title: Feasibility and safety of endoscopic transumbilical thoracic surgical lung biopsy: a survival study in a canine model.
abstract: BACKGROUND
  Transumbilical laparoscopy allows the patient to undergo various surgical procedures associated with abdominal disease. 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
  We performed the procedure in 12 dogs weighting 7.1-9.1 kg. The thoracic cavity was accessed using a metal tube inserted via umbilical and diaphragmatic incisions. After transumbilical thoracoscopy, we resected the predetermined lung lobe with an electrocautery loop. We carried out daily clinical examinations, including determination of respiratory rate and rectal temperature. Laboratory parameters (white blood cell count) and inflammatory parameters, including serum interleukin-6 and C-reactive protein, were measured before surgery and at postoperative days 1, 3, 7, and 14. We performed necropsies 2 wk after surgery.
  
  
  RESULTS
  We successfully performed corrected surgical lung biopsies for the predetermined lung lobe in all animals, with a median time of 43.5 min (range, 32-65 min). We observed two perioperative complications: One dog had minor postoperative air leakage and one had hemodynamic collapse because of inadequate ventilation. These animals recovered well without signs of perioperative infection. Necropsies at 2 wk 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 in this canine model of survival. This procedure may have potential advantages over currently used transthoracic thoracoscopy techniques.
authors.affiliation: Laboratory Animal Center, Department of Surgery, Chang Gung Memorial Hospital at Linko, Chang Gung University, Taoyuan, Taiwan.
authors.forename: Chih-Tsung
authors.initials: CT
authors.lastname: Wen
authors.forename: Yen
authors.initials: Y
authors.lastname: Chu
authors.forename: Chi-Ju
authors.initials: CJ
authors.lastname: Yeh
authors.forename: Chien-Ying
authors.initials: CY
authors.lastname: Liu
authors.forename: Hsu-Chia
authors.initials: HC
authors.lastname: Yuan
authors.forename: Po-Jen
authors.initials: PJ
authors.lastname: Ko
authors.forename: Yun-Hen
authors.initials: YH
authors.lastname: Liu
authors.forename: Hui-Ping
authors.initials: HP
authors.lastname: Liu
mesh_terms: D000818:Animals; D001706:Biopsy / Q000009:adverse effects / Q000379:methods; D001831:Body Temperature; D003964:Diaphragm / Q000473:pathology; D004285:Dogs; D005240:Feasibility Studies; D007249:Inflammation / Q000209:etiology; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods; D008168:Lung / Q000473:pathology*; D056152:Respiratory Rate; D013906:Thoracoscopy / Q000009:adverse effects / Q000379:methods*; D014472:Umbilicus / Q000601:surgery