Study explores video-assisted transdiaphragmatic lung lobectomy in dogs

A newly published feasibility study in Veterinary Surgery reports that a video-assisted transdiaphragmatic technique allowed total lobectomy of caudal and accessory lung lobes in canine cadavers, with the strongest results in caudal lobes. Published online ahead of print on October 8, 2026, the study evaluated 12 cadavers and found an overall success rate of 91.7%, with successful resection in all caudal lobe cases and in three of four accessory lobe cases. (pubmed.ncbi.nlm.nih.gov)

The work builds on a broader shift in small animal surgery toward less invasive thoracic approaches. Traditional intercostal thoracotomy remains common, but prior veterinary literature has associated it with postoperative pain, and median sternotomy, while offering bilateral access, has been reported to carry meaningful complication risk in some series. In human surgery, video-assisted thoracic techniques have been used to reduce surgical pain and support recovery, and veterinary surgeons have been adapting related concepts where anatomy and instrumentation allow. (pmc.ncbi.nlm.nih.gov)

In the new study, cadavers were randomized to left caudal, right caudal, or accessory lung lobectomy, with four procedures in each group. Surgeons used a cranial midline celiotomy and transdiaphragmatic entry with rigid videoendoscopic assistance, then completed lobectomies with an endoscopic linear stapler. Investigators tracked whether complete lobectomy was achieved, along with surgical time, incision length, and technical events, and they assessed staple-line integrity with an air leak test. Mean total surgical time was 65.6 ± 26.8 minutes, and two procedures required a second staple cartridge. Procedural success was not associated with cadaver weight or body condition score. (pubmed.ncbi.nlm.nih.gov)

The weak point was the accessory lung lobe. While all caudal lobes were successfully resected, accessory lobectomy succeeded in 75% of cases, and both recorded air leaks occurred in accessory lobe procedures. That fits with the broader literature describing the accessory lung lobe as technically challenging because of its position near the diaphragm, heart, and caudal vena cava. A 2023 anatomical study noted that the accessory lobe has distinct exposure challenges, and a 2025 clinical case series of 11 dogs undergoing accessory lung lobectomy reported postoperative complications in 6 dogs, including one major complication requiring revision surgery. (pubmed.ncbi.nlm.nih.gov)

Direct outside commentary on this specific paper was limited at the time of writing, but related studies help frame its importance. The same lead author previously reported that a transdiaphragmatic approach was feasible for partial caudal lung lobectomy in canine cadavers without longer operative times or greater apparent tissue trauma than lateral thoracotomy. More recently, another cadaveric study using a subxiphoid single-incision thoracoscopic approach achieved accessory lung lobectomy in all eight dogs studied, with no detected air leakage, suggesting that surgeons are actively testing multiple routes to improve access to caudal thoracic structures. (pmc.ncbi.nlm.nih.gov)

Why it matters: For veterinary professionals, this paper is less about immediate practice change and more about where thoracic surgery may be heading. If transdiaphragmatic, video-assisted access can be translated safely into clinical patients, it could offer another option for lesions in caudal lung lobes, where exposure can be difficult and morbidity from open approaches matters. But the current evidence base is still early. This was a 12-cadaver feasibility study, not a live-patient outcomes trial, and it cannot answer the questions that matter most in practice: hemorrhage control, postoperative pain, chest tube duration, ventilation challenges, leak rates under physiologic conditions, length of hospitalization, cost, and case selection. (pubmed.ncbi.nlm.nih.gov)

There are also practical considerations around equipment and training. The study used rigid endoscopic assistance and an endoscopic linear stapler, and one-third of procedures needed two staple cartridges. That has implications for procedural cost, operating room setup, and the learning curve in referral settings. The funding record listed support from Universidad Europea de Madrid and B. Braun Medical, which is relevant context for readers evaluating how quickly such techniques might diffuse into specialty practice. (pubmed.ncbi.nlm.nih.gov)

What to watch: Watch for the first live-dog clinical series, especially cases comparing this approach with intercostal thoracotomy, median sternotomy, thoracoscopic-assisted methods, or subxiphoid thoracoscopy. The key question now isn’t whether the approach can be done in cadavers, but whether it improves real-world outcomes for dogs and pet parents without adding unacceptable technical risk. (pubmed.ncbi.nlm.nih.gov)