Rapid, reliable lung-lobe removal using a modified Miller's knot


Reintroducing the "flashing" technique, also useful for wide vascular pedicles requiring ligation

A simple and rapid technique for the emergency removal of lung lobes was developed with my experience in a small set of dogs and cats in 1999, and since then I have used the procedure on more than 50 patients.

I first presented and published the procedure in 2004 at the International Veterinary Emergency and Critical Care Symposium in San Diego in 2004. At that time I reported the technique was successful in two cats and 10 dogs without recognized complications, with a minimum follow-up of four months.

Since that time, more cases have been done with longer follow-ups, and the procedure has been taught to more than 100 veterinarians at various wet labs and during surgeries. Through this experience, the technique is now recognized by respected veterinary surgeons as a very effective and practical one that can be performed for the removal of a lung lobe within a few minutes without complications and without the need of any special equipment or training.

My purpose here is to describe how the technique is performed and compare its results with those of the conventional, well-published technique where the pulmonary lobar artery and vein branches are individually ligated and the bronchus individually closed.

One case is presented that demonstrates how easy it is to do, even in a limited space and complex situation.

More in this package:


Methodology: figure 1

Methodology: figure 2

Methodology: figure 3

Methodology: figure 4

Applying a Miller's knot: step 1

Applying a Miller's knot: step 2

Applying a Miller's knot: step 3

Case study: step 1

Case study: step 2

Case study: step 3

Comparison to traditional technique


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