Veterinary Surgery August 2025 – Soft Tissue Part 2: Iliosacral Access & Axillary Node Strategy

In this Simini Small Animal Surgery Podcast episode, we explore two studies from the August 2025 issue of Veterinary Surgery that push forward lymph node access in small animal oncologic surgery.

We cover:

✅ Monti et al. — A pilot study demonstrating the feasibility of laparoscopic iliosacral lymphadenectomy using near-infrared fluorescence (NIRF) and indocyanine green (ICG) in dogs. With a median dissection time of 12 minutes and zero post-op complications, this technique offers a safer, faster alternative to traditional open approaches—even for nodes as small as 5–6 mm.

✅ Schneider et al. — A standardized open surgical technique using anatomical landmarks for axillary lymph node (ALN) removal. In 44 tumor-bearing dogs, the team achieved 100% node identification with a median dissection time of 16.6 minutes—without using dye or imaging guidance. Even "normal-sized" nodes revealed metastasis in 22% of cases.

Together, these papers make a strong case for moving beyond imaging alone—and toward proactive, standardized node removal as part of everyday surgical oncology.

🎓 Journal Articles Discussed:

• Monti et al. — Near-infrared fluorescence-guided minimally invasive surgery for iliosacral lymph node removal in 18 dogs (2023–2025)
• Schneider et al. — Axillary lymph node removal for staging cancer; description of a lateral approach and application in 44 tumor-bearing dogs
  📚 From the August 2025 issue of Veterinary Surgery

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Chapters

• 0:00 Introduction: Nodal Mapping and Surgical Access
• 1:29 Monti et al. Study: NIRF-Guided Laparoscopy for Iliosacral Lymph Nodes
• 4:43 Limitations: Conversion Due to Dye Spill or Lack of ICG Uptake
• 7:23 Schneider et al. Study: 100% Identification Rate with Anatomical Approach
• 9:58 Low Morbidity and High Diagnostic Yield
• 11:52 Clinical Takeaway: Proactive ALN Removal for At-Risk Patients