway and medial iliac lymph node (MILN). Fluorescence quality, staining time, structures stained, and lymph node histopathology were assessed. Thoracic duct staining was also evaluated.

Results

ID administration showed staining of parts of the lymphatic pathway of the iliosacral lymph center in all cases using a single dose of ICG, with left MILN visualization in four carcasses. IPP administration showed staining of the right MILN in all cases, using a single dose in four carcasses. ICG reached the thoracic duct in one case. The two administration routes showed similar results in terms of required ICG volume, staining time, and visualization quality, although IPP was more effective in staining the MILN.

Conclusions

This study confirms the feasibility of staining the iliosacral lymph center (mainly the MILNs) by LFL in thawed dog carcasses via ID or IPP administration of ICG. However, the IPP route showed greater effectiveness in staining the MILN.

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

Computed tomography is increasingly used as a treatment planning method in canine patients with diseases of the retroperitoneum, however, published information on normal variations in the caudal vena cava (CVC) are currently lacking. The objectives of this retrospective descriptive study were to characterize CVC variants using CT angiography in a sample of small breed dogs and localize the CVC bifurcations for each variant. Inclusion criteria were small breed dogs (weight ≤ 15) that underwent contrast-enhanced CT scans of the CVC, abdominal aorta, and CVC tributaries. A total of 121 small breed dogs were sampled. Four right-sided and one left-sided CVC variations were identified: normal (88/121, 72.7%), caudal-partial split (17/121, 14.0%), partial duplication (8/121, 6.6%), complete duplication (7/121, 5.8%), and left-sidedness (1/121, 0.8%). The mean lumbar vertebral levels of the CVC bifurcation were L6.39 ± 0.41, L5.70 ± 0.35, L4.39 ± 0.42, L2.74 ± 0.38, and L6.4 in the normal, caudal-partial split, partial duplication, complete duplication, and left-sidedness types, respectively. The location of the CVC bifurcation, the relationship between the aortic trifurcation and the CVC bifurcation, and the location of the bilateral deep circumflex iliac veins with respect to the CVC bifurcation were significantly different among the right-sided types (P ≤ .001). Bilateral deep circumflex iliac veins joined to the ipsilateral common iliac veins and the CVC in the caudal-partial split and duplication types, respectively. The results of this study indicated that canine CVC variants may be frequent and should be considered during surgery or diagnostic imaging of the retroperitoneum.

Use of Minimally Invasive Surgery in the Diagnosis and Treatment of Cancer in Dogs and Cats

Surgical management of neoplastic disease is common in veterinary medicine. Minimally invasive surgery (MIS) has gained widespread acceptance by veterinary surgeons and is experiencing rapid growth and frequency of use. Many neoplastic diseases in the abdomen and thorax of dogs and cats can be treated as effectively with MIS as with traditional open surgery. Additionally, MIS allows for less invasive options for organ biopsy in cancer patients either for initial diagnosis or for staging to inform prognosis and treatment. Despite the recent increase in MIS, additional research is required to further characterize the benefits to oncology patients and to ensure that surgical oncologic principles and patient outcomes are not compromised by the use of MIS.