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As with open surgical procedures, the ability for the surgeon to improve regional visibility with lavage and suction is critical. Suction and irrigation devices (Figures 4.27 and 4.28) are commonly used in both human and veterinary thoracoscopy and laparoscopy. Most suction and irrigation systems are combined into a single device and are available as single use or resterilizable hand pieces. Irrigation and suction functions are controlled by either a stopcock (Figure 4.27) or trumpet valve mechanism (Figure 4.28). Irrigation systems may be pressurized in one of several ways including a pressure bag, compressed air pump, roller pump, or electrical motor systems [3–5]. The irrigation function is typically used for lavage of debris and tissue, although a high‐pressure water jet has also been used for hydrodissection [3, 4]. A variety of suction tip styles are available including single fenestration tips for more focal aspiration and multiple fenestration tips for aspiration of large fluid volumes (Video 4.2). The use of suction in a body cavity may decrease visualization by loss of pneumoperitoneum [3, 4]. To reduce this occurrence, a smaller (5 mm) suction probe can be used. Suction should be applied only once the probe tip is submerged into the fluid to be aspirated, and suction should be applied in short interrupted bursts to minimize inadvertent CO₂ loss [3, 4].

Figure 4.27 (A). A suction irrigation device with a 2‐way stopcock and lateral fenestrations. (B, C). Image of 2‐way stopcock in different positions depending on the use of irrigation or suction.