Occlusion of the Thoracic Duct Using Ultrasonically Activated Shears in Six Dogs

Authors

  • Christopher S. Leasure DVM,

  • Gary W. Ellison DVM, MS, Diplomate ACVS,

    Corresponding author
    • Department of Small Animal Clinical Sciences, University of Florida College of Veterinary Medicine, Gainesville, FL
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  • John F. Roberts DVM, Diplomate ACVP,

  • Alastair R. Coomer BVSc, MS, Diplomate ACVS,

  • Christina J. Choate DVM


  • Presented in part at the Veterinary Endoscopy Society Conference, Duck Key, FL, March 26–28, 2007 and the American College of Veterinary Surgeons Symposium, Chicago, IL, October 18–21, 2007.

Corresponding Author

Gary W. Ellison, DVM, Department of Small Animal Clinical Sciences, P.O. Box 100126 Health Science Center, College of Veterinary Medicine, University of Florida, Gainesville, FL 32610

E-mail: ellisong@ufl.edu

Abstract

Objective

To assess the feasibility of sealing the thoracic duct (TD) in dogs using ultrasonically activated shears via thoracoscopy.

Study Design

In vivo experimental study.

Animals

Mature dogs (n = 6).

Methods

Dogs were anesthetized without pulmonary exclusion and positioned in left lateral recumbency. Lymphangiography was performed to identify TD anatomy. Methylene blue was injected into the lymphatic catheter to identify the TD and its branches. Under thoracoscopic guidance (right dorsal 8–10th intercostal spaces), the TD was sealed with an ultrasonic device and lymphangiography was repeated. If the flow of contrast continued beyond the occlusion site, additional attempts to seal the duct were made. Dogs were euthanatized, the TD was excised and fixed in formalin for histopathology.

Results

Thoracoscopic identification of the TD was possible in 5 dogs. Three dogs required conversion to a thoracoscopic-assisted approach and 3 dogs required resealing of the TD closer to the diaphragm. Thoracic duct occlusion (TDO) was ultimately achieved in all 6 dogs based on follow-up lymphangiography. TDO by tissue coagulation was confirmed by histopathology.

Conclusions

Thoracoscopic identification and occlusion of the TD using ultrasonically activated shears with bilateral lung ventilation is technically feasible in normal dogs and provides a less invasive alternative to open thoracotomy procedures.

Ancillary