Laparoscopic Extirpation of the Medial Iliac Lymph Nodes in Normal Dogs

Michele A Steffey, Leticia Daniel, Philipp Mayhew, Verena K Affolter, Joao H N Soares, Mark C. Fuller

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Objective: To describe a surgical technique for laparoscopic medial iliac lymph node (MILN) extirpation, and to describe the quality of biopsy specimens obtained. Design: Experimental study. Animals: Purpose-bred male hound-mix research dogs (n=8). Methods: Dogs were randomized to groups of left or right-sided laparoscopic surgical approaches. Three transperitoneal portals were established with the dogs in lateral recumbency, and ipsilateral MILN dissection was achieved under CO<inf>2</inf> pneumoperitoneum using a vessel-sealing device. Results: MILN ipsilateral to the approach were successfully identified and removed laparoscopically in 8 dogs. Observed complications included mild to moderate hemorrhage that was controlled laparoscopically in 4 dogs, and tearing of the MILN capsule during retraction and dissection in 3 dogs. No other major complications occurred and all dogs recovered uneventfully. Areas of either minor peripheral (9/9) or central (4/9) pinch artifact affected a median percentage of 5% of surface area (range, 5-30%) of bisected lymph nodes. Conclusions: Laparoscopic MILN extirpation is feasible in dogs with normal MILN and may serve as a minimally invasive approach for excisional biopsy in the diagnostic staging of canine onocologic patients with normal-sized MILN. This lateral laparoscopic approach allows dissection of the ipsilateral MILN but precludes removal of the contralateral MILN. Minimal handling of the lymph node during dissection and removal is required to reduce the risk of capsular tear, or introduction of possible histologic artifact by tissue crush that may impact diagnosis.

Original languageEnglish (US)
Pages (from-to)59-65
Number of pages7
JournalVeterinary Surgery
Volume44
Issue numberS1
DOIs
StatePublished - Jun 1 2015

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lymph nodes
Lymph Nodes
Dogs
dogs
Lymph Node Excision
Artifacts
Dissection
biopsy
Biopsy
Pneumoperitoneum
hounds
Tears
Capsules
Canidae
Research Design
hemorrhage
Hemorrhage
surface area
Equipment and Supplies
surgery

ASJC Scopus subject areas

  • veterinary(all)

Cite this

Laparoscopic Extirpation of the Medial Iliac Lymph Nodes in Normal Dogs. / Steffey, Michele A; Daniel, Leticia; Mayhew, Philipp; Affolter, Verena K; Soares, Joao H N; Fuller, Mark C.

In: Veterinary Surgery, Vol. 44, No. S1, 01.06.2015, p. 59-65.

Research output: Contribution to journalArticle

Steffey, Michele A ; Daniel, Leticia ; Mayhew, Philipp ; Affolter, Verena K ; Soares, Joao H N ; Fuller, Mark C. / Laparoscopic Extirpation of the Medial Iliac Lymph Nodes in Normal Dogs. In: Veterinary Surgery. 2015 ; Vol. 44, No. S1. pp. 59-65.
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abstract = "Objective: To describe a surgical technique for laparoscopic medial iliac lymph node (MILN) extirpation, and to describe the quality of biopsy specimens obtained. Design: Experimental study. Animals: Purpose-bred male hound-mix research dogs (n=8). Methods: Dogs were randomized to groups of left or right-sided laparoscopic surgical approaches. Three transperitoneal portals were established with the dogs in lateral recumbency, and ipsilateral MILN dissection was achieved under CO2 pneumoperitoneum using a vessel-sealing device. Results: MILN ipsilateral to the approach were successfully identified and removed laparoscopically in 8 dogs. Observed complications included mild to moderate hemorrhage that was controlled laparoscopically in 4 dogs, and tearing of the MILN capsule during retraction and dissection in 3 dogs. No other major complications occurred and all dogs recovered uneventfully. Areas of either minor peripheral (9/9) or central (4/9) pinch artifact affected a median percentage of 5{\%} of surface area (range, 5-30{\%}) of bisected lymph nodes. Conclusions: Laparoscopic MILN extirpation is feasible in dogs with normal MILN and may serve as a minimally invasive approach for excisional biopsy in the diagnostic staging of canine onocologic patients with normal-sized MILN. This lateral laparoscopic approach allows dissection of the ipsilateral MILN but precludes removal of the contralateral MILN. Minimal handling of the lymph node during dissection and removal is required to reduce the risk of capsular tear, or introduction of possible histologic artifact by tissue crush that may impact diagnosis.",
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