Background: Thoracoscopy has proved to be effective in the treatment of stage 2 (fibrinopurulent)
empyema, but this technique requires different abilities from those needed in open surgery. The aim
of this study is to evaluate the usefulness of an experimental empyema in rabbits as a thoracoscopic
training model.
Materials and Methods: Twenty New Zealand rabbits were anesthetized with acepromazine and
ketamine. A Veress needle was introduced into the pleural space, and a turpentine and saline
solution were injected. Twenty-four hours later, 1016 colony-forming units of Escherichia coli
and 1 g of agar in 1 mL of saline solution were injected. The rabbits were operated on 96 hours
after bacterial injection by 30 pediatric surgeons attending a hands-on pediatric laparoscopic
course. The contralateral lung was selectively intubated and three ports were placed to perform
an empyema debridement. The surgeons evaluated the model using subjective criteria from an
evaluation form.
Results: One animal died (5%) and 2 (10%) did not form empyema. The other 17 rabbits (85%)
presented with a fibrinopurulent empyema. All usual surgical steps could be performed. As regards
the surgeons’ opinion of the model, 23 (76.7%) considered it very good while 7 (23.3%) thought it
was good. Twenty-three (76.7%) answered that the empyema stage was correct for thoracoscopic
treatment.
Conclusion: As reflected by our experience and the survey completed by the 30 pediatric surgeons,
this empyema model in rabbits is very useful for thoracoscopic training.
