Page 199 - BSAVA Manual of Canine and Feline Head, Neck and Thoracic Surgery, 2nd Edition

BSA V A Manual of Canine and F eline Head, Neck and Thoracic Surger y
BSAVA Manual of Canine and Feline Head, Neck and Thoracic Surgery

OPERATIVE TECHNIQUE 14.1
VetBooks.ir Partial or complete lung lobectomy

PATIENT POSITIONING
Right or left lateral recumbency, depending on the side of the lesion. Placing a rolled towel under the opposite side
widens the near-side intercostal space and can simplify the surgical approach.
ASSISTANT

Useful for retraction.

ADDITIONAL INSTRUMENTS
Electrocautery; Finochietto rib retractor (appropriate size for patient); laparotomy pads (counted); sterile saline flush and
sterile bowl; trochar chest tube (appropriate size for patient); lung lobe retractors; sterile cotton-tipped applicators;
right-angled forceps; DeBakey forceps; Satinsky forceps; crushing forceps; long-handled Metzenbaum scissors.

SURGICAL TECHNIQUE
Approach

As for lateral thoracotomy (see Chapter 11). The affected lung lobe should be located. Unaffected lung lobes may inflate
and obscure the surgical field. These lobes should be gently packed cranially or caudally within the thorax using
moistened laparotomy pads, to allow isolation of the affected lobe. Careful resection of pleural attachments can further
mobilize the lobe and simplify its removal.
Surgical manipulations
Partial lobectomy
1 Apply crushing forceps at the level of resection.

2 Place a continuous overlapping suture pattern (2 metric (3/0 USP) or 1.5 metric (4/0 USP) absorbable suture
material) and tie it 0.5 cm proximal to the forceps to provide haemostasis/pneumostasis.
3 Transect the lung between the forceps.
4 Oversew the viable distal lung tissue in a simple continuous pattern (1.5 metric (4/0 USP) or 1 metric (5/0 USP)
absorbable suture material).

artial lung lobectomy for removal of an apical lesion dark circle . haemostatic/pneumostatic
overlapping continuous suture pattern is placed mm pro imal to the forceps. The lobe is incised along the
dotted line and oversewn using a simple continuous pattern.

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