pulmonary

Question 1

complete lobectomy

Answer 1

diseased process involving the entire lobe or area near the hilus or lobe

Question 2

list examples where a complete lobectomy may be necessary

Answer 2

lun lobe torsion

neoplasia

trauma

contamination

infection

Question 3

when do u use partial lobectomy

Answer 3

when u have a focal lesion distal in lobe

Question 4

how much of the lung can u remove with complete lobectomy

Answer 4

up to 50%

n.b because the right lung posses slightly more than 50% of the lung,complete pneumonectomy is not recommended

complete pneumonectomy may be performed on the left lung if the right one is healthy

Question 5

surgical tech. for complete lobectomy

Answer 5

• isolate and pack off the lung lobeto be resected
• vessels and bronchus are ligated at the hilus
• isolate pulmonary artery(using right angled forcepts)
• place 3 ligatures(middle ligature is transfixing)
• repeat process with pulmonary vein
• excise vessels with transfixing and distal ligatures

Question 6

when does pulmonary vein ligated before the pulmonary artery

Answer 6

• in cats and small dogs
• ligation of pulmonary artery causes collapse of pulmonary vein increasing difficulty to ligate
• if dealing with neoplasia or abscess, vein should be ligated first

Question 7

you have a dog that you have to do complete lobectomy to remove an abscess, how should u ligate the vessels

Answer 7

vein first then artery

Question 8

sx tech for complete lobectomy

Answer 8

• the bronchus is transected between two crushed clumps
• 1 or 2 rows of horizontal mattress sutures,interupted or continuous are placed through bronchus
• cut margin of bronchus is over sewn with simple continuous sutures.

Question 9

sx tech. for complete lobectomy using a TA stapler

Answer 9

the hilus of the lobe is isolated

the entire pedicle is ligated

the lobe is excised distal to the staples

Question 10

discuss surgical technigue for partial lobectomy

Answer 10

crushing clamps are placed across the lobe proximal to the lesion

1 or 2 rows of continuous horizontal mattress sutures placed proximal to the clamp(3/0 or 4/0 absobable suture,small taper needle)

Question 11

how to check for leaks in patial lobectomy

Answer 11

the incision is examined for air leaks

• sterile saline is dripped across the suture line while the lung is inflated
• in large dogs the suture line may be placed in a large bowl of fluid while the lung is inflated
• leaks are closed with interupted sutures

Question 12

a dog is present ed with lameness and lung lobe tumer .what do u think may have caused the lameness

Answer 12

the tumer may have matestasised to other sites or caused bone reactions along the toes and along the lower bones of the leg (hypertrophic osteopathic)