Читать книгу Veterinary Endoscopy for the Small Animal Practitioner - Группа авторов - Страница 21

A video endoscopy system is absolutely essential for both diagnostic and operative endoscopy in today's practice environment. Video provides improved image quality including magnification, allowing us to see anatomy and pathology that would otherwise elude us. Projection of the endoscopic image on a monitor also allows all members of the team to see what is happening and to participate as an effective assistant. Many simple diagnostic procedures are performed solo, but complicated diagnostic procedures and minimally invasive surgery require one or more assistants. Operative assistance is not possible without video. Minimally invasive surgery did not develop until effective video systems were available.

The video system and its supportive accessories are assembled in a tower that is a movable cart or cabinet on wheels containing the components of the video system needed for performing endoscopic procedures (Figures 2.1 and 2.2). A wide array of options is available for video towers depending on procedures to be performed, personal preference, available space, and economics. A tower assembled strictly for one endoscopic technique will be very different from one setup for multiple diagnostic endoscopic techniques plus minimally invasive soft tissue surgery and arthroscopy (Figure 2.3). The necessary components of a video system for endoscopy are a video camera, video monitor, light source, and a cart or cabinet on wheels. Additional optional components include a video recording or capture device, diode or holmium laser, an insufflator for laparoscopy, a monopolar/bipolar radio‐frequency unit, a vessel sealing device, a fluid management system, and a power shaver for arthroscopy.

Figure 2.1 A double wide video tower with room for a large amount of equipment. A high‐definition flat screen monitor on a movable arm is at the top with a second touch screen monitor for data entry. On the next shelf down on the left side is a camera control box with two attachment points for video camera heads and an integral image capture device. Next to the camera box on the right of the same shelf is a 175‐W LED light source. The bottom contains an insufflator for laparoscopy on the left and a fluid management pump on the right.

(Source: Photo courtesy of Karl Storz: ©Karl Storz SE & Co KG, Germany.)

Figure 2.2 A smaller video tower setup for small animal rigid endoscopy with a single high‐definition flat screen monitor on a rotating arm at the top of the tower. Stacked on the top shelf are an Image One image capture module on top, a high‐definition camera control box in the middle, and a Xenon 300‐W light source on the bottom. The next shelf down has a Thermoflator insufflator with gas flow capacity up to 30 l/min and ability to preheat insufflation gas to body temperature. Below is an Autocon II 200 radio‐frequency generator with bipolar and monopolar capabilities. On the bottom shelf is a Vetpump 2 fluid management system for irrigation and suction.

(Source: Photo courtesy of Karl Storz: ©Karl Storz SE & Co KG, Germany.)

Figure 2.3 The video endoscopy tower used by the author in a private referral practice setting for multiple endoscopic techniques. A flat screen monitor is on the top of the cart on a rotating table. A keypad is present on the top shelf that pulls out for access to the keypad for data entry. On the next shelf down on the left side is a 30‐W diode laser and stacked on the right side from top to bottom are a laparoflator, a 300‐W Xenon light source, and a camera control box with two attachment points for video camera heads and an integral image capture device. The middle shelf has an arthroscopy power shaver control box on the left and the foot switch for the diode laser on the right. The bottom shelf from top to bottom has a LigaSure control box and a VAPR bipolar radio‐frequency device for arthroscopy. The drawer at the bottom contains support supplies.