Оглавление
Группа авторов. Veterinary Endoscopy for the Small Animal Practitioner
Table of Contents
List of Tables
List of Illustrations
Guide
Pages
Veterinary Endoscopy for the Small Animal Practitioner
List of Contributors
Preface
Acknowledgments
About the Companion Website
1 Introduction and History of Endoscopy
1.1 Introduction
1.2 The History of Endoscopy
1.3 Clinical Application in Veterinary Medicine
References
2 Instrumentation for Endoscopy
2.1 Endoscopy Room Setup and Organization
2.2 Instrumentation for Small Animal Endoscopy. 2.2.1 The Endoscopy Video Tower
2.2.2 Video Cameras (Table 2.1)
2.2.3 Video Monitors (Table 2.1)
2.2.4 Light Source (Table 2.1)
2.2.5 Documentation Equipment
2.2.6 Power Equipment. 2.2.6.1 Radio‐Frequency Instrumentation
2.2.6.2 Vessel Sealing Devices
2.2.7 Irrigation Fluid Management Systems
2.2.7.1 Gravity Flow
2.2.7.2 Pressure‐Assisted Flow
2.2.7.3 Mechanical Fluid Pumps
2.2.8 Operating Tables
2.2.9 Rigid Telescopes
2.2.10 Flexible Endoscopes
2.2.11 Sheaths, Cannulas, and Trocars
2.2.12 Diagnostic and Operative Instruments
3 Gastrointestinal Endoscopy
3.1 Equipment
3.1.1 Flexible Endoscopy
3.1.2 Rigid Endoscopy
3.1.3 Ancillary Equipment
3.1.3.1 Biopsy Forceps
3.1.3.2 Foreign Body Retrieval Instruments
3.1.3.3 Others
3.2 Technique. 3.2.1 Handling the Endoscope
3.2.2 Handling Accessory Instruments
3.2.3 Taking Biopsies and Brush Cytology
3.2.4 Patient Preparation
3.2.5 Anesthesia
3.2.6 Complications and Contraindications
3.2.7 Endoscopic Training
3.3 Esophagoscopy. 3.3.1 Indications, Limitations
3.3.2 Procedure
3.3.3 Normal Findings
3.3.4 Abnormal Findings
3.4 Gastroscopy and Duodenoscopy
3.4.1 Indications, Limitations
3.4.2 Procedure
3.4.3 Normal Findings
3.4.4 Abnormal Findings
3.5 Colonoscopy/Ileoscopy. 3.5.1 Indications, Limitations
3.5.2 Procedure
3.5.3 Normal Findings
3.5.4 Abnormal Findings
3.6 Therapeutic Flexible GI Endoscopy
3.6.1 Foreign Body Retrieval
3.6.1.1 Esophageal Foreign Body Removal
cssStyle="font-weight:bold;font-style:italic;" 3.6.1.1.1 Gastric Foreign Body Removal
3.6.1.2 Duodenal Foreign Body Removal
3.6.1.3 Colonic and Rectal Foreign Body Removal
3.6.2 Feeding Tube Placement
3.6.2.1 Procedure
3.6.2.2 Tube Management
3.6.2.3 Replacement and Removal
3.6.3 Stricture Dilation
3.6.4 Stent Placement
3.6.5 Polyp Removal
3.7 Additional Techniques in GI Endoscopy
3.7.1 Capsule Endoscopy
3.7.2 Double Balloon Endoscopy
3.7.3 Confocal Endomicroscopy
3.7.4 Natural Orifice Transluminal Endoscopic Surgery
3.7.5 Endoscopic Retrograde Cholangiopancreatography
3.8 Care and Cleaning of GI Endoscopic Equipment
3.8.1 Pre‐Cleaning
3.8.2 Manual Cleaning
3.8.3 Machine Cleaning
3.8.4 Storage
3.8.5 Sterilization or High‐Level Disinfection
References
4 Rhinoscopy
4.1 Introduction
4.2 Indications
4.3 Instrumentation
4.4 Preparation of the Patient
4.5 Technique
4.5.1 Radiographic Imaging
4.5.2 Culture Sample Collection
4.5.3 Rhinoscopy
4.5.4 Frontal Sinoscopy
4.6 Normal Nasal Cavity and Frontal Sinuses
4.7 Nasal Pathology
4.7.1 Nasal Neoplasia
4.7.2 Mycotic Rhinitis and Sinusitis. 4.7.2.1 Aspergillosis
4.7.2.2 Cryptococcosis
4.7.3 Allergic Rhinitis
4.7.4 Nasal Foreign Bodies
4.7.5 Rhinitis Secondary to Dental Disease
4.7.6 Nasal Turbinate Infarction
4.7.7 Traumatic Rhinitis
4.7.8 Nasal Disease Secondary to Otic Diseases
4.7.9 Parasitic Rhinitis
4.7.10 Canenoid and Felenoid Diseases
4.7.11 Nasal Hamartomas
4.7.12 Viral Rhinitis
4.7.13 Bacterial Rhinitis
4.7.14 Nasal Vascular Dysplasia
4.7.15 Epistaxis
4.7.16 Rhinitis of Undetermined Origin
4.7.17 Brachiocephalic Nasal Airway Syndrome
4.7.18 Nasopharyngeal Stenosis
4.7.19 Nasal Lymphoid Hyperplasia
4.7.20 Nasal Angiofibroma
References
Note
5 Bronchoscopy
5.1 Introduction
5.2 Equipment
5.2.1 Equipment Care and Cleaning
5.3 Indications and Contraindications of Bronchoscopy
5.4 Anesthesia for Bronchoscopy
5.4.1 Monitoring and Positioning the Patient for Bronchoscopy
5.5 Bronchoscopic Training
5.6 Bronchoscopic Procedure
5.7 Normal and Abnormal Bronchoscopic Findings
5.8 Sample Procurement and Handling
5.9 Summary
References
Notes
6 Cystoscopy
6.1 Introduction
6.2 Cystoscopy Indications
6.2.1 Chronic Cystitis
6.2.2 Hematuria
6.2.3 Tenesmus or Stranguria
6.2.4 Increased Frequency of Urination
6.2.5 Urinary Incontinence
6.2.6 Ureteroceles
6.2.7 Alteration of the Urinary Stream
6.2.8 Trauma
6.2.9 Cystic and Urethral Calculi
6.3 Instrumentation for Cystoscopy
6.3.1 Transurethral Cystoscopy in Female Dogs and Cats
6.3.2 Instrumentation for Transurethral Cystoscopy in Male Dogs
6.3.3 Instrumentation for Transurethral Cystoscopy in Male Cats
6.3.4 Instrumentation for Prepubic Percutaneous Cystoscopy
6.3.4.1 Telescopes
6.3.4.2 Sheaths
6.3.4.3 Sharp Trocars and Blunt Obturators
6.3.4.4 Second Puncture Cannulas (See Chapter 8)
6.3.4.5 Operative Instrumentation
6.3.5 Instrumentation for Percutaneous Perineal Cystoscopy in Male Dogs
6.3.6 Instrumentation for Laparoscopic‐Assisted Cystoscopy
6.3.6.1 Telescopes
6.3.6.2 Flexible Cystourethroscopes (Figure 2.10 and Table 6.12)
6.3.6.3 Cannulas and Sheaths
6.3.6.4 Operative Instrumentation
6.3.7 Instrumentation for Lithotripsy
6.4 Techniques for Transurethral Cystoscopy. 6.4.1 Patient Preparation
6.4.2 Transurethral Cystoscopy in Female Dogs and Cats
6.4.3 Transurethral Cystoscopy in Male Dogs
6.4.4 Transurethral Cystoscopy in Male Cats
6.4.5 Technique for Prepubic Percutaneous Cystoscopy
6.4.5.1 The Original Technique
6.4.5.2 Modified PPC Technique
6.4.5.3 Diagnostic Sample Collection
6.4.6 Technique for Laparoscopic‐Assisted Cystoscopy
6.4.6.1 Diagnostic Sample Collection
6.4.7 Photodynamic Diagnostics with Cystoscopy
6.5 Normal Endoscopic Anatomy of the Lower Urinary Tract. 6.5.1 Transurethral Cystoscopy in Female Dogs and Cats: Vagina
6.5.2 TUC in Female Dogs and Cats: Urethra and Bladder
6.5.3 Transurethral Cystoscopy in Male Dogs
6.5.4 Transurethral Cystoscopy in Male Cats
6.5.5 Normal Endoscopic Anatomy: LAC and PPC in the Dog and Cat
6.6 Diagnoses with Cystoscopy. 6.6.1 Cystitis and Urethritis
6.6.1.1 Interstitial Cystitis
6.6.1.2 Follicular Cystitis
6.6.1.3 Polypoid Cystitis
6.6.1.4 Chronic Diffuse Cystitis
6.6.1.5 Urethral Strictures
6.6.1.6 Urethrocutaneous Fistula
6.6.1.7 Prostatitis
6.6.2 Neoplasia of the Lower Urinary Tract. 6.6.2.1 Transitional Cell Carcinomas
6.6.2.2 Other Tumors of the Lower Urinary Tract
6.6.2.3 Vaginal Tumors and Masses
6.6.3 Cystic and Urethral Calculi
6.6.3.1 Oxalate Calculi
6.6.3.2 Struvite Calculi
6.6.3.3 Urate Calculi
6.6.3.4 Silica Calculi
6.6.4 Anatomic Abnormalities. 6.6.4.1 Vaginal Anatomic Abnormalities
6.6.4.2 Ectopic Ureters and Ureteroceles
6.6.4.3 Ureteroceles
6.6.4.4 Ectopic Ureters in Male Dogs
6.6.4.5 Bladder Diverticula
6.6.4.6 Vascular Dysplasia
6.6.5 Urinary Tract Trauma
6.6.6 Renal Hematuria
6.7 Interventional and Operative Cystoscopy. 6.7.1 Minimally Invasive Management of Inflammatory Disease
6.7.2 Minimally Invasive Management of Neoplasia. 6.7.2.1 Transitional Cell Carcinoma Management
6.7.2.2 Management of Other Tumor Types
6.7.3 Minimally Invasive Urolithiasis Management
6.7.3.1 Hydropropulsion
6.7.3.2 Transurethral Cystoscopy
6.7.3.3 Laparoscopic‐Assisted Cystoscopy
6.7.3.4 Minimally Invasive Management of Urethral Calculi in Male Dogs
6.7.4 Minimally Invasive Management of Anatomic Abnormalities. 6.7.4.1 Ectopic Ureters
6.7.4.2 Laparoscopic‐Assisted Ectopic Ureter Correction in Male Dogs
6.7.4.3 Minimally Invasive Vaginal Web and Septum Transection
6.7.4.4 Minimally Invasive Management of Urachal Diverticula
6.7.5 Minimally Invasive Management of Urinary Incontinence
References
7 Vaginal Endoscopy in the Bitch
7.1 Canine Vaginal Anatomy
7.2 Instrumentation
7.3 Cleaning and Sterilization of Equipment
7.4 Procedures in the Bitch. 7.4.1 Transcervical Insemination (TCI)
7.4.1.1 Introduction of the Endoscope and Catheterization of the Cervix
7.4.1.2 Insemination
7.4.2 Observation of the Vaginal Changes Throughout the Estrous Cycle
7.4.2.1 Proestrus
7.4.2.2 Estrus
7.4.2.3 Diestrus and Anestrus
7.4.3 Diagnostic Vaginoscopy
7.4.3.1 Anomalies Related to the Paramesonephric Ducts
7.4.3.2 Vaginitis, Vaginal Mass, and Foreign Body
7.4.4 Other Uterine Procedures
7.4.4.1 Hysteroscopy
7.4.4.2 Endometrial Biopsy
7.4.4.3 Uterine Cytology and Culture
7.4.4.4 Uterine Lavage
7.4.4.5 Other Usages
7.4.5 Complications and Limitations
7.4.6 Tips and General Comments
7.5 Conclusion
References
8 Laparoscopy
8.1 Introduction
8.2 Indications for Laparoscopy. 8.2.1 Indications for Diagnostic Laparoscopy
8.2.2 Indications for Operative Laparoscopy
8.3 Instrumentation for Small Animal Laparoscopy
8.3.1 Insufflator
8.3.2 Laparoscopes
8.3.3 Trocar‐Cannulas (Figures 2.38–2.40) (Table 8.8)
8.3.4 Operative Instruments
8.3.5 Hemostasis
8.3.6 Single Incision Laparoscopic Surgery (SILS) Instruments
8.3.7 Single Incision Wound Protectors/Retractors for MIS
8.4 Laparoscopy Technique. 8.4.1 Portal Placement and Insufflation
8.4.2 Laparoscopic‐Assisted Technique
8.4.3 Anesthesia for Laparoscopy
8.5 Normal Laparoscopic Anatomy
8.5.1 The Abdominal Wall, Diaphragm, and Falciform Ligament
8.5.2 Normal Liver and Gall Bladder
8.5.3 Normal Kidneys
8.5.4 Normal Pancreas
8.5.5 Normal Spleen
8.5.6 Normal Urinary Bladder and Ureters
8.5.7 Normal Gastrointestinal Tract
8.5.8 Normal Ovaries and Uterus
8.5.9 Normal Adrenal Glands
8.5.10 Normal Blood Vessels
8.6 Laparoscopic Abdominal Abnormalities
8.6.1 Abdominal Wall Abnormalities
8.6.2 Diaphragmatic Abnormalities
8.6.3 Fat Abnormalities
8.6.4 Free Abdominal Foreign Bodies
8.6.5 Liver Abnormalities
8.6.6 Gall Bladder Abnormalities
8.6.7 Extra‐Hepatic Bile Duct Abnormalities
8.6.8 Kidney Abnormalities
8.6.9 Pancreatic Abnormalities
8.6.10 Splenic Abnormalities
8.6.11 Adrenal Gland Abnormalities
8.6.12 Bladder and Ureteral Abnormalities
8.6.13 Abnormalities of the Gastrointestinal Tract
8.6.14 Ovarian Abnormalities
8.6.15 Abnormalities of the Uterus
8.6.16 Testicular Abnormalities
8.6.17 Blood Vessel and Lymphatic Abnormalities
8.6.18 Abdominal Fluid, Ascites, and Bleeding
8.6.19 Abdominal Masses and Cancer Staging
8.7 Diagnostic Laparoscopy and Biopsy Techniques. 8.7.1 Exploratory Laparoscopy
8.7.2 Liver Biopsy
8.7.3 Cholecystocentesis
8.7.4 Pancreatic Biopsy
8.7.5 Kidney Biopsy
8.7.6 Gastrointestinal Biopsy
8.7.7 Biopsy of the Spleen
8.7.8 Biopsy Techniques for Additional Organs and Tissues
8.7.9 Cancer Staging
8.8 Minimally Invasive Abdominal Surgery
8.8.1 Laparoscopic Ovariectomy
8.8.1.1 Single‐Port Technique
8.8.1.2 Two‐Port Techniques
8.8.1.3 Three‐Port Technique
8.8.2 Laparoscopic Ovariohysterectomy
8.8.3 Ovarian Remnant Removal
8.8.4 Cryptorchid Castration
8.8.5 Laparoscopic Vasectomy
8.8.6 Prophylactic Gastropexy
8.8.6.1 Laparoscopic‐Assisted Gastropexy
8.8.6.2 Laparoscopic Gastropexy
8.8.7 Laparoscopic‐Assisted Gastrotomy
8.8.8 Laparoscopic Pyloroplasty
8.8.9 Laparoscopic‐Assisted Enterotomy and Intestinal Resection with Anastomosis
8.8.10 Laparoscopic‐Assisted Cecectomy
8.8.11 Laparoscopic Cholecystectomy
8.8.12 Laparoscopic Partial Pancreatectomy
8.8.13 Pancreatic Cyst Ablation
8.8.14 Laparoscopic Nephrectomy
8.8.15 Laparoscopic Adrenalectomy
8.8.16 Laparoscopic Portosystemic Shunt Occlusion
8.8.17 Laparoscopic Splenectomy
8.8.18 Laparoscopic Herniorrhaphy
8.8.19 Laparoscopic Urethral Occluder Implantation
8.8.20 Laparoscopic‐Assisted Cystoscopy
8.8.21 Laparoscopic‐Assisted Cystopexy
8.8.22 Laparoscopic‐Assisted Intestinal Feeding Tube Placement
8.8.23 Laparoscopic‐Assisted Gastrostomy Feeding Tube Placement
8.8.24 Additional Minimally Invasive Abdominal Surgical Procedures
References
9 Thoracoscopy
9.1 Introduction
9.2 Indications
9.3 Thoracoscopy Instrumentation
9.3.1 Telescopes
9.3.2 Cannulas
9.3.3 Operative and Sample Collection Instruments
9.4 Thoracoscopy General Technique. 9.4.1 Patient Preparation
9.4.2 Technique Anesthesia and Pneumothorax
9.4.3 Telescope Portal Placement
9.4.3.1 Paraxiphoid Telescope Portal (Figure 9.6)
9.4.3.2 Lateral Telescope Portal Placement
9.4.4 Operative Portal Placement
9.4.5 Portal Closure and Pleural Space Management
9.4.6 Postoperative Recovery
9.5 Thoracoscopy: Normal Thoracic Anatomy
9.6 Thoracic Pathology
9.6.1 Pleural and Pericardial Fluid
9.6.2 Chest Wall Abnormalities
9.6.3 Abnormalities of the Diaphragm
9.6.4 Mediastinal Abnormalities
9.6.5 Thoracic Foreign Bodies
9.6.6 Lung Pathology
9.6.6.1 Neoplasia
9.6.6.2 Pneumothorax
9.6.6.3 Spontaneous Pneumothorax
9.6.6.4 Primary Pulmonary Disease
9.6.6.5 Lung Lobe Torsion
9.6.7 Pleural Effusion
9.6.8 Chylothorax
9.6.9 Pericardial Effusion
9.7 Diagnostic Thoracoscopy Procedures
9.7.1 Pleural, Hilar Lymph Node, Mediastinal, Pericardial, and Chest Wall Mass Biopsy
9.7.2 Lung Biopsy
9.8 Thoracic Operative Procedures. 9.8.1 Pericardial Window
9.8.2 Right Atrial Mass Resection
9.8.3 Subtotal Pericardiectomy
9.8.4 Partial Lung Lobectomy
9.8.5 Lung Lobectomy
9.8.6 Thoracic Duct Occlusion
9.8.7 Patent Ductus Arteriosus Occlusion
9.8.8 PRAA Correction
9.8.9 Mediastinal Mass Removal
9.8.10 Thoracic Foreign Body Removal
9.9 Contraindications for Thoracoscopy
9.10 Complications of Thoracoscopy
9.11 Conclusions
References
10 Video Otoscopy
10.1 Normal Anatomy of the Ear as Seen Through the Video Otoscope
10.2 Pathophysiology of the Ear as Seen Through the Video Otoscope
10.3 Video Otoscopes
10.4 Video Otoscope Instrumentation
10.5 Video Otoscopy as a Diagnostic Aid – “In Examination Room” Use
10.6 Video Otoscopy Procedures
10.6.1 Deep Ear Cleaning of the Ear Canals
10.6.2 Deep Ear Cleaning of the Middle Ear
10.6.3 Intralesional Glucocorticoid Injections
10.6.4 Laser Surgery
10.6.5 Myringotomy
10.6.6 Management of Primary Secretory Otitis Media
10.6.7 Biopsies and Mass Removals
10.6.8 Feline Aural Polyp Removal
10.6.9 Visualization of the Tympanic Cavity and Bulla
Suggested Reading
11 Otheroscopies
11.1 Introduction
11.2 Instrumentation for Otheroscopy in Small Animals
11.3 Transabdominal Nephroscopy and Ureteroscopy
11.4 Transabdominal Cholecystodocoscopy
11.5 Transabdominal Gastrointestinal Endoscopy
11.6 Prepuceoscopy
11.7 Laceroscopy
11.8 Drain Retrieval
11.9 Fistuloscopy
11.10 Oculoscopy
11.11 Oncoscopy
11.12 Oraloscopy
11.12.1 Dentaloscopy
11.12.2 Tonsiloscopy
11.12.3 Pharyngoscopy
11.13 Laryngoscopy
11.14 Dermoscopy
11.15 Analsacoscopy
References
Index
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