Improved method for cannulation of the right lymph duct in dogs

Abstract

We have developed a relatively simple technique for cannulating the right lymph duct in the dog. We have successfully cannulated 19 of 20 dogs and have obtained stable lymph flows for up to 6 h. We make a skin incision over the origin of the pectoralis superficialis muscle and extend it laterally and cephalically until it is parallel and lateral to the external jugular vein. Using the cephalic vein as a landmark, we identify the cervical lymphatic which lies deep to the external jugular vein. We trace the cervical lymphatic posteriorly to the lymphatic ampulla, which is located at the external jugular and axillary venous junction. The ampulla receives the cervical, axillary, and right lymph ducts. We place a ligature around the ampulla and tie it off, forming a lymphatic pouch and obstruction lymph flow into the vein. We then cannulate the cervical lymphatic and advance the catheter into the ampulla and tie it in place. All lymphatic branches draining into the ampulla, except the right lymph duct, are ligated, enabling us to collect lymph form only the right duct. The high success rate is due, we believe, to the fact that we approach the right duct high in the neck and cannulate via the cervical lymphatic. We avoid direct dissection over the right lymph duct, and usually we do not have to cannulate the right duct directly.