Perikardiektomia torakoskopowa. Wskazania i techniki u małych zwierząt. Cz. I/Thoracoscopic pericardectomy. Indications and techniques in small animals. Part I

Surgical techniques

Given the short duration of the procedures and the work in a non-contaminated environment, intra-operative antibiotics using broad-spectrum antibiotics are sufficient (if needed), but post-operative antibiotic therapy is usually not necessary. Pain control is necessary as with any surgical procedure. Pressure of the ports on the intercostal nerves are assumed to be particularly painful. Surgical preparation depends on the chosen approach. Anyway, enough cranial abdomen (caudal to the xyphoïd process) shall be prepared, in case a portal shall be placed trans-diaphragmatically.

Thoracoscopic creation of a pericardial window that is approximately 4 to 5 cm in diameter has been recommended to palliate the clinical signs associated with pericardial effusion in dogs (19). Whether a 4 to 5 cm pericardial window is large enough is not known; therefore, it may be advisable to create a larger pericardial window or to perform a sub-phrenic pericardectomy (28) in order to improve long-term outcome in dogs with idiopathic pericardial effusion (28, 33, 34).

Patient positioning and techniques

Thoracoscopic pericardectomy can be performed with the patient in lateral, in dorsal or in sternal recumbency (when combined with thoracic duct surgery). This depends mainly on surgeon’s preference and on type of disease. We do select preferably the dorsal recumbency except for those patients with heart-base tumors in which lateral recumbency is preferred. Some authors [...]

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