Exposing Brachial Plexus: A Surgical Technique to Visualize Brachial Plexus in Neonatal Piglet

After confirming a lack of palpebral and withdrawal reflexes, place the anesthetized pig in the supine position on the operating table, with the upper limb in abduction to expose the axillary region. Place a drape over the animal, and use a #10 scalpel blade to make incisions over the marked skin.

Midline incision is overlying the trachea down to the upper third of the sternum, exposing the brachial plexus complex on both sides of the spine. To expose one side of the animal's brachial plexus, a superior incision is made from the upper end of the midline incision, corresponding to C3 to the upper arm, and an inferior incision is made from the lower end of the midline incision corresponding to T3 to the upper arm.

Use forceps on each side of the incision to separate tissue from the suprasternal notch along the edge of the clavicle to the upper arm, while sparing the cephalic and basilic veins. Using scissors, forceps, and blunt dissection, release the superior flap to access the cervical region of the brachial plexus, and the inferior flap to access the thoracic region of the brachial plexus.

Perform blunt dissection on superficial muscles to expose the brachial plexus, then, examine the plexus carefully to locate bifurcations of the divisions, and identify the brachial plexus regions below the bifurcations closer to the arm as the cord and the nerve and the regions above the bifurcations closer to the spine as the root or trunk.