Veterinary Endoscopy for the Small Animal Practitioner

2 Chapter 2 Figure 2.1 A double wide video tower with room for a large amount of equipme... Figure 2.2 A smaller video tower setup for small animal rigid endoscopy with... Figure 2.3 The video endoscopy tower used by the author in a private referra... Figure 2.4 A Karl Storz Endoscopy IMAGE 1 FULL HD Three‐Chip Camera Head H3‐... Figure 2.5 An endoscopic video camera head attached securely to a 10 mm lapa... Figure 2.6 A Karl Storz Endoscopy Tele Pack Vet X LED self‐contained endosco... Figure 2.7 A Xenon Nova 300‐W light source. Figure 2.8 A Xenon 100 light source for gastrointestinal endoscopy with inte... Figure 2.9 A 300‐W LED light source. Figure 2.10 The FlexXC video cystourethroscope with an internal LED light so... Figure 2.11 A battery‐powered LED light source attached to an otoscope. Figure 2.12 A minimally invasive surgery instrument with a connection post f... Figure 2.13 A minimally invasive surgery bipolar vessel sealing and cutting ... Figure 2.14 The ForceTriad vessel sealing device with standard monopolar rad... Figure 2.15 A 10 mm diameter 37 cm long “Atlas” vessel sealing instrument fo... Figure 2.16 An open‐surgery handpiece for use with the ForceTriad that seals... Figure 2.17 An open‐surgery handpiece for use with the ForceTriad that seals... Figure 2.18 An intravenous fluid administration set with a filter in the cap... Figure 2.19 A Vet Pump 2 fluid management system with irrigation and suction... Figure 2.20 A manual Tankersley tilt table (TTT) designed for performing lap... Figure 2.21 The Tankersley table tilted 45° in the position used for laparos... Figure 2.22 A large dog fixed in place on the TTT ready for performing a lap... Figure 2.23 A DRE Panomed operating table for small animal use shown with th... Figure 2.24 The DRE Panomed powered operating table for small animal practic... Figure 2.25 The same patient as seen in the Figure 2.24 tilted to the right ... Figure 2.26 Telescopes available for use in small animal practice including ... Figure 2.27 A diagram showing the angle of view of rigid telescopes used in ... Figure 2.28 The ENDOCAMELEON telescope for laparoscopy with variable angles ... Figure 2.29 A diagram of the Hopkins rod lens system shown in the telescope ... Figure 2.30 The 2.7 mm diameter, 18 cm long, 30° multipurpose rigid telescop... Figure 2.31 A one‐piece cystoscope incorporating the telescope and sheath in... Figure 2.32 A 10 mm diameter, 0° operating laparoscope with a working length... Figure 2.33 The Veterinary Otoscope for ear examination in awake patients wi... Figure 2.34 The anatomy of a flexible fiberoptic gastrointestinal endoscope.... Figure 2.35 (a) An assembled cystoscope for performing transurethral cystosc... Figure 2.36 Round and oval sheaths for the 2.7 mm MPRT. The round sheath on ... Figure 2.37 Locking mechanism designs for attaching sheaths to telescopes. F... Figure 2.38 A trocar‐cannula for laparoscopy. (a) An 11 mm diameter, 10.5 cm... Figure 2.39 A 6 mm diameter, 10.5 cm long Ternamain Endo TIP cannula, with a... Figure 2.40 A 3.9 mm diameter, 5.0 cm long lightweight trocar‐cannula with a... Figure 2.41 Flexible instruments for use with flexible endoscopes and rigid ... Figure 2.42 An example of rigid instruments used with rigid telescopes. The ... Figure 2.43 An example of a rigid 5 mm diameter, 36 cm long minimally invasi...

3 Chapter 3 Figure 3.1 Silverline video‐gastroscope from Karl Storz, Tuttlingen, with 1.... Figure 3.2 A veterinary‐specific feline video gastroscope (outer diameter 5.... Figure 3.3 Schematic figure of four‐way tip deflection with at least one way... Figure 3.4 Schematic drawing of the handpiece of a video‐gastroscope. Figure 3.5 Distal tip of video endoscope; note the working channel (a), fibe... Figure 3.6 Commonly used accessory instruments for flexible GI endoscopy: (f... Figure 3.7 Different types of biopsy forceps (top to bottom): smooth‐edged, ... Figure 3.8 Four‐wire basket, alligator grasper, and rat tooth (top to bottom... Figure 3.9 Foreign body grasping instrument (length 60 cm) that is used alon... Figure 3.10 Cytology brush with protective tubing to obtain cytology samples... Figure 3.11 Holding the handpiece of the endoscope with the left hand. The i... Figure 3.12 The rubber cap on the instrumentation channel of a rigid endosco... Figure 3.13 Foreign body grasper that is integrated into the sheath of a rig... Figure 3.14 Histopathology of two endoscopically taken duodenal biopsies. Sa... Figure 3.15 Obstructed view of gastric mucosa in a dog that has recently ing... Figure 3.16 Drawing showing a dog in left lateral recumbency with normal ori... Figure 3.17 Self‐made model for training of flexible endoscopy. Plastic tube... Figure 3.18 Ex‐vivo stomach model of a pig. The stomach is obtained from the... Figure 3.19 Training of flexible esophago‐gastro‐duodenoscopy in a live anim... Figure 3.20 (a) Plain thoracic radiograph of an eight‐year‐old male Cairn Te... Figure 3.21 Normal appearance of upper esophageal sphincter in a dog. Figure 3.22 Pictures of normal esophagus: (a) normal esophagus of a dog with... Figure 3.23 Typical appearance of normal esophagus of a cat with “herringbon... Figure 3.24 Trachea is visible over the base of the heart at 7 o'clock posit... Figure 3.25 At the cardia, the gastric mucosa can be seen extending into the... Figure 3.26 Examples of open cardia and Z‐line in two French Bulldogs. This ... Figure 3.27 Pictures of mild‐to‐severe esophagitis. (a) Mildly irregular muc... Figure 3.28 Pictures of esophageal strictures. (a) A seven‐month‐old Doberma... Figure 3.29 Esophageal stenosis in a three‐month‐old kitten which looks endo... Figure 3.30 Pictures of esophageal foreign bodies: (a) nine‐year‐old Papillo... Figure 3.31 Pictures of esophageal tumors: (a) adenocarcinoma of the esophag... Figure 3.32 A gastric leiomyosarcoma protruding into the esophagus in a 12‐y... Figure 3.33 Two images of Spirocerca lupi with a granuloma in the esophagus ... Figure 3.34 Pictures of a vascular ring anomaly: (a) a typical band seen in ... Figure 3.35 Gastroesophageal intussusception in a 12‐year‐old 27 kg mixed br... Figure 3.36 A nine‐year‐old Border Collie with chronic vomiting and signs of... Figure 3.37 Anatomy of the stomach and cranial duodenum. It is important to ... Figure 3.38 (a) With a dog placed in left lateral recumbency, the tip of the... Figure 3.39 (a) The normal stomach with the animal in left lateral recumbenc... Figure 3.40 Various pictures of the normal, closed, or partly open pylorus: ... Figure 3.41 Examples of iatrogenic damage of duodenal mucosa after the biops... Figure 3.42 The normal stomach with the patient in left lateral recumbency a... Figure 3.43 (a) Clearly visible rugal folds seen upon entering a normal part... Figure 3.44 Various pictures of normal duodenal mucosa: (a) 2‐year‐old 22 kg... Figure 3.45 Various pictures of normal duodenal papillae: (a) 3‐year‐old Bri... Figure 3.46 Gastric erosions (a) in a nine‐year‐old Border Collie and (b) in... Figure 3.47 Gastric friability in a 12‐year‐old European Shorthair cat with ... Figure 3.48 Gastric granularity (a) in a six‐year‐old giant Schnauzer with h... Figure 3.49 Gastric ulcers (a) in a 13‐year‐old Domestic Shorthair cat with ... Figure 3.50 Gastric masses (a) in a 12‐year‐old mixed breed dog with a polyp... Figure 3.51 Duodenal mucosal friability (a) in a five‐year‐old Jack Russel T... Figure 3.52 Duodenal granularity of various severities: (a) mild granularity... Figure 3.53 Duodenal erosion in a four‐year‐old Bichon Frise with hypoadreno... Figure 3.54 Duodenal lymphatic dilation of various severities: (a) mild lymp... Figure 3.55 Pictures of various gastric foreign bodies: (a–c) crown caps in ... Figure 3.56 Endoscopic picture from the stomach of a dog with a single Physa ... Figure 3.57 Normal variations of the ileocolonic sphincter: (a) 12‐year‐old ... Figure 3.58 Taking blind biopsies through the iliocolonic sphincter when the... Figure 3.59 Retroflexed view in the descending colon in a great Dane to bett... Figure 3.60 Pictures of normal colonic mucosa: (a) 9‐year‐old German Shepher... Figure 3.61 Colonic erosions (a) in a 7‐year‐old German Brake with mild coli... Figure 3.62 Two examples of colonic friability (a) in a nine‐year‐old Golden... Figure 3.63 Colonic granularity examples: (a) an 11‐year‐old mixed breed dog... Figure 3.64 An ulcerated ilieocolonic sphincter in a three‐year‐old Leonberg... Figure 3.65 Histiocytic ulcerative colitis in (a) an 8‐month‐old Boxer and (... Figure 3.66 Colonic masses in (a) a 6‐year‐old Border Collie (histologically... Figure 3.67 Whipworms ( Trichuris vulpis ) in a six‐year‐old German Shepherd d... Figure 3.68 A plastic “overtube” with an endoscope inside to protect the end... Figure 3.69 Esophageal fishhook removal: (a) a lateral radiograph of a nine‐... Figure 3.70 Marked esophageal irritation after removal of a deeply seated bo... Figure 3.71 Typical foam and saliva obstructing the view of an esophageal fo... Figure 3.72 Various forms of low‐profile feeding tubes, also called buttons.... Figure 3.73 Components of a commercial human PEG tube set (Freka), 16 Fr siz... Figure 3.74 Placement of a commercial PEG tube: (a) generous clipping of lef... Figure 3.75 (a) Materials used for a “home‐made” PEG tube using a Pezzer ure... Figure 3.76 (a) Low‐profile feeding tube (button) in a cat; (b) pet body cov... Figure 3.77 Guide wire with a balloon placed over the guide wire in a strict... Figure 3.78 Balloon catheter (length 4 cm, inflated to width 10 mm) used for... Figure 3.79 Manometer for use during balloon dilation of esophageal strictur... Figure 3.80 Mucosal tear in an esophageal stricture after balloon dilation (... Figure 3.81 Metallic stent in the esophageal lumen of a cat in which balloon... Figure 3.82 Manometer or pressure tester to use before each cleaning procedu... Figure 3.83 Example of a plastic tub filled with cleaning detergent in which... Figure 3.84 Cleaning of all channels with a cleaning brush. Figure 3.85 Plastic tubes attached with adapters to the instrumentation chan... Figure 3.86 Washing machine with endoscope ports attached to tubes for flush... Figure 3.87 Endoscope storage options: (a) one example of a cabinet for stor... Figure 3.88 Plastic tube attached to wall for disinfection of flexible endos...