OBJECTIVE: To show the feasibility of thoracoscopic pericardectomy without pulmonary exclusion in dogs. STUDY DESIGN: Prospective clinical study. SAMPLE POPULATION: Nine client-owned dogs. METHODS: Dogs referred for the treatment of pericardial effusion by thoracoscopic pericardectomy were intubated with a standard endotracheal tube, mechanically ventilated, and placed in dorsal recumbency. The thoracoscope was introduced into the thorax lateral to the xyphoid process. The operating instruments were inserted at the level of the ventral third of each sixth intercostal space. The pericardium was cut and retrieved through 1 instrument portal. RESULTS: Lung inflation did not interfere with the surgical dissection. A subphrenic pericardectomy was performed in all dogs without iatrogenic trauma. Operative time, from portal placement to skin closure, ranged from 60 to 100 minutes for the first 2 dogs and decreased to 30 to 45 minutes for the latter 7 dogs. CONCLUSIONS: The reported technique avoids the need for selected intubation which requires special tubes, can be technically difficult to perform, and is not recommended in compromised animals in which bilateral lung ventilation is necessary to ensure adequate tissue oxygenation. CLINICAL RELEVANCE: Thoracoscopic pericardectomy offers several advantages over open techniques, including less postoperative pain and morbidity, shorter hospital stay, and improved cosmetic appearance. It can be performed without pulmonary exclusion.
OBJECTIVE: To show the feasibility of thoracoscopic pericardectomy without pulmonary exclusion in dogs. STUDY DESIGN: Prospective clinical study. SAMPLE POPULATION: Nine client-owned dogs. METHODS:Dogs referred for the treatment of pericardial effusion by thoracoscopic pericardectomy were intubated with a standard endotracheal tube, mechanically ventilated, and placed in dorsal recumbency. The thoracoscope was introduced into the thorax lateral to the xyphoid process. The operating instruments were inserted at the level of the ventral third of each sixth intercostal space. The pericardium was cut and retrieved through 1 instrument portal. RESULTS: Lung inflation did not interfere with the surgical dissection. A subphrenic pericardectomy was performed in all dogs without iatrogenic trauma. Operative time, from portal placement to skin closure, ranged from 60 to 100 minutes for the first 2 dogs and decreased to 30 to 45 minutes for the latter 7 dogs. CONCLUSIONS: The reported technique avoids the need for selected intubation which requires special tubes, can be technically difficult to perform, and is not recommended in compromised animals in which bilateral lung ventilation is necessary to ensure adequate tissue oxygenation. CLINICAL RELEVANCE: Thoracoscopic pericardectomy offers several advantages over open techniques, including less postoperative pain and morbidity, shorter hospital stay, and improved cosmetic appearance. It can be performed without pulmonary exclusion.
Authors: Keaton R S Morgan; Christopher G Dominic; Janet Beeler-Marfisi; Karlee Craig; Katie L Hoddinott; Siobhan O'Sullivan; Ameet Singh Journal: Can Vet J Date: 2019-09 Impact factor: 1.008