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Kuvaldina et al: Development of a minimally invasive endoscopic technique for excisional biopsy of the axillary lymph nodes in dogs
Veterinary Surgery 6, 2023

🔍 Key Findings

  • Endoscopic excisional biopsy of axillary lymph nodes was successfully performed in cadavers and clinical dogs with minimal complications.
  • The technique used a SILS port and CO₂ insufflation through a small incision between the latissimus dorsi and superficial pectorals.
  • In 4 cadavers (6 limbs), mean time to remove axillary nodes was 33 minutes, and single nodes were found in 5/6 limbs.
  • In 3 clinical dogs, the procedure was successful in 2 cases; 1 required conversion to open surgery due to difficulty manipulating the node.
  • Accessory axillary nodes were successfully excised when present, located adherent to deep latissimus dorsi.
  • No cases developed lymphedema, pneumothorax, or major complications postoperatively.
  • Subjective benefits included better visualization, reduced dissection, and less postoperative morbidity than open techniques.
  • Study suggests MIS lymphadenectomy may improve staging accuracy and reduce complications, though larger studies are needed.

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← Articles

Kuvaldina et al: Development of a minimally invasive endoscopic technique for excisional biopsy of the axillary lymph nodes in dogs
Veterinary Surgery 6, 2023

🔍 Key Findings

  • Endoscopic excisional biopsy of axillary lymph nodes was successfully performed in cadavers and clinical dogs with minimal complications.
  • The technique used a SILS port and CO₂ insufflation through a small incision between the latissimus dorsi and superficial pectorals.
  • In 4 cadavers (6 limbs), mean time to remove axillary nodes was 33 minutes, and single nodes were found in 5/6 limbs.
  • In 3 clinical dogs, the procedure was successful in 2 cases; 1 required conversion to open surgery due to difficulty manipulating the node.
  • Accessory axillary nodes were successfully excised when present, located adherent to deep latissimus dorsi.
  • No cases developed lymphedema, pneumothorax, or major complications postoperatively.
  • Subjective benefits included better visualization, reduced dissection, and less postoperative morbidity than open techniques.
  • Study suggests MIS lymphadenectomy may improve staging accuracy and reduce complications, though larger studies are needed.

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Multiple Choice Questions on this study

In Kuvaldina 2023 et al., on endoscopic axillary lymphadenectomy, what was the reported complication rate in clinical cases?

A. Severe hemorrhage and infection were common
B. Conversion to open surgery occurred in all cases
C. Lymphedema was the most frequent complication
D. No major complications were encountered; some mild lameness and seroma were observed
E. All patients developed pneumothorax

Answer: No major complications were encountered; some mild lameness and seroma were observed

Explanation: Clinical cases were largely complication-free, aside from minor, transient issues.
In Kuvaldina 2023 et al., on endoscopic axillary lymphadenectomy, what structure must be carefully preserved during dissection?

A. Suprascapular nerve
B. Accessory axillary artery
C. Thoracodorsal nerve bundle
D. Long thoracic nerve
E. Brachial plexus trunk

Answer: Thoracodorsal nerve bundle

Explanation: The thoracodorsal nerve was consistently identified and preserved to avoid functional loss.
In Kuvaldina 2023 et al., on endoscopic axillary lymphadenectomy, what was the typical surgical time for axillary node removal in cadavers?

A. 10 minutes
B. 22 minutes
C. 33 minutes
D. 45 minutes
E. 60 minutes

Answer: 33 minutes

Explanation: Mean removal time in cadavers was 33 minutes, showing feasibility of the procedure.
In Kuvaldina 2023 et al., on endoscopic axillary lymphadenectomy, what was a key benefit of the minimally invasive approach compared to open surgery?

A. Improved cosmetic appearance of the surgical site
B. Reduced need for lymph node identification
C. Decreased visualization of critical structures like vessels
D. Increased bleeding from deeper planes
E. Improved visualization of surgical landmarks and vascular structures

Answer: Improved visualization of surgical landmarks and vascular structures

Explanation: The study highlighted better identification of vessels and nerves using endoscopy, enhancing safety.
In Kuvaldina 2023 et al., on endoscopic axillary lymphadenectomy, what led to conversion to open surgery in one clinical case?

A. Pneumothorax during insufflation
B. Inability to locate the SILS port
C. Inadequate analgesia for recovery
D. Failure to identify the accessory node
E. Difficulty grasping and elevating the axillary node near vessels

Answer: Difficulty grasping and elevating the axillary node near vessels

Explanation: The surgeon could not safely mobilize the node adjacent to the vasculature.
In Kuvaldina 2023 et al., on axillary lymph node excision, which complication was NOT observed in any of the clinical cases following axillary lymphadenectomy?

A. Mild lameness
B. Seroma
C. Lymphedema
D. Incisional bruising
E. Discomfort on palpation

Answer: Lymphedema

Explanation: No cases developed lymphedema postoperatively, a complication often seen in humans.
In Kuvaldina 2023 et al., on axillary lymph node excision, what was the reason for conversion to an open approach in one clinical case?

A. Node was too large
B. Unexpected hemorrhage
C. Anesthesia time exceeded limits
D. Node could not be grasped and elevated
E. CO₂ insufflation failed

Answer: Node could not be grasped and elevated

Explanation: The node's proximity to the thoracic wall and inability to elevate it safely led to conversion.
In Kuvaldina 2023 et al., on axillary lymph node excision, which anatomical landmark helped identify the location of the axillary lymph node during endoscopic dissection?

A. Medial epicondyle of the humerus
B. First rib and axillary vessels
C. Glenohumeral joint capsule
D. Supraspinatus tendon
E. Median nerve

Answer: First rib and axillary vessels

Explanation: The axillary lymph node was located adjacent to the axillary artery and vein and near the first rib.
In Kuvaldina 2023 et al., on axillary lymph node excision, which of the following tools was essential for minimally invasive access to the axillary region?

A. Surgical microscope
B. SILS port and laparoscope
C. Standard thoracotomy set
D. Arthroscopic shaver
E. C-arm fluoroscopy

Answer: SILS port and laparoscope

Explanation: The study employed a single-incision laparoscopic (SILS) port with CO₂ insufflation and a laparoscope to access the axillary region.
In Kuvaldina 2023 et al., on axillary lymph node excision, what was the average surgical time to remove axillary lymph nodes using the minimally invasive technique in cadavers?

A. 12 minutes
B. 25 minutes
C. 33 minutes
D. 41 minutes
E. 52 minutes

Answer: 33 minutes

Explanation: The mean time reported for excision of axillary lymph nodes in cadaver specimens was 33 minutes.

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