Thoracoscopy is a therapeutic and diagnostic tool used in cats1–4 that offers several advantages over open thoracotomy, including a reduction in signs of postoperative pain, more rapid return to function, and fewer wound complications.5–8 Thoracoscopy has been used for pulmonary biopsy, transection of the ligamentum arteriosum with a persistent right aortic arch, thoracic duct ligation, and pericardiectomy in cats.2–4,8 The minimally invasive nature of thoracoscopy makes it particularly appealing for use in lung lobectomy in cats.9 However, thoracoscopy in cats has some limitations, including the need for specialized anesthetic procedures (one lung ventilation [OLV]) and equipment.10,11 Furthermore, endoscopic stapling devices commonly used for total thoracoscopic lung lobectomy in dogs are too large to be safely placed into the thoracic cavity of cats without risk of iatrogenic damage to the surrounding anatomic structures.12
A technique for thoracoscopic-assisted pulmonary surgery for lung lobectomy in dogs and cats has been described.1 In that report,1 thoracoscopic-assisted pulmonary surgery was performed by creating an intercostal minithoracotomy followed by insertion of a wound retractor device, which allowed for exteriorization of the lung lobe of interest. After the lung lobe was exteriorized through the wound retractor device, a stapling device was applied to the exteriorized portion of the lung to perform the lobectomy. The technique for thoracoscopic-assisted pulmonary surgery for lung lobectomy in cats may provide many benefits of a total thoracoscopic procedure while eliminating the need for 1 lung ventilation and a specialized endoscopic stapling device. The importance of identifying the optimal ICS and of achieving hilar resections when performing thoracoscopic-assisted lung lobectomy is emphasized because of the need to maintain oncological principles when removing pulmonary neoplasms and reduce the risk of air leaks. Investigators of a recent cadaveric study12 in which thoracoscopic-assisted pulmonary surgery was used for feline lung lobectomies reported that cadavers with a hilar cuff of pulmonary tissue > 5 mm were more likely to leak air from the cut surface.
The purpose of the cadaveric study reported here was to determine the optimal ICS for thoracoscopic-assisted pulmonary surgery for lung lobectomy in cats. We hypothesized that an optimal ICS for thoracoscopic-assisted lung lobectomy in cats could be identified for each lung lobe.
The authors declare there were no conflicts of interest.
Thoracoport, Medtronic, Mansfield, Mass.
Laparoscope, Karl Storz Endoscopy, Goleta, Calif.
SurgiSleeve extra small, Medtronic, Mansfield, Mass.
TA30V3, Medtronic, Mansfield, Mass.
Alexis wound retractor extra small, Applied Medical Resources, Rancho Santa Margarita, Calif.
TA55, Medtronic, Mansfield, Mass.
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