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Gibson et al: Evaluation of mediastinoscopy for cranial mediastinal and tracheobronchial lymphadenectomy in canine cadavers
Veterinary Surgery 5, 2024

🔍 Key Findings

  • Mediastinoscopy was technically feasible in large-breed canine cadavers using a SILS port and standard laparoscopic instruments.
  • The left tracheobronchial lymph node (LTBLN) was successfully retrieved in all cadavers (7/7), while cranial mediastinal lymph nodes were retrieved in only 1/7.
  • Postprocedural pleural gas was observed in 4/7 cadavers, likely due to CO₂ insufflation.
  • Instrument limitations with a human-designed mediastinoscope led to preference for laparoscopic instruments and SILS port for improved access and visualization.
  • Complication rates were low, with only two minor (Grade 1) adverse events (pleural tear and LN rupture).
  • Obesity and mediastinal fat were cited as potential challenges to visualization and node retrieval.
  • NASA-TLX workload scores were lowest for tracheobronchial nodes, indicating these were the easiest to access.
  • The authors concluded this approach may facilitate minimally invasive biopsy or resection of cranial mediastinal masses in live dogs, but clinical trials are needed to validate safety and efficacy.

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← Articles

Gibson et al: Evaluation of mediastinoscopy for cranial mediastinal and tracheobronchial lymphadenectomy in canine cadavers
Veterinary Surgery 5, 2024

🔍 Key Findings

  • Mediastinoscopy was technically feasible in large-breed canine cadavers using a SILS port and standard laparoscopic instruments.
  • The left tracheobronchial lymph node (LTBLN) was successfully retrieved in all cadavers (7/7), while cranial mediastinal lymph nodes were retrieved in only 1/7.
  • Postprocedural pleural gas was observed in 4/7 cadavers, likely due to CO₂ insufflation.
  • Instrument limitations with a human-designed mediastinoscope led to preference for laparoscopic instruments and SILS port for improved access and visualization.
  • Complication rates were low, with only two minor (Grade 1) adverse events (pleural tear and LN rupture).
  • Obesity and mediastinal fat were cited as potential challenges to visualization and node retrieval.
  • NASA-TLX workload scores were lowest for tracheobronchial nodes, indicating these were the easiest to access.
  • The authors concluded this approach may facilitate minimally invasive biopsy or resection of cranial mediastinal masses in live dogs, but clinical trials are needed to validate safety and efficacy.

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Multiple Choice Questions on this study

In Gibson 2024 et al., on mediastinoscopy in dogs, what lymph node was **most consistently retrieved** using the SILS-port technique?

A. Right sternal
B. Left sternal
C. Left tracheobronchial
D. Cranial mediastinal
E. Right tracheobronchial

Answer: Left tracheobronchial

Explanation: The left tracheobronchial lymph node was retrieved in all 7 cadavers.
In Gibson 2024 et al., on mediastinoscopy in dogs, what was the **overall complication rate** observed during the cadaveric procedures?

A. 0%
B. 5%
C. 15%
D. 29%
E. Low with only two minor adverse events

Answer: Low with only two minor adverse events

Explanation: Only minor grade 1 events (pleural tear and LN rupture) were reported, with no major complications.
In Gibson 2024 et al., on mediastinoscopy in dogs, what was the most common **postprocedural finding on CT** after the procedure?

A. Pleural effusion
B. Pneumothorax
C. Subcutaneous emphysema
D. Pericardial effusion
E. Pleural gas accumulation

Answer: Pleural gas accumulation

Explanation: Pleural gas was seen in 4 of 7 cadavers, likely from CO₂ insufflation.
In Gibson 2024 et al., on mediastinoscopy in dogs, which factor was identified as a major **technical limitation** of using a human-designed mediastinoscope?

A. Inadequate lighting
B. Overheating of the scope
C. Working channel too short and narrow
D. Instrument reach and stability limitations
E. Too few instrument ports

Answer: Instrument reach and stability limitations

Explanation: Human-designed mediastinoscopes had channels too short and lacked adequate reach in dogs.
In Gibson 2024 et al., on mediastinoscopy in dogs, which factor most likely contributed to **difficulty in lymph node identification**?

A. Tracheal deviation
B. Contrast media reaction
C. Absence of thymus
D. Excessive thoracic movement
E. Obesity and mediastinal fat

Answer: Obesity and mediastinal fat

Explanation: Increased mediastinal fat reduced visibility and working space during dissection.

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