This report describes the video-assisted thoracoscopic surgical approach for 2 dogs with minimally invasive thymomas.Before surgery, dog 1 had incidental laryngeal paralysis that was also treated surgically, and dog 2 had paraneoplastic myasthenia gravis, megaesophagus, and aspiration pneumonia.Both dogs underwent computed tomography before surgery to confirm the size and arrangement of both tumors. Surgery began with the placement of a double-lumen endobronchial tube via bronchoscopy.This tube is especially designed for placement within 1 bronchus; the other lung is left collapsed for preferred viewing of the tumor.The double lumen provides access to either lobe during the surgery without bronchoscopic interruption of the procedure,which allows the surgeon to work from both sides or to inflate either lung to ensure adequate ventilation.Blunt dissection of the thymomas was performed via 3 portholes,with some digital manipulation of the tumor.The tumors were then removed via a specimen retrieval bag.Both dogs recovered uneventfully from surgery and required only minimal analgesics and postoperative care.Dog 1 developed aspiration pneumonia after surgery but responded to antibiotics and oxygen therapy; the dog was released 5 days after surgery.Dog 2 also developed signs consistent with aspiration pneumonia and was then euthanized.However, his recovery up to 4 days after surgery was relatively uncomplicated.

COMMENTARY: This exciting technique provides a minimally invasive approach to resecting noninvasive thoracic  masses.Disadvantages are the limited availability of expertise and advanced imaging techniques (since computed tomography is required to ensure the patient is an appropriate candidate).However,we desperately need more minimally invasive techniques for high-risk patients, and video-assisted surgery (vs traditional thoracotomies) will most certainly be a comforting option to our clients.—Heather Troyer, DVM, Diplomate ABVP (Canine & Feline Practice)

Video-assisted thoracoscopic resection of noninvasive thymomas using one-lung ventilation in two dogs. Mayhew PD, JS Friedberg. VET SURG 37:756-762, 2009.