A new technology using intraoperative near-infrared imaging is being tried out at the University of California-Davis School of Veterinary Medicine. It has proven extremely helpful in soft tissue surgical cases, as this new technique uses infrared wavelengths of light that travel through tissue and fat easily, allowing the surgeons to envision what is underneath the skin.
The owners of a 3-year-old male mastiff opted to try this new technique when it was discovered the dog had chylothorax, a potentially life-threatening condition in which chyle leaks from the thoracic ducts into the chest. Chest radiographs, an echocardiogram and a thoracic ultrasound ruled there was no obvious cause of the patient’s condition. When it was decided they would pursue a surgical option, the surgeons opted for thoracic duct litigation as it is minimally invasive, has a similar success rate and provides less discomfort and a quicker recovery for the patient than an open surgery approach.
During the surgery, a medical dye is injected into a lymph node, where it travels through the lymphatic vessels into the chest to form the thoracic ducts. The dye is not visible to the naked eye and does not distort the appearance of the tissues. However, when surgeons transition from a normal view with the thoracoscope to the near-infrared view, the special dye within the ducts allows them to see their position quite clearly. This greatly minimizes any chance of missing the ducts, and allows the surgeons to easily locate where the patient was leaking chyle. This makes dissection much more precise, since with normal illumination, the ducts are nearly impossible to see.
Surgeons at UC-Davis believe this near-infrared approach may soon become the standard, in cases such as this. Other Veterinary schools have also purchased the necessary equipment and are beginning to utilize the technique.