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Endoscopic surgery can be done to make a diagnosis, such as obtaining biopsy of an organ that history, examinations and laboratory studies suggest is not working properly.
This can result in more directed and appropriate treatment.
Another widespread use is to diagnose the type and spread of cancer.
This can produce a more accurate understanding of the cancer and provide information to recommend, or not to, recommend specific cancer treatment.
In the case of determining whether cancer is treatable, small openings reduce anesthetic and surgical stresses making it possible to wake the patient up.
Many terminal patients can have extension of good quality life following endoscopic surgery.
This contrasts to the traditional approach of euthanizing terminal patients during anesthesia, rather than permitting them to recover from a major surgery.
What procedures are being done in small animal practice using endoscopes?
Download our poster showing endoscopic diagnostic and treatment procedures.
Procedures used to study body areas.
Examination of the abdominal cavity using a rigid scope. Diagnostic procedures to biopsy mass and organs have been performed for some time. Recent clinical advances have increased a variety of treatments. Laparoscopy has the obvious advantage being minimally invasive, resulting in less postoperative stress and earlier discharge from the hospital. Laparoscopy provides much better viewing than that seen during open surgery. The optical space is provided with carbon dioxide insufflation.
Patients are usually placed under general anesthesia, but some quick organ biopsies can be done with heavy sedation and local anesthesia.
Examination of the thorax using a rigid scope.
Diagnostic procedures to biopsy mass and organs have been done for some time.
Recent clinical advances have developed treatments, especially resection of pericardium and lung lobectomy.
Thoracoscopy has the obvious advantage being minimally invasive, resulting in less postoperative stress and earlier discharge from the hospital that a thoracotomy which requires chest retractors to spread the ribs widely apart.
As compared to traditional thoracotomy, thorascopy provides a much more thorough examination with improved viewing.
Letting the lungs collapse by their elastic recoil provides the optical space.
This is facilitated by using a scope that looks at a 30 degree angle versus the traditional "straight-on" or 0 degree viewing.
Patients must be placed under general anesthesia.
Examination of the joints as a specialized orthopedic procedure. This can be used as a diagnostic procedure to evaluate joint surfaces, cartilage, and ligaments. Abnormalities, particularly cartilage fragments can be removed without the need to perform a traditional arthrotomy. The most commonly evaluated joints include the shoulder, elbow, stifle (knee), hip, radiocarpal, and hock. Rehabilitation is usually very quick as the two or three openings are very small.
Examination of the nose, nasal turbinates, frontal sinuses, and nasopharynx.
This is usually done as a diagnostic procedure, but foreign bodies can be removed with minimal trauma.
Endoscopic examination can be performed with either flexible or rigid scopes, with the rigid scopes providing the ability to avoiding clouding by using fluid infusion as an optical media.
Viewing is improved by using the fluids to flush away the blood.
At least one referral surgeon, Dr. Tim McCarthy states, "Rhinoscopy has proved the opportunity to avoid performing a rhinotomy, a very traumatic procedure. I can get better biopsy samples more consistently when using a rigid scope." Hemorrhage following rhinoscopy is modest.
Examination of the external ear. This can be done using a camera attached to an otoscope during examination of awake or sedated patients. When animals are anesthetized to perform a thorough cleaning, fluid can be used to provide an optical space and insure complete cleansing and examination. Dogs with ruptured typmpanic (ear drums) can also have their middle ears examined. Endoscopic viewing is much more complete than other images, even contrast-enhanced computed tomography.
>> View ear mites through the endoscope (AVI file - 35,519kb).
Examination of the urogenital tract using a rigid scope with a sheath that has a channel for instruments to biopsy, catheterize, or inject.
This provides a minimally invasive examination of the lower urinary tract (vestibule, vagina, urethra, bladder, and ureteral entrances into the bladder).
The cystoscopic view is vastly superior to that seen during surgery as cystoscopy is minimally invasive, examination is more complete, there is less hemorrhage, surfaces are magnified, and the tract is distended with fluid.
The optical space is provided with fluid infusion, which also maintains good viewing in case of hemorrhage.
Patients are placed under general anesthesia, are treated with antibiotics during the catheterization period, and the bladder is emptied of the infused fluid at the end of cystoscopy.
Transcervical catheterization is done in the standing female dog to inseminate the bitch with frozen semen, fresh chilled semen, or semen of poor quality.
Catheterization can also be performed to sample the utereus for culture, cytology, or biopsy.
The use of a special endoscope while the dog is in “standing estrous” avoids the need to anesthetize the dog for intrauterine administration of semen by laparotomy.
This technique was developed by Dr. M. S. Wilson at Massey University, New Zealand and the material on this site was prepared by Dr. Autumn Davidson.
She has performed hundreds of transcervical inseminations and is a frequent instructor in our endoscopy courses and at other meetings.
>> Vaginoscopy for transcervical catherterization in the female dog
What diagnostic procedures can be done with a rigid scope?
- Thoracic exploration and biopsies
- Abdominal exploratory and biopsies (liver, kidney, pancreas, lymph nodes, small intestines, prostate, etc)
- Endoscopic examination and biopsies of urinary bladder, nose, and ears
- Biopsy for diagnosis and staging of cancer
What treatments are being done as minimally invasive treatments?
An exciting new area for surgical endoscopy in animals is to treat using much smaller openings and tissue injury. This use of rigid endoscopes to treat people accelerated their application in human medicine. Examples include laparoscopic removal of disease gall bladders. Techniques currently being performed as treatments in dogs and cats include:
- Laparoscopic incisional gastropexy (Preventative and Treatment)
- Laparoscopic enterostomy tube placement
- Laparoscopic cyptorchid castration
- Laparoscopic ovariohysterectomy
- Laparoscopic cystopexy for retroflexed bladder in perineal hernia
- Laparoscopic cystoscopic calculi removal
- Laparoscopic colopexy for recurrent rectal prolapse
- Laparoscopic gastrostomy for foreign body removal
- Thoracoscopic pericardial resection for pericardial effusion
- Thoracoscopic assisted lung lobectomy
- Thoracoscopic correction of persistent right arotic arch
- Thoracoscopic thoracic duct ligation for chylothorax
- Coelioscopy (birds and reptiles)
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