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Small Animal Laparoscopy and Thoracoscopy


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blocke...Figure 27.8 Double‐lumen tubes showing the right (A) and left (B) bronchial ...Figure 27.9 Robertshaw double‐lumen endotracheal tubes from four different m...Figure 27.10 Proximal end of a Robertshaw tube with a connector to allow bot...Figure 27.11 Diagram showing the placement of the proximal and distal balloo...Figure 27.12 Diagram showing correct and incorrect placement of left and rig...

      31 Chapter 28Figure 28.1 For thoracoscopic procedures performed in dorsal recumbency with...Figure 28.2 For thoracoscopic procedures with the patient in sternal or late...Figure 28.3 Nondisposable cannulae can readily be used for thoracoscopic acc...Figure 28.4 In this case, the thorascopic port was placed too caudally, and ...Figure 28.5 In this case, the pleural reflection has been entered from a sub...Figure 28.6 This Alexis wound retractor device (Applied Medical Inc.) has be...Figure 28.7 During placement of instrument ports, the telescope is used to v...Figure 28.8 A bleeding intercostal vessel can be seen in this image. Interco...Figure 28.9 A seroma can be seen in this dog associated with one of the thor...Figure 28.10 A specimen retrieval bag is used in a thymoma to decrease the r...

      32 Chapter 29Figure 29.1 The left pulmonary ligament is visible extending from the ventra...Figure 29.2 The left pulmonary ligament being digitally transected during a ...Figure 29.3 A large pulmonary bullae is readily identified on the ventral ma...Figure 29.4 CT images of a dog with spontaneous pneumothorax in sternal (A) ...Figure 29.5 (A) Port placement for thoracic exploration. (B) Operating room ...Figure 29.6 Localization of paraxiphoid port placement for diagnostic thorac...Figure 29.7 Localization of intercostal port placement for diagnostic thorac...Figure 29.8 (A) A 10‐mm variable angle scope (©KARL STORZ SE & Co. KG, Germa...Figure 29.9 A 10‐mm endoscopic fan retractor may be used to gently retract l...Figure 29.10 The ventral mediastinum has been fenestrated and is retracted b...Figure 29.11 (A) The accessory lung lobe is seen through the thin caudal med...Figure 29.12 Visualization of the medial aspect of the hilus of right (A) an...Figure 29.13 A bullous lesion identified on the lateral aspect of the left c...

      33 Chapter 30Figure 30.1 Intraoperative image of a thermally injured lung lobe during vid...Figure 30.2 Intraoperative video‐assisted thoracic surgery image of the left...Figure 30.3 Cardiac apex in a dog undergoing VATS pericardiectomy for chroni...Figure 30.4 The paraconal interventricular branch of the left coronary arter...Figure 30.5 Intraoperative image of a puppy undergoing video‐assisted thorac...Figure 30.6 The craniodorsal mediastinal defect after VATS thymectomy in a d...Figure 30.7 (A) Thoracoscopic image of the mediastinum during a thoracic duc...Figure 30.8 A linear parenchymal lung laceration can be seen in the caudal l...

      34 Chapter 31Figure 31.1 Radiograph of a dog with a solitary lung mass in the left caudal...Figure 31.2 Computed tomography of a single tumor in the right middle lung l...Figure 31.3 Pulmonary bullae visualized during thoracoscopic exploration for...Figure 31.4 Biopsy of hilar lymph nodes are often indicated in dogs with tho...Figure 31.5 Intraoperative view of a mass in the left caudal lung lobe (Figu...Figure 31.6 The endobronchial blocker has been placed in the left main stem ...Figure 31.7 Operating room setup for thoracoscopic lung lobectomy of a cauda...Figure 31.8 Operating room setup for thoracoscopic lung lobectomy of a crani...Figure 31.9 Portal placement for thoracoscopic lung lobectomy of a caudal lu...Figure 31.10 Portal placement for thoracoscopic lung lobectomy of a cranial ...Figure 31.11 Portal placement in the ninth intercostal space for a cranial l...Figure 31.12 Example of a thoracoscopic‐assisted approach from a cadaveric s...Figure 31.13 Linear stapler staple cartridge (EndoGIA roticulated, Medtronic...Figure 31.14 The dorsal pulmonary ligament of a caudal lung lobe.Figure 31.15 The cartridge of the linear stapler (EndoGIA, Medtronic, Minnea...Figure 31.16 The cartridge of the linear stapler (EndoGIA, Medtronic, Minnea...Figure 31.17 The linear stapler (EndoGIA, Medtronic, Minneapolis, MN, USA) a...Figure 31.18 The stapled hilus after lung lobe removal.Figure 31.19 Lung lobe is introduced in a retrieval bag. It is important to ...Figure 31.20 A retrieval bag containing a lung lobe after removal from the t...Figure 31.21 Cadaveric example of a thoracoscopic‐assisted approach performe...Figure 31.22 A combined intra‐ and extracorporeal technique can be used to t...Figure 31.23 (A) A hilar lymph node of the cranial lung lobe is pictured in ...

      35 Chapter 32Figure 32.1 Operating room layout for thoracoscopic pericardial window or su...Figure 32.2 Possible placement of the telescope for thoracoscopic pericardec...Figure 32.3 (A) Instrument port placement for thoracoscopic pericardectomy i...Figure 32.4 Alternative port positioning of the telescope and instrument por...Figure 32.5 Possible telescope and instrument portal placement for pericarde...Figure 32.6 Tenting the pericardium. With the patient in dorsal recumbency, ...Figure 32.7 Endoscopic view of heart after the subphrenic pericardectomy has...Figure 32.8 Endoscopic view of heart after pericardectomy has been achieved....Figure 32.9 In this case, grasping the pericardium was proving challenging, ...

      36 Chapter 33Figure 33.1 (A) Cannula positions: paraxiphoid 5‐mm telescope cannula, right...Figure 33.2 The lead applicator is inserted via the left instrument portal; ...Figure 33.3 Lead implantation is performed in an area of the epicardium with...Figure 33.4 Incorrect insertion of the lead: the pigtail is visible; screwin...Figure 33.5 The generator is placed against the intercostal muscle as soon a...Figure 33.6 Radiography showing the correct position of the cable with one l...

      37 Chapter 34Figure 34.1 Resection of a small tumor (1 cm) located on the right atrial (a...Figure 34.2 Pericardioscopy view of a tumor that is too large to be resected...Figure 34.3 Operating room layout. The dog is positioned on the rear part of...Figure 34.4 Cannula position. A paraxiphoid 5‐mm telescope cannula, operatin...Figure 34.5 Pericardial window extended cranially to increase visualization ...Figure 34.6 Atraumatic 5‐mm grasping forceps used to grasp the tip of the ri...Figure 34.7 The staples have been applied and the right atrial appendage. 5 ...Figure 34.8 The staples have been applied and the right atrial appendage wit...

      38 Chapter 35Figure 35.1 Lymphangiogram depicting cisterna chyli and thoracic ducts with ...Figure 35.2 Lymphangiogram depicting thoracic duct and the classical lymphan...Figure 35.3 Representative appearance of cisterna chyli in a normal dog (A) ...Figure 35.4 The thoracic duct anatomy is highly variable between individuals...Figure 35.5 Anatomy of the dorsal thorax in a less chronically affected dog ...Figure 35.6 A preoperative CT lymphangiogram facilitates surgical planning. ...Figure 35.7 Dog positioned on the CT table and draped for popliteal lymphang...Figure 35.8 Severe fibrosing pleuritis in a dog with an eight‐month history ...Figure 35.9 Port placement for thoracic duct ligation procedure with the dog...Figure 35.10 Operating room setup for thoracic duct ligation procedure. If a...Figure 35.11 When positioning a patient for TDL in sternal recumbency, padde...Figure 35.12 Thoracic duct branches are difficult to visualize without dye i...Figure 35.13 (A‐C1) Dissection based on a preoperative CT lymphangiogram (A‐...Figure 35.14 Position of thoracic cannulas and paracostal access with wound ...Figure 35.15 Fluoroscopic lymphangiography performed intraoperatively on a d...Figure 35.16 Intraoperative image of left‐sided single port approach for cis...Figure 35.17 A subcutaneous pleural catheter‐vascular access port being plac...Figure 35.18 CT lymphangiograms obtained approximately six months postoperat...Figure 35.19 Reoccurrence of lymphatic vessels (black arrow) bypassing a pre...

      39 Chapter 36Figure 36.1 Normal anatomy. Left aortic arch (LAA) with the brachiocephalic ...Figure 36.2 Vascular ring anomalies with persistent right aortic arch (PRAA)...Figure 36.3 Vascular ring anomalies without PRAA. (A) Left aortic arch (LAA)...Figure 36.4 Operating room setup for vascular ring anomaly treatment.Figure 36.5 Portal placements for vascular ring anomaly treatment. If one‐lu...Figure 36.6 Esophagram of a dog with a persistent right aortic arch and seve...Figure 36.7 Endoscopy of the esophagus. The aortic arch is on the right side...Figure 36.8 Three 5‐mm thoracoscopic cannulas with low profile. Those cannul...Figure 36.9 (A) View of the cranial part of the thoracic cavity with the dil...Figure 36.10 The ligamentum arteriosum (in the forceps) has been dissected f...Figure 36.11 Vascular clips have been placed on the ligamentum arteriosum. T...Figure 36.12 (A, B) Remaining fibers (black arrows) have been picked up from...Figure 36.13 Esophageal ballooning used to identify remaining fibrous bands ...Figure 36.14 Dorsal compression of the esophagus cranial to the ligamentum a...

      40 Chapter 37Figure 37.1 Schematic transverse section of the thorax through the heart and...Figure 37.2 Thoracoscopic image demonstrating the relationship between a t...Figure 37.3 Computed tomography angiogram of a dog with a thymoma. (A) The p...Figure 37.4 Operating room setup for thoracoscopic