Endoscopy Case Study

Courtesy of
Eric Monnet, DVM, Ph.D.
Diplomate ACVS, ECVS
Assistant Professor, Small Animal Surgery
Colorado State University

Thoracoscopic Lung Mass Removal

Radiograph 1

An 8 year old Labrador was referred to Colorado State University for a mass in the left caudal lung lobe (Radiograph 1). Physical examination did not reveal any abnormalities. The mass was an incidental finding on thoracic radiographs. Blood work was unremarkable. The decision was made to go ahead and remove the mass in the caudal lung. After discussion with the owner the decision to proceed with thoracoscopy was made. The dog was placed in the right lateral recumbency and one lung ventilation was started.

The left main bronchus was occluded with a bronchial blocker placed under bronchoscopy (Figure 1). The animal was placed on a ventilator and PEEP. Open cannulas (12 mm) were used to gain access to the thoracic cavity. One cannula was placed ventral at the level of the 8th intercostal space to introduce the camera. Cannulas were placed at the level the 10th and 6th intercostal spaces for introduction of instruments. The mass in the left caudal lung lobe was visualized (Figure 2).

After dissection of the dorsal ligament of the caudal lung lobe (Figure 3), an EndoGIA 60 was used to stapled the lung lobe at the level of hilus (Figure 4). A limited intercostal thoracotomy was made at the level of the the 10th intercostal space to extract the lung lobe. No retractors had to be used. The dog recovered in the critical care unit. Four hours after surgery the dog was awake, walking and eating.