Evaluation of the incidence of intraoperative and postoperative complications following laparoscopic extirpation of enlarged and no enlarged sentinel medial iliac lymph node in four dogs

The evaluation of sentinel lymph node (SLN) known as lymph node mapping, is a critical process in assessing the stage of various solid tumors, such as mast cell tumors (MCTs). Several sentinel lymph node (SLN) mapping techniques, have been investigated in the last 10 years in veterinary oncology. If SLN is a Medial Iliac Lymph Node ( MILN) the methods to evaluate it, include diagnostic imaging, fine needle aspiration (FNA) or excisional biopsy. MILN extirpation can be a challenge for localization between the deep circumflex iliac and the external iliac arteries.The aim of this study is to evaluate incidence of intraoperative and postoperative complications following laparoscopic extirpation of enlarged and no enlarged sentinel medial iliac lymph node in four dogs (SMILN), after SLN mapping.A Golden retriever male, 8 yo, 30 kg, a mixed breed neutered male, 25 kg, 7 yo, a English Bouledogue, male, 6 yo, 30kg, and a mixed breed male, 13 yo, 18 kg presented for extirpation of SMILN secondary to neoplasia. The first case a Golden retriever had an enlarged SMILN. CT scan described maximum size of approximately 3-4 cm with irregular and undefined margins, resulting in moderate osteolysis of the underlying bone tissue and clear destruction of the bone cortex. The SMILN’s mixed breed were mild enlargement. The SMILN’s English Bouledogue was no enlargement. For the first one the enlarged SMILN no use of blue di metilene was used intra operatory for identify the SMILN, in other cases the blue of metilene was used.The dogs were positioned in dorsal recumbency.After exploring the entire abdomen with a 5 mm × 29 cm 30° to evaluate the organs for iatrogenic damage, the second cannula 6 mm × 6.5 cm was inserted at a point equidistant from the midline and the camera portal on the contralateral side of the MILN under laparoscopic guidance. The third portal was established in the caudal abdomen at a location approximately one third of the distance between the pubic brim and the ipsilateral instrumental portal. The retroperitoneum was incised between the right external iliac artery and the testicular vessels. The tissue surrounding the retroperitoneum and the small vessels attached to the lymph nodes were dissected using blunt dissection and sealing/transection by the vessel-sealing device, respectively. During the procedure, the lymph node was retracted away with laparoscopic Babcock forceps from the large vessels.SMILNs were successfully identified and excised by using the ventral approach in all dogs. There were no major complications defined as a treatment-related adverse event requiring further therapy with increase in the level of care or prolonged hospitalization, or minor complications defined as a treatment-related adverse event requiring nominal therapy or no treatment with or without overnight hospitalization for observation were. No animal required conversion from laparoscopic procedure to open laparotomy.