Endoscopy 2012; 44 - A21
DOI: 10.1055/s-0032-1329294

Feasibility and safety of endoscopic transumbilical thoracic surgical lung biopsy: A survival study in a canine model

WH Chen 1, Y Chu 1, CJ Yeh 1, CY Liu 1, HC Yuan 1, PJ Ko 1, YH Liu 1
  • 1Adress available at: European Society of Gastrointestinal Endoscopy (ESGE), HG Editorial & Management Services, Mauerkircher Str. 29, 81679 Munich, Germany

Background: Post-thoracotomy discomfort is an unavoidable complication following thoracoscopic surgery. Transumbilical laparoscopy allows the patient to undergo various surgical procedures associated with abdominal diseases and prevents post-thoracotomy discomfort by avoiding the creation of an incision through the chest wall. The aim of this study was to evaluate the feasibility and safety of transumbilical thoracic exploration and surgical lung biopsy in a canine survival model.

Methods: The procedure was performed in 12 dogs weighting 7.1–9.1 kg. The thoracic cavity was accessed using a metal tube inserted via umbilical and diaphragmatic incisions. Following transumbilical thoracoscopy, the predetermined lung lobe was resected with an electrocautery loop. Clinical examinations, including determination of respiratory rate and rectal temperature, were carried out daily. Laboratory parameters (white blood cell [WBC] count) and inflammatory parameters, including serum interleukin-6 (IL-6) and C-reactive protein (CRP) levels, were measured before surgery and at postoperative days 1, 3, 7, and 14. Necropsies were performed 2 weeks after surgery.

Results: Corrected surgical lung biopsies were performed successfully for the predetermined lung lobe in all animals, with a median time of 43.5 min (range, 32–65 min). Two peri-operative complications were observed; 1 dog suffered from minor postoperative air leakage, and 1 dog suffered from hemodynamic collapse due to inadequate ventilation. These animals recovered well without signs of peri-operative infection. Necropsies at 2 weeks after surgery showed no evidence of mediastinitis or peritonitis.

Conclusions: Exposure of the thoracic cavity and surgical lung biopsy via a transumbilical incision is feasible and practical in this canine model of survival, and this procedure may have potential advantages over currently used transthoracic thoracoscopy techniques.