Clinical evaluation of a pre‐tied ligating loop for liver biopsy and liver lobectomy

Cuddy, Laura; Risselada, Marije; Ellison, Gary W.

doi:10.1111/jsap.12008

Cited by 12 publications

(6 citation statements)

References 20 publications

(37 reference statements)

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“…Similar PCV decreases of 1% to 3% have been previously reported in studies 21,22 of liver lobectomy in dogs and cats and laparoscopic hepatic biopsy in dogs. Similar PCV decreases of 1% to 3% have been previously reported in studies 21,22 of liver lobectomy in dogs and cats and laparoscopic hepatic biopsy in dogs.…”

Section: Discussionsupporting

confidence: 87%

Short-term outcome following partial or complete liver lobectomy with a commercially prepared self-ligating loop in companion animals: 29 cases (2009–2012)

Goodman

Casale²

2014

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Section: Discussionsupporting

confidence: 87%

Short-term outcome following partial or complete liver lobectomy with a commercially prepared self-ligating loop in companion animals: 29 cases (2009–2012)

Goodman

Casale²

2014

javma

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“…Achieving an effective airway seal is essential when lung lobectomy is performed; adequate hemostasis of the pulmonary artery and vein is similarly important, but this was not evaluated in our cadaveric study. The effectiveness of a PLL for hemostasis is, however, supported by several previous in vivo studies that provided evidence for its clinical use for complete and partial liver lobectomies in dogs and cats 8,10,11 and for gastrointestinal and urogenital applications in man. 4,5 From our clinical experience, we estimate that the pulmonary vessels in dogs are of similar size compared to the hepatic lobar vessels, and, thus, effective occlusion of these vessels was anticipated to be possible with this technique.…”

Section: Discussionmentioning

confidence: 97%

“…4,5 Their simple construction makes PLL a cost effective option because they are less expensive than a linear stapling device. Pre-tied ligature loops have been described for complete or partial liver lobectomies in dogs and cats [8][9][10][11] and for lung biopsy in dogs. 12 In dogs, the PLL has been evaluated as a safe method of tissue biopsy up to 3 cm from the lung lobe margin in a canine cadaver model.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of a pre‐tied ligature loop for canine total lung lobectomy

et al. 2019

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Objective: To determine the ability of a pre-tied ligature loop (PLL) to create a seal against physiological airway pressures after total lung lobectomy and report outcomes in dogs requiring lung lobectomy. Study design: Ex vivo experimental randomized study and clinical case study.Sample population: Thirty cadaveric canine lung lobes and 5 client-owned dogs.Methods: Thirty canine lung lobes from dogs weighing 22.5-35 kg were randomized to lobectomy with stapler, PLL, or suture ligation. After lobectomy, each bronchial stump was submerged in water, and the mainstem airway pressure was increased to 80 mm Hg. Leakage was compared between techniques. The PLL was subsequently used in 5 dogs (17-25 kg) with neoplastic disease requiring total lung lobectomy. Results: Two stapled and 4 sutured bronchial stumps leaked at supraphysiological pressures >15 mm Hg. One stapled bronchial stump failed at a physiological airway pressure (5 mm Hg). None of the PLL lobectomies leaked. The incidence of bronchial stump failures did not differ among techniques (P = .15). Lung lobectomy was performed successfully with the PLL in 5 clinical cases with no intraoperative or postoperative complications; median follow-up time was 6 months. Conclusion: Bronchial ligation with the PLL reliably resisted physiological airway pressures and performed comparably to current standard techniques in cadavers. The PLL provided an adequate air and vascular seal in 5 clinical cases undergoing total lung lobectomy. Clinical relevance: Pre-tied ligature loops provide an alternative method for total lung lobectomy in dogs.

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“…RELAVE et al (2008) reported that biopsies collected in equine lungs had a complication rate of 31%, including slippage of the loop ligature or bleeding from the pulmonary parenchyma. Although, the successful use of a pre-tied ligating loop for resection of tissue for diagnosis or treatment has been reported in various clinical scenarios in humans, horses, dogs and cats (PONSKy & ROTHENBERG 2008;CUDDy et al 2013;DA CONCEIÇÃO et al 2018;CRONIN et al 2019). In the present study, we not observed slippage or bleeding from the pulmonary parenchyma after pre-tied loop ligature applied and biopsy collected.…”

Section: Discussionmentioning

confidence: 99%

Thoracoscopy pulmonary biopsy by two portals with a novel pre-tied loop ligature device in rabbits: an experimental study

et al. 2023

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Thoracoscopy is replacing open lung biopsies because it is less invasive, usually the technique is done using three portals and intracorporeal suture technique. This study described the feasibility and efficacy of a novel pre tied loop ligature and to propose a thoracoscopic access strategy with two portals to perform lung biopsy in patients under 5 kg. Ten rabbits were positioned in dorsal recumbency. Total thoracoscopic lung biopsy was performed using a combined transdiaphragmatic approach and a right intercostal approach. A pre tied loop ligature was placed to perform a caudal lung lobe biopsy. Insufflation of the thoracic cavity was not performed. The total surgery time was 41.4 ± 14.5 min. The procedure was carried out free of complications that prevented slippage or tightening the knot or that made it come loose after the lung biopsy; there was no serious complication during the surgical procedure. The samples obtained averaged 1x0.64x0.45 cm (Length, Width, Depth) and were considered satisfactory according to the histopathologic evaluation. Thorax radiographs taken before and after the surgeries were compared and showed no pneumothorax or hemothorax. Necropsy confirmed no knot failure occurred at the biopsy site. The use of the novel pre tied loop ligature is a safe and effective technique, avoiding problems with the limited size of the thoracic cavity in small patients.

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Clinical evaluation of a pre‐tied ligating loop for liver biopsy and liver lobectomy

Abstract: The pre-tied ligating loop is a versatile and safe method for liver biopsy or lobectomy. As with other surgical techniques, alternative methods of haemostasis should always be available.

Cited by 12 publications

References 20 publications

Short-term outcome following partial or complete liver lobectomy with a commercially prepared self-ligating loop in companion animals: 29 cases (2009–2012)

Short-term outcome following partial or complete liver lobectomy with a commercially prepared self-ligating loop in companion animals: 29 cases (2009–2012)

Evaluation of a pre‐tied ligature loop for canine total lung lobectomy

Thoracoscopy pulmonary biopsy by two portals with a novel pre-tied loop ligature device in rabbits: an experimental study

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