• Veterinary Radiology

• Veterinary Radiology

MaryAnn G. Radlinsky DVM, University of Georgia, Athens, Georgia, USA, gave a presentation in which she encouraged veterinarians to consider using endoscopy for more procedures. In addition to providing a clear view of internal structures, endoscopic procedures can reduce morbidity and damage to target sites and lead to more rapid recovery times. The equipment consists of a tower that includes a strong light source, a highdefinition camera, a capable image processor, and recording equipment. In addition, instruments on a long, narrow delivery system must be used for sampling or treatment.

Several types of endoscopic procedures were reviewed. Rhinoscopy requires control and patience. Dr. Radlinsky emphasized that small, deliberate movements are imperative for any endoscopic procedure. This is particularly true during rhinoscopy because any misguided movements in these rigid surroundings can result in hemorrhage. A 30° endoscope will enable the veterinarian to visualize structures within the confines of the nasal cavity. Biopsies can be obtained with the small biopsy channel, but better samples are obtained with forceps passed adjacent to endoscope. To avoid aspiration pneumonia, Dr. Radlinsky recommended using a properly sized endotracheal tube with a functioning cuff inflated to 20 cm H₂O. While the use of the angled endoscope will take some practice, Dr. Radlinsky believes that it is worth the effort.

Cystoscopy can also be performed endoscopically. It is very important to visualize the lumen at all times to avoid perforation to the tract. Dr. Radlinsky further stressed that fluid cannot be under pressure during irrigation, as this will cause severe diffuse trauma and hemorrhage to the bladder. This is another procedure that is best performed with the angled endoscope. Since small biopsy samples are taken via the channel, many must be made to obtain an accurate diagnosis. Veterinarians can move on to therapeutic procedures, such as calculi removal and the treatment of small polyps, once they have mastered diagnostic cystoscopy.

Performing otoscopy with an endoscopy tower has several advantages. The video otoscope works very well for ear flushes and deep ear cleanings and is faster than typical methods. Biopsies can be obtained; stricture, hyperplasia, neoplasia, and foreign bodies can be diagnosed; and polyps can be removed. The risks with otoscopy include tympanic membrane rupture, middle ear hemorrhage, and deafness.

Performing laparoscopy and thoracoscopy requires the development of many new skills. These abilities include the safe placement of ports without damaging internal organs, triangulation, organ manipulation, and hemorrhage control. Appropriate monitoring equipment is required as well. Veterinarians must be comfortable with the open procedure before moving on to endoscopic procedures, and it is best to start with diagnostic procedures, such as collection of samples. Dr. Radlinsky emphasized that these skills are achievable, and she encouraged veterinarians—particularly those who have already invested in endoscopy equipment—to obtain adequate training and perform procedures regularly to maintain their expertise.

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