Fig 1.
Location of the trocars for access to the (a) pelvic and (b) thoracic cavity.
Fig 2.
Canine lymphatic anatomy analysed and areas of ICG administration.
Table 1.
Quality of lymphatic pathway and lymph node visualizations in thawed dog carcasses [3].
Table 2.
Classifications of time intervals for laparoscopic fluorescence lymphography.
Table 3.
Distributions of the structures visualized by LFL via intradermal administration of ICG in the torso of thawed dog carcasses (C1–C6) according to ICG dose (0.05%), staining time, and visualization quality.
Table 4.
Distributions of the structures visualized by LFL via intrapopliteal administration of ICG in thawed dog carcasses (C1–C6) according to ICG dose (0.05%), staining time, and visualization quality.
Fig 3.
Laparoscopic fluorescence lymphography (LFL) in carcass 1 (C1) (A-D), C2 (E-H), and C3 (I-L). In A, B, C, E, and F, indocyanine green (ICG) was administered intradermally in the torso. In D, G, H, I, J, K, and L, ICG was administered via IPP. The blue stain shows the medial iliac lymph node (MILN) (white arrows) and/or efferent lymphatic pathways (green arrows). In C1, the left efferent lymph vessels (A) and the left MILN (B) are stained while entering the abdominal cavity along with the deep circumflex iliac vessels. Two left MILNs (C) and one right MILN (D) are shown. Efferent lymphatic pathways without (E) and with (F) near-infrared fluorescence filtering and right MILN without (G) and with (H) near-infrared fluorescence filtering are visible in C2. In C3, the right MILN (I, J, and L) and the lymph ducts (K, with green narrows) communicate with the left MILN (not stained). (L) shows the afferent lymphatic vessel (red arrow) to the cisterna chyli. In all carcasses, ICG fluorescence improved (or allowed) visualization of the MILN and lymphatic pathways. UR = ureter.
Fig 4.
Laparoscopic fluorescence lymphography (LFL) in carcass 4 (C4) (A-D), C5 (E-H), and C6 (I-L). In A, B, E, F, I, and J, indocyanine green (ICG) was administered intradermally in the torso. In C, D, G, H, K, and L, ICG was administered via IPP. The blue stain shows the medial iliac lymph node (MILN) and/or efferent lymphatic pathways. In C4, the left MILN is shown without (A) and with (B) near-infrared fluorescence filtering. The right MILN is shown without (C) and with (D) near-infrared fluorescence filtering. In C5, IPP administration of ICG did not stain the left MILN but did stain the efferent lymphatic pathways (E and F). The right MILN is shown without (G) and with (H) near-infrared fluorescence filtering. In C6, ICG fluorescence enhanced MILN and lymphatic pathway identification (I-L). UR = ureter; DC = descending colon.
Fig 5.
Left medial iliac lymph node (MILN) during laparoscopic lymphadenectomy without (A) and with (B) near-infrared fluorescence filtering in carcass 1 (C1). In C2, while the left MILN is not stained (C) but communication lymphatic vessels between the right and left MILN are stained (D). In C6, the right internal iliac lymph node (IILNR) was located by laparoscopic visualization (E, dotted circumference) but was not stained. In C5, the IILNR was stained following intrapopliteal (IPP) administration of indocyanine green (ICG) (F), allowing its localization and lymphadenectomy by laparoscopy (G). In C6, the caudal vena cava (H) was stained (I) after IPP ICG administration. C2 was the only carcass in which the thoracic duct (J) was stained (K) by ICG. Laparoscopic fluorescence lymphography (LFL) using ICG allows easy identification of the thoracic duct (L and M) for occlusion by titanium clips. DI = diaphragm.
Fig 6.
(a) Fragment of fibrovascular tissue artifacted with areas of amorphous granular background, with meatein crystals and in the absence of identifiable cellularity. (b) Trabecular adipose and fibrous tissue with an amorphous nodular aggregate with few identifiable hemophagocytic cells.
Table 5.
Histological analysis of samples collected from each carcass after ICG administration via ID and IPP.