Diagnostic Endoscopy

Diagnostic Endoscopy
univ. prof. Zdenek Knotek, DVM, PhD.
Faculty of Veterinary Medicine Brno
knotekz@vfu.cz
Basic equipment
telescop
system Hopkins,
2.7 mm, 30°, 180 mm
Karl Storz (Germany)
- Protective -
Basic equipment
telescop
system Hopkins,
2.7 mm, 30°, 180 mm
Karl Storz (Germany)
Working sheath
Basic equipment
telescop
system Hopkins,
2.7 mm, 30°, 180 mm
Karl Storz (Germany)
Working s.
Protective s.
Bioptic forceps
Basic equipment
Cold lightfountain
Halogen
150 - 175 W
Basic equipment
Cold light
Xenon 175 W
Flexible endoscopy - equipment
Bronchoscopes
2.5 mm, 1.2 mm
550 mm or 1 000 mm
Karl Storz (Germany)
4.9 mm, 2.0 mm
575 mm Fujinon (Japan)
5.0 mm, 2.2 mm
550 mm Olympus (Japan)
Diagnostic endoscopy
•
•
•
•
•
•
Small mammals
birds
reptiles
amphibians
fishes
zooanimals
Advanced
Endo-tower
Endoscopy in exotic pets
•
•
•
•
•
•
•
•
•
mouth cavity inspection, laryngoscopy
rhisnoscopy, tracheoscopy, oesophagoscopy
otoscopy
laparoscopy
ophthalmoscopy
Vaginoscopy, cloacoscopy
proctoscopy
cystoscopy
tracheal intubation
Endoscopy of the reptilian respiratory tract
Indication
Diseases of the upper respiratory tract are common in reptiles.
„Classic“ examination methods are of limited value.
(Knotek et al. 1999)
Differential diagnosis in dyspnoic reptile patient
disease of the respiratory tract
pregnancy (eggs)
effusion in pleuroperitoneal cavity
GIT dilatation (meteorism, lithophagy…..)
RTG
+
endoscopy
CROCODILES
Epiglottic valve
Trachea
in the neck - left side
in the thoracic cavity right side
tracheal rings - complete and rigid - O
bifurcation - 2nd third of thoracic cavity
Diaphragmatic separation of the body cavity
CHELONIANS
Glottis deep in mouth cavity
at the base of the tongue
Trachea
short in some groups
long in aquatic species
bifurcation spec. specific
rings rigid - O
Lungs
(bronchi) turns dorsally
direct visualisation (rigid endoscope)
Lungs large saccular structures
(surface reticular and interspersed
with bands of smooth muscle and
connective tissue)
SNAKES
Glottis opens in the floor of the mouth cavity, posterior to
the tongue. In young and small snakes - control through
the skin.
Trachea long and flexible, incomplete cartilaginous rings U, dorsal part membranous (flexible)
Lungs right lobe (left - residual part only)
left lobe in boid snakes (30 % of the right lung)
caudal part - long air sac
The right „lung“ generally courses from near the hearth to
just cranial to the right kidney.
The anterior part of the lung is vascularized (gas
exchange), the posterior part is air sac.
Snakes - air sac - approach
liver
air sac wall
liver + v. hepatica
Lizards
Pleuroperitoneal cavity (coelomic)
Urinary bladder
Lungs, heart
Liver
LIZARDS
Glottis
in the floor of the mouth cavity
Intubation needs immobilisation of the agressive lizard
with anesthetics (tiletamin-zolazepam).
„Mask“ could be feasible method for small
chamaeleons.
Trachea
flexible
bifurcation
incomplete cartilaginous rings - U
dorsal part membranous (flexible)
the first 1/3 of the pleuroperitoneal cavity
species specific!!!
monitor lizards - bifurcation 2nd 1/3
Lungs
two lobes (left, right).
air sacs present in some species - chamaeleons
In advanced lizards the lungs are divided into interconnected
chambers covered with reticulations and alveoli are more
spong-like than sac-like.
Diseases of the upper respiratory tract are
common in reptiles. „Classic examination
methods“ are of limited value (Knotek et al.
1999).
Differential diagnosis - dyspnoic reptile
disease of the respiratory tract
pregnancy (eggs)
effusion in pleuroperitoneal cavity
GIT dilatation (meteorism, lithophagy…..)
RTG
+
endoscopy
Lizards
Sexing
Endoscopy – small mammals
Endoscopy – small mammals
Rabbit - laparoscopy
insufflation
CO2 - 10 mm Hg
1,0 - 1,4 l/min
Endoscopy – small mammals
Intubation - trachea
tracheoscopy
airsac
(Boa constrictor)
Tracheitis
(Python molurus bivittatus)
JEKL, V., KNOTEK, Z. (2006)
Endoscopic examination of snakes
with access through an air sac
Vet. Record 158: 12: 407 – 410
2 - endosurgery
2 - endosurgery
Endoscopic Removal of a Bullet from the Cardiac Region of a Peregrine Falcon
(Falco peregrinus)
JEKL, V., TUKAC, V., HAUPTMAN K., KNOTKOVÁ, Z., KNOTEK, Z.
J. Avian Medicine and Surgery (in press)
2 - endosurgery