Laparoscopic extirpation of iliosacral lymph nodes in select dogs is safe and effective with or without intraoperative lymphangiography.

Laparoscopic ISLN extirpation is safe and effective for staging and treating AGASACA metastasis in dogs.

This retrospective case series describes laparoscopic extirpation of iliosacral lymph nodes (ISLNs) in 18 dogs with apocrine gland anal sac adenocarcinoma (AGASACA) across 19 procedures performed between March 2012 and May 2024. The study population consisted of 11 castrated males and 7 spayed females with a mean age of 9.95 years. The primary objectives were oncologic staging and management of suspected ISLN metastasis. Laparoscopic completion was achieved in 84.2% of procedures, with 15.8% requiring conversion to open celiotomy. Intraoperative lymphangiography was attempted in 6 procedures using indocyanine green (ICG), methylene blue, or both; ICG demonstrated superior success (66.7%) compared to methylene blue (0%). Intraoperative complications occurred in 47.3% of procedures but were predominantly mild and self-limiting. Histopathology confirmed metastatic disease in 73.7% of cases, underscoring the diagnostic value of the procedure. All dogs were discharged successfully, and 94.7% survived beyond 14 days postoperatively. The findings support laparoscopic ISLN extirpation as a safe and clinically viable minimally invasive approach for both staging and therapeutic management in canine AGASACA patients. ICG-based lymphangiography shows promise as an adjunctive intraoperative tool to facilitate lymph node identification, while methylene blue demonstrated no utility in this context. This study contributes meaningful evidence supporting the expanding role of minimally invasive oncologic surgery in veterinary medicine.

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