scholarly journals Thoracoscopic-assisted lung lobectomy using hem-o-lok clips in a dog with lung lobe torsion: a case report

2014 ◽  
Vol 59 (No. 6) ◽  
pp. 315-318
Author(s):  
SY Lee ◽  
SJ Park ◽  
SH. Seok ◽  
YK. Kim ◽  
HC. Lee ◽  
...  
Keyword(s):  
Clinical Signs ◽  
Lung Ventilation ◽  
Middle Lobe ◽  
One Lung Ventilation ◽  
Presumptive Diagnosis ◽  
Lung Lobe ◽  
Lung Lobectomy ◽  
Minimally Invasive Surgical ◽  
Time Period ◽  
The Right

An eleven-year-old, 3-kg, intact female Maltese was presented for depression, anorexia and dyspnoea. Thoracic radiographs showed right-side pleural effusion, a vesicular emphysema pattern and consolidation of the right middle lung lobe. A presumptive diagnosis of lung lobe torsion (LLT) in the right middle lobe was made using a computed tomography scan. Thoracoscopic exploration was performed without one-lung ventilation in the right hemithorax. Pleural fluid and engorgement of the torsed lung lobe were observed. A total lung lobectomy of the right middle lung lobe was performed with a thoracoscopic-assisted procedure using hem-o-lok clips applied to the hilus. The dog was discharged three days after surgery, and no recurrence of the clinical signs of disease related to the respiratory system was observed during the follow-up time period of six months. Based on these findings, we conclude that thoracoscopic-assisted lung lobectomy using hem-o-lok clips is a minimally invasive surgical alternative to thoracotomy and successful operative intervention for lung lesions in small breed dogs.  

scholarly journals Use of an Endobronchial Blocker and Selective Lung Ventilation to Aid Surgical Removal of a Lung Lobe Abscess in a Dog

2012 ◽  
Vol 2012 ◽  
pp. 1-4 ◽  
Author(s):  
Carl Bradbrook ◽  
Louise Clark ◽  
Martina Mosing
Keyword(s):  
Lung Ventilation ◽  
Blood Gas Analysis ◽  
Gas Analysis ◽  
Surgical Removal ◽  
Arterial Blood Gas ◽  
Lung Lobe ◽  
Lung Lobectomy ◽  
Arterial Blood ◽  
Endobronchial Blocker ◽  
The Right

This paper documents use of an endobronchial blocker (EBB) to achieve selective lung ventilation (SLV) for the purpose of lung lobectomy with thoracoscopy. A 3-year-old female neutered Labrador Retriever, body mass of 18.5 kg, was presented for exploratory thoracoscopy. Acepromazine and methadone were administered as premedication, and anaesthesia was induced with propofol and maintained with isoflurane in 100% oxygen and continuous infusions of fentanyl and lidocaine. Mechanical ventilation of the dog’s lungs was performed prior to placement of an Arndt EBB caudal to the right cranial bronchus to allow SLV. Successful SLV was achieved with this technique, allowing continued inflation of the right cranial lobe. A reduction in the arterial partial pressure of oxygen to fractional inspired oxygen ratio (PaO2 : FiO2) of 444 to 306 occurred after placement of the EBB, with no change in monitored cardiopulmonary variables. F-shunt increased from 17.4% to 23.7% with a reduction in oxygen content (CaO2) of 20.0 to 18.7 mg dL-1, remaining within the physiologic range. Due to lung adhesions to the diaphragm, conversion to thoracotomy was required for completion of the procedure. This technique is challenging to perform in the dog. Arterial blood gas analysis should be performed to allow adequate monitoring of ventilation.

The “Spacemaker”, a New Device for Minimally Invasive Cardiothoracic Surgery: An Evaluation and Feasibility Study

2015 ◽  
Vol 10 (4) ◽  
pp. 241-247
Author(s):  
Pieter W.J. Lozekoot ◽  
Sandro Gelsomino ◽  
Paul B. Kwant ◽  
Orlando Parise ◽  
Francesco Matteucci ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Surgical Procedures ◽  
Lung Tissue ◽  
Lung Ventilation ◽  
Cardiothoracic Surgery ◽  
Respiratory Compromise ◽  
One Lung Ventilation ◽  
New Device ◽  
Lead Placement ◽  
The Right

Objective Our aim was to evaluate a new inflatable lung retractor, the “Spacemaker”, and its efficacy in facilitating minimally invasive cardiothoracic surgery without the need of one lung ventilation or carbon dioxide overpressure insufflation. Methods The device was tested in 12 anesthetized pigs (90–100 kg) placed on standard endotracheal ventilation. The device was introduced into the right or left side of the chest, depending on the intended procedure to be performed, via a 3-cm incision in the fifth intercostal space. A total of seven animals were used to evaluate hemodynamic and respiratory response to the device, whereas another five animals were used to assess the feasibility of a variety of minimally invasive cardiothoracic surgical procedures. Results Introduction was easy and unhindered. The device was inflated up to 0.6 bar, thereby pushing the lung tissue gently away cranially, posteriorly, and caudally without interfering with pulmonary function or resulting in respiratory compromise. In addition, hemodynamics remained stable throughout the experiments. Different closed-chest surgical procedures such as left atrial appendage exclusion, pulmonary vein exposure, pacemaker lead placement, and endoscopic stabilization for coronary surgery, were successfully performed. Removal was quick and complete in all cases, and lung tissue showed no remnant atelectasis. Conclusions The “Spacemaker” may represent a reliable alternative to current conventional techniques to facilitate minimally invasive cardiothoracic surgery. Further research is warranted to confirm the effectiveness and the safety of this device and to optimize the model before its use in humans and its introduction into clinical practice.

Constrictive Bronchiolitis Obliterans in a Dog

2019 ◽  
Vol 55 (2) ◽  
Author(s):  
Stacey Lynn Wylie ◽  
Daniel Langlois ◽  
Stephan Carey ◽  
Nathan C. Nelson ◽  
Kurt J. Williams
Keyword(s):  
Bronchiolitis Obliterans ◽  
Clinical Signs ◽  
Histopathologic Examination ◽  
Lung Lobe ◽  
Computed Tomographic ◽  
Airway Lumen ◽  
Alveolar Collapse ◽  
Airway Pathology ◽  
The Right ◽  
Lung Lobes

ABSTRACTA 2 yr old, neutered male rottweiler was evaluated for a chronic cough that had acutely worsened. Computed tomographic examination revealed a diffuse alveolar pattern in the right, middle, and left cranial lung lobes. Aerated parenchymal tissue was not observed in the left cranial lung lobe, and both lobes were markedly decreased in volume. Lobectomy of the right middle and left cranial lung lobes was performed. Histopathologic examination of both lungs identified alveolar collapse associated with marked chronic bronchial and bronchiolar luminal concentric fibrosis leading to reduced airway lumen diameter and bronchiolar destruction. The clinical signs and airway pathology were consistent with constrictive bronchiolitis obliterans. The dog remained stable for over 2 yr with glucocorticoid therapy and intermittent antimicrobics. Although the polypoid form of bronchiolitis obliterans has been described in cattle and occasionally in dogs, constrictive bronchiolitis obliterans has not been reported previously in veterinary species.

scholarly journals A rare anaesthetic challenge in a one-lung ventilated paediatric patient with right upper lobe tracheal bronchus

2020 ◽  
Vol 48 (10) ◽  
pp. 030006052096760
Author(s):  
Yuangui Zhang ◽  
Meiman Qin ◽  
Xiaoqian Wang ◽  
Quanzhang Yan
Keyword(s):  
Paediatric Patient ◽  
Left Lung ◽  
Recurrent Infection ◽  
Lung Ventilation ◽  
Tracheal Bronchus ◽  
One Lung Ventilation ◽  
Recurrent Pneumonia ◽  
Single Lumen ◽  
History Of ◽  
The Right

A tracheal bronchus is a rare congenital anomaly, suggesting abnormal bronchial development. The prevalence of tracheal bronchus in children who undergo bronchoscopy is estimated to be between 0.2% and 3%. When associated with recurrent infection, lobes of the lung must be removed to avoid further lung injury. In such cases, perioperative one-lung ventilation and airway management remain a huge challenge for anaesthesiologists. The case of this rare airway anatomic abnormality in a paediatric patient with two bronchial openings into the right upper lobe, and with a history of recurrent pneumonia, is reported. In addition to a normal opening, a distinct opening in the upper lobe of the right lung was observed, that originated directly from the trachea, superior to the carina. The entire right lung was deflated by left-lung ventilation using a single lumen tracheal tube, and the patient underwent right upper lobe resection. No anaesthesia complications were observed during recovery. In this case, timely identification of the tracheal bronchus and successful collapse of the right lung were key points in the anaesthesia management of this patient.

scholarly journals Difficulty Intubating a Double-Lumen Tube due to a Tracheal Bronchus: A Case Report

2021 ◽  
Author(s):  
Wenzhu Wang ◽  
Ji Li ◽  
Jian Liu ◽  
Chengwei Song ◽  
ya-nan Zhang
Keyword(s):  
Left Lung ◽  
Lung Ventilation ◽  
Double Lumen Tube ◽  
Bronchial Blocker ◽  
Tracheal Bronchus ◽  
One Lung Ventilation ◽  
Double Lumen ◽  
Lumen Tube ◽  
The One ◽  
The Right

Abstract Background: Intubation difficulties, hypoxemia, inability to perform a one-lung ventilation, and high airway pressure often occur during double-lumen tube intubation. Tracheal bronchus is a very rare and difficult to find reason. We present a case of tracheal bronchus accidentally discovered during double-lumen tube intubation in a patient undergoing thoracic surgery. We are the first one to summarize the one-lung ventilation strategy for patients with tracheal bronchus. Case Presentation: A 53-year-old man underwent a scheduled thoracoscopic left upper lobectomy. After two unsuccessful attempts to pass the right-sided double-lumen tube through the right mainstem bronchus, fiberoptic bronchoscopy revealed an aberrant tracheal bronchus with an incidence of 0.1%–3%. Finally we used a left-sided DLT to ventilate the right lung. The patient had no airway complications and was discharged 7 days after the operation.Conclusions: This case serves to remind us that preoperative visits must be thorough and careful. Although a computed tomography chest examination was performed before surgery, we just looked at the inspection report and did not look at the images. We also reviewed relevant literature and summarized the one-lung ventilation strategies for patients with tracheal bronchus. For left-lung ventilation, either a left-sided double-lumen tube or a combination of a bronchial blocker and Fogarty artery embolization catheter can be used. For right-lung ventilation, a bronchial blocker or a left-sided double-lumen tube is a good choice.

scholarly journals Successful one-lung ventilation by blocking the right intermediate bronchus in a 7-year-old child: a case report

2019 ◽  
Vol 47 (6) ◽  
pp. 2740-2745
Author(s):  
Seung Youp Baek ◽  
Jin Hwan Kim ◽  
Goo Kim ◽  
Jin Ho Choi ◽  
Chang Young Jeong ◽  
...  
Keyword(s):  
Endotracheal Tube ◽  
Main Bronchus ◽  
Left Lung ◽  
Lung Ventilation ◽  
Surgical Excision ◽  
One Lung Ventilation ◽  
Lower Lung ◽  
Endobronchial Blocker ◽  
Surgical Field ◽  
The Right

A 7-year-old child underwent surgical excision of a benign mesothelioma of the pleura near the right lower lung. Although insertion of a wire-reinforced endotracheal tube through the left main bronchus was attempted for one-lung ventilation to secure the surgical field of view, the attempt failed. Therefore, an endotracheal tube was inserted into the trachea, and an Arndt endobronchial blocker (Cook Medical, Bloomington, IN, USA) was placed in the right intermediate bronchus under bronchoscopic guidance to selectively block the right lower and middle lobes. The surgery was performed while ventilating the right upper lobe and left lung, and no specific intraoperative adverse events occurred.

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