title: Feasibility of Subxiphoid Anatomic Pulmonary Lobectomy in a Canine Model.
abstract: Purpose Transthoracic thoracoscopic approach is the gold standard in surgical treatment for thoracic disease. However, it is associated with significant chronic postoperative wound discomfort. Currently, limited data are available regarding the subxiphoid approach to the thoracic cavity. The present study is aimed to evaluate the performance of a subxiphoid anatomic pulmonary lobectomy (SAPL) in a canine model. Methods The SAPL procedure was performed in 10 beagle dogs using a 3-cm incision over the xiphoid process. After thoracic exploration, SAPL was performed under flexible bronchoscopy guidance. The pulmonary vessel was divided with Ligasure and secured with a suture ligature. The bronchus was divided with endostapler. Surgical outcomes were evaluated by the success of SAPL and operative complications. Results SAPL was successfully completed in 9 animals. One animal required conventional thoracotomy to resuture the pulmonary artery stump. Another animal encountered small middle lobe laceration after SAPL and died at 8 days postoperation due to respiratory distress. Conclusion Subxiphoid anatomic pulmonary lobectomy is technically feasible. Refinement of endoscopic instruments combined with more research evidences may facilitate the development of subxiphoid platform in thoracic surgery.
authors.affiliation: Department of Surgery, Chang Gung Memorial Hospital and Chang Gung University.
authors.forename: Ming-Ju
authors.initials: MJ
authors.lastname: Hsieh
authors.affiliation: Department of Surgery, Chang Gung Memorial Hospital and Chang Gung University.
authors.lastname: Yen-Chu
authors.affiliation: Department of Surgery, Chang Gung Memorial Hospital and Chang Gung University.
authors.forename: Yi-Cheng
authors.initials: YC
authors.lastname: Wu
authors.affiliation: Department of Pathology, Chang Gung Memorial Hospital and Chang Gung University.
authors.forename: Chi-Ju
authors.initials: CJ
authors.lastname: Yeh
authors.affiliation: Department of Medicine, Chang Gung Memorial Hospital and Chang Gung University.
authors.forename: Chieng-Ying
authors.initials: CY
authors.lastname: Liu
authors.affiliation: Department of Surgery, Koo-Foundation Sun Yat-Sen Cancer Center.
authors.forename: Chia-Chuan
authors.initials: CC
authors.lastname: Liu
authors.affiliation: Department of Surgery, Chang Gung Memorial Hospital and Chang Gung University.
authors.forename: Po-Jen
authors.initials: PJ
authors.lastname: Ko
authors.affiliation: Department of Surgery, Chang Gung Memorial Hospital and Chang Gung University yunhenliu@gmail.com.
authors.forename: Yun-Hen
authors.initials: YH
authors.lastname: Liu
mesh_terms: D000818:Animals; D004195:Disease Models, Animal; D004285:Dogs; D005240:Feasibility Studies; D005544:Forecasting; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D061646:Operative Time; D011013:Pneumonectomy / Q000379:methods*; D020775:Thoracic Surgery, Video-Assisted / Q000379:methods*; D016896:Treatment Outcome; D014989:Xiphoid Bone / Q000601:surgery*
keywords: NOTES; SILS; flexible endoscopy; single-site surgery