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Thoracoscopic hilar lung lobectomy in two dogs

This report aimed to describe the surgical procedure and outcome of thoracoscopic hilar lung lobectomy in two dogs with a solitary pulmonary emphysema. Both patients were positioned in left lateral semirecumbency, where the angle formed between the median plane and the operating table became approximately 45°. Three ports were placed in the third, fifth and seventh intercostal spaces at the level of the costochondral junction. The thoracoscope was inserted toward the base of lobe; the blood vessels and bronchi branching to the lung lobe were bluntly dissected from the lung lobe and surrounding connective tissues and were closed using intracorporal ligation, ligating loop and/or clipping. Hilar lung lobectomy was completed by dissection. Both patients had no postoperative complications. Thoracoscopic hilar lung lobectomy without staplers was feasible in small-sized dogs where the right medial lobe had congenital emphysema. The patient’s position and portal formation were suggested to be important for this procedure.

Case 1, a neutered male toy poodle, 18 months of age and weighing 4.6 kg, was presented with main complaints of cough, sudden onset of dyspnoea and sputum production after becoming listless 2 weeks previously.

Case 2, an intact male Pomeranian, 3 years of age and weighing 4.7 kg, was presented due to a decline in energy and dyspnoea.

In case 1, serum alanine aminotransferase concentration was elevated (120 U/l); however, there were no other abnormalities found on the blood test. The X-ray and CT revealed a collapsed pneumothorax in the right lung and multiple emphysemas measuring approximately 15.1 x 7.1 x 5.6~59.3 x 46.3 x 32.7 mm throughout the right middle lobe (figure 1).



Figure 1 
CT image of multiple bullas in the right middle lobe in case 1. A pneumothorax was found, and a large bulla and multiple small ones were detected in the right middle lobe.



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