This article describes a surgical procedure for tumor implantation in the liver of an anesthetized rabbit model. The methodology includes careful dissection and tumor fragment placement to study hepatic tumor growth.
First, prep an anesthetized rabbit in the supine position. Sterilize its abdomen and make a midline skin incision to expose the linea alba - a thin white band of collagenous tissue connecting the abdominal muscles. Next, dissect the linea alba and cut through the peritoneum - the serous membrane that lines the abdominal cavity - to access the intraperitoneal organs.
Locate the red-brown liver in the upper central abdominal region. The rabbit liver comprises the right, left lateral, left medial, quadrate, and caudate lobes. Identify the left lateral lobe, lying infero-lateral to the left medial lobe. Now, draw out the left lateral lobe and place it onto a dry gauze to prevent retraction into the abdominal cavity. Cover the organ with a wet gauze to keep it hydrated.
Meanwhile, process the tumor tissue of interest - obtained from a tumor-bearing donor - to acquire appropriately sized fragments. Using a blade, puncture the exteriorized liver capsule deep enough to create a small pocket for tumor fragment implantation.
Transfer the processed tumor fragment inside the pocket and remove the blade. Apply a hemostatic agent over the pocket to stop bleeding and prevent ejection of the tumor fragment. Post-hemostasis, return the liver inside the abdominal cavity. Suture the surgical incision and allow the rabbit to recover. Monitor the animal weekly, observing the growth of hepatic tumor.
For implementation of the tumor, first, confirm a lack of response to pedal reflex. Once confirmed, the animal subject is placed under anesthesia. An appropriate level of anesthesia is confirmed, and the abdomen is sterilely prepared and draped. After anesthetization, use a #15 blade to make a 3 to 4-centimeter vertical midline skin incision starting from the xiphoid process.
Retract the skin to identify the linea alba, a reflective white band of tissue that travels inferiorly along the midline, and use both blunt and sharp dissection to traverse the linear alba, exposing the peritoneum, taking care not to perforate the underlying bowel tissue. Carefully dissect through the abdominal cavity tissue to locate the liver, using a hemostat to extend the midline incision 1 to 2 centimeters inferiorly through the skin, muscle, and peritoneum as necessary.
Identify the left lobe, which is infero-lateral to the medial lobe that sits in the midline, and place a dry piece of gauze at the inferior aspect of the incision to prevent the liver from retracting back into the abdomen. Place a new piece of wet gauze over the extracted liver.
Select a 1 to 2-cubic millimeter tumor tissue piece with forceps, and use a #11 blade to puncture the liver tissue at a 45-degree angle to a 0.5-centimeter deep pocket, taking care not to penetrate the dorsal aspect of the liver capsule. Gently lift the blade in ventrally to create a small pocket in the liver bed, and place the tumor into the pocket.
Place a piece of hemostatic agent over the tumor pocket to promote hemostasis and to prevent ejection of the tumor piece, and after confirming hemostasis, return the liver to the abdominal cavity. Then, use a 3-0 polydioxanone suture on a taper needle, and a simple continuous stitch to close the abdominal wall, and 4-0 polyglactin 910 sutures on a cutting needle, and a continuous subcuticular stitch to close the skin.
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