Feasibility of the single‐incision subxiphoid approach for video‐assisted thoracoscopic surgery in dogs

Abstract

ObjectivesTo report early results of uniportal video‐assisted thoracoscopic surgery in dogs using a single‐incision subxiphoid approach.Materials and MethodsRetrospective study of 10 client‐owned dogs with: pyothorax (n=5), pericardial effusion (n=2), bilateral pneumothorax (n=1), retained surgical swab (n=1), cranial mediastinal mass (n=1). With the dog in dorsal recumbency a 3‐4 cm incision was made over the xiphoid process. After resection of the xiphoid process, a tunnel was created towards the pleura and open access maintained with an Alexis™ wound retractor. The pleural cavity was explored with a 10 mm 30° or 5 mm 0° telescope and straight laparoscopic instruments.ResultsMedian surgical time was 75 minutes. The SISA technique was performed successfully in five of 10 cases and allowed easy and adequate inspection of the intra‐thoracic structures. One case was converted to lateral thoracotomy after laceration of the vena cava and one converted to median sternotomy because of adhesions. An additional port was placed in three cases to facilitate triangulation and surgical manipulation. No other intra‐operative complications were encountered.Clinical SignificanceIn this initial report of uniportal thoracic approach in dogs, this technique allowed excellent access and treatment of mediastinal structures. Further cases are required to assess its suitability for pulmonary surgery.

Clinical Application of Thoracoscopic Resection of Anterior Mediastinal Tumors under the Xiphoid Process

“…The visual field of thoracoscopic resection of anterior mediastinal tumors via the subxiphoid process approach is obviously better than that of the lateral thoracic approach [9]. However, because most thoracic surgeons are more accustomed to lateral thoracic approaches, there is a big difference between the subxiphoid and lateral thoracic approaches [10][11][12][13]. Therefore, thoracoscopic resection of anterior mediastinal tumors under the xiphoid process has not been very popular at present.…”