Small Animal Laparoscopy and Thoracoscopy

4 Chapter 3 Figure 3.1 The basic endoscopic imaging chain. Figure 3.2 Rigid endoscopes used in laparoscopy and thoracoscopy. From botto... Figure 3.3 Operating laparoscopes. (A). Right angled. (B). Oblique. Figure 3.4 Telescope viewing angles. (A). 0°. (B). 30°. Figure 3.5 ENDOCAMELEON ®telescope with variable viewing angle, adjuste... Figure 3.6 New‐generation electronic LED cold light source CO2mbi LED. Figure 3.7 A unique state‐of‐the‐art light source combining LED white light ... Figure 3.8 (A) FULL HD CMOS single chip lightweight camera, 1920 × 1080 pixe... Figure 3.9 (A). 4K modular imaging system combining white light and NIR/ICG ... Figure 3.10 Insufflators. (A). Veterinary dedicated insufflator with max flo... Figure 3.11 Digital capture and archiving system with integrated touch scree... Figure 3.12 Mobile cart equipped with NIR/ICG imaging system for laparoscopi... Figure 3.13 (A). State‐of‐the‐art integrated operating room with simultaneou...

5 Chapter 4-1 Figure 4.1 Endoscopic surgical instrument components. (A). Working end (jaws... Figure 4.2 Minimally invasive surgical instrument handle types (from left to... Figure 4.3 Examples of a single‐action jaw mechanism (left) and a double‐act... Figure 4.4 Duvall and Babcock forceps (from left to right): 10‐mm, double‐ac... Figure 4.5 (A). Grasping forceps (from top to bottom): straight dissecting a... Figure 4.6 Biopsy forceps (from top to bottom): biopsy forceps without teeth... Figure 4.7 Endoscopic scissors (from top to bottom): straight scissors; curv... Figure 4.8 (A). Palpation probe with centimeter markings. Inset shows detail... Figure 4.9 Retractors used in human minimally invasive surgery (from top to ... Figure 4.10 An ovariectomy hook with a T‐shaped handle. Figure 4.11 KOH macro‐endoscopic needle driver with straight handle. Used wi... Figure 4.12 Endoscopic needle holders (from top to bottom): straight jaws, j... Figure 4.13 Endo stitch device with suture loaded into jaws. Figure 4.14 Suture assist devices (from top left to bottom right): Koeckerli... Figure 4.15 An example of a laparoscopic instrument pack in its tray for ste...

6 Chapter 4-2 Figure 4.16 Veress needle. Figure 4.17 Close up photograph of the specialized tip to a Veress needle.... Figure 4.18 Disposable bladeless cannula with a safety shield. Figure 4.19 Disposable optical view cannula–trocar with an internal flange a... Figure 4.20 Different sizes of smooth stainless steel reusable cannulas. Figure 4.21 A Ternamian (i.e., threaded) EndoTIP stainless steel reusable ca... Figure 4.22 Multiple types of plastic reusable thoracic ports. Figure 4.23 Reusable Thoracoport. Figure 4.24 Principal function of many port closure devices (PCD) include a ... Figure 4.25 Many port closure systems utilize a suture guide to facilitate p...

7 Chapter 4-3 Figure 4.25 (A).Homemade retrieval bags are cost effective. (B).Commercial... Figure 4.26 (A).A homemade retrieval bag for small lesions can be made out ... Figure 4.27 (A).A suction irrigation device with a 2‐way stopcock and later... Figure 4.28 (A).A suction irrigation device has many fenestrations in the t... Figure 4.29 Use of a wound retractor in abdominal minimally invasive surgery... Figure 4.30 A wound retractor applies centrifugal force on the incision, gre... Figure 4.31 Wound retractor in the chest. Figure 4.32 The wound retractor facilitates exteriorizing of organs while pr... Figure 4.33 (A).Application of a wound retractor. With the flexible ring po... Figure 4.34 A laparoscopic cap makes a wound retractor to a laparoscopic sys... Figure 4.35 A morcellator.

8 Chapter 5 Figure 5.1 Most electrosurgery units operate within the medium radiofrequenc... Figure 5.2 Pure cut is a continuous low‐voltage waveform. Coagulation wavefo... Figure 5.3 Alternating current flows from the generator to the handpiece. El... Figure 5.4 Electrode extensions are available in various tip configurations.... Figure 5.5 Both J‐ and L‐shaped extensions are available for use with monopo... Figure 5.6 Direct coupling occurs when the active electrode is in close prox... Figure 5.7 Indirect coupling or insulation failure occurs when there is dama... Figure 5.8 Valley Lab Force Triad generator, which combines monopolar, bipol... Figure 5.9 Valley Lab LigaSure generator with numerous bipolar handpieces fo... Figure 5.10 A variety of bipolar handpieces are available for open and MIS. ... Figure 5.11 Sonicision is a cordless ultrasonic dissector that is approved f... Figure 5.12 Endoclips come in different shaft diameters and clip sizes. They... Figure 5.13 Endoscopic gastrointestinal anastomosis staplers have a 10‐mm‐di...

9 Chapter 6 Figure 6.1 This operating laparoscope (Karl Storz Endoscopy, Goleta, CA) inc... Figure 6.2 Single‐port access laparoscopy is performed by the passage of thr... Figure 6.3 The SILS (single‐incision laparoscopic surgery) port (Covidien, M... Figure 6.4 With the SILS (single‐incision laparoscopic surgery) device (Karl... Figure 6.5 With some port devices, some triangulation can still be maintaine... Figure 6.6 A wound retractor with latex glove and finger ports can be used a... Figure 6.7 This wound retractor (Alexis; Applied Medical, Rancho Santa Marga... Figure 6.8 The wound retractor in figure 11 can be used with a laparoscopic ... Figure 6.9 Coaxial instruments used through single‐port devices can obviate ... Figure 6.10 A right‐angle adaptor placed onto the connection between the lig...

10 Chapter 7 Figure 7.1 Inadvertent splenic puncture. Figure 7.2 Radiographic image showing inadvertent placement of insufflation ... Figure 7.3 Dog prepared for laparoscopic intervention in Fowler position (re...

11 Chapter 8Figure 8.1 When the Veress needle (VN) is used to achieve abdominal access, ...Figure 8.2 Veress needles (VNs) come in a variety of forms. ( A), Reusable VN...Figure 8.3 Intercostal placement of a Veress needle.Figure 8.4 In some commercially available ports, the distance between the ex...Figure 8.5 Cannula design compatible with use in small patients. A very shor...Figure 8.6 Open placement with the Hasson technique. ( A), Dissection of the ...Figure 8.7 The Visiport Plus Optical Trocar Covidien/Medtronic, Salem, CT. T...Figure 8.8 Ternaminan visual (TV) laparoscopic entry (Video 8.2) utilizes a ...Figure 8.9 Single‐port‐single Instrument surgery. In this technique (here a ...Figure 8.10 Port site metastasis demarcated with asterisks identified at the...Figure 8.11 Intra‐abdominal view of a cat undergoing transperitoneal insuffl...Figure 8.12 Gasless isobaric pneumoperitoneum by use of an abdominal wall li...Figure 8.13 Reverse Trendelenburg is pictured in (A), while Trendelenburg is...Figure 8.14 The patient is in lateral recumbency while utilizing the lateral...

12 Chapter 9Figure 9.1 Intra‐abdominal adhesions after previous surgery, as in this case...Figure 9.2 Illustration of an improper stance, consisting of neck rotation a...Figure 9.3 Endoscopic view of the visual entry technique with a 30‐degree an...Figure 9.4 Extreme abdominal wall tenting occurs when the skin incision is t...Figure 9.5 Blunt insertion techniques can lead to the trocar ricocheting off...Figure 9.6 Stay sutures, used to lift the abdominal wall during direct troca...Figure 9.7 Splenic laceration or perforation, due to improper trocar entry t...Figure 9.8 Starting a laparoscopic procedure with a near‐empty CO 2‐cannister...Figure 9.9 Preoperative check of the integrity of the cannula valve to avoid...Figure 9.10 The two most common causes for obscured visualization are lens f...Figure 9.11 Obscured visualization (A) caused by placing the caudal midline ...Figure 9.12 Intraoperative view of a hemostatic sponge sticking to the grasp...Figure 9.13 Intraoperative view of the sliding knot of a ligating loop engag...Figure 9.14 Intraoperative view of profuse arterial bleeding occurring durin...Figure 9.15 Intraoperative view demonstrating collateral thermal damage from...Figure 9.16 Persistent hemorrhage from a liver biopsy site in a dog with sev...Figure 9.17 Placing an activated light cable on the patient drapes will quic...Figure 9.18 Alternate pathway burns, in this case resulting from return pad ...Figure 9.19 Liver laceration occurred in this dog when, during a sudden loss...Figure 9.20 Emergent conversion was performed after the Endotip cannula perf...