Exam 3: Lecture 26 - Principles of Minimally Invasive surgery Flashcards
1
Q
what is the definition of endoscopy
A
use of instrument to visualize interior of organ or body cavity that cannot be examined without surgery
2
Q
what is the definition of flexible endoscopy
A
endoscope that bents to look and/or move around corners
3
Q
what are the components of flexible endoscopes
A
handle, insertion tube, umbilical cord, biopsy channel
4
Q
what is the handle of flexible endoscope
A
where the scope held by operator
5
Q
what is the insertion tube
A
part inserted into patient
6
Q
what is the umbilical cord
A
part attaches scope to light source and video processor
7
Q
what is the biopsy channel
A
allows instruments placement through scope
8
Q
what are immersible scopes
A
they have handles that can be placed in water without any risk of damage
9
Q
what is A
A
umbilical cord
10
Q
what is B
A
handle
11
Q
what is C
A
insertion tube
12
Q
what is rigid endoscopy
A
plastic or metal scope that cant bend
13
Q
what is the lens
A
at the scope tip, allows looking at various angles
14
Q
what is the obturator
A
device placed through hollow endoscope to facilitate insertion of scope into organ
15
Q
what is a trocar
A
obturator with sharp point to facilitate penetration through tissue
16
Q
what is a portal
A
the insertion point through the skin of rigid endoscopy
17
Q
what are portals defined as
A
scope inserted through scope or camera portal, power and hand tools inserted through instrument portal
18
Q
what are cannulas
A
metal tubes that maintain portals and protect instruments
19
Q
what is triangulation
A
visualization of instruments through scope perform biopsies or therapeutic procedures within a body cavity
20
Q
what is gastroduodenoscopy
A
endoscopy of esophagus, stomach and duodenum
21
Q
what is a colonoscopy
A
endoscopy of colon
22
Q
what is ileoscopy
A
endoscopy of ileum (performed with colonoscopy)
23
Q
what is proctoscopy
A
examination of anus and rectum
24
Q
what is bronchoscopy
A
endoscopy of trachea and bronchi
25
what is laryngoscopy
examination of pharynx and larynx
26
what is rhinoscopy
endoscopy of anterior nares and examining nasal passages...may include exam of choanae
27
what is cystoscopy
endoscopy of urinary bladder
28
what is a retrograde cystoscopy
advancing scope through urethra into bladder
29
what is transabdominal cystoscopy
placing scope thru cannula thru abdominal wall and bladder wall
30
what is vaginoscopy
endoscopy of vagina
31
what is laparoscopy
endoscopy of peritoneal cavity
32
why do we do interventional laparoscopy
to perform minimally invasive surgery (gastropexy or jejunostomy tube placement)
33
what is a thoracoscopy
endoscopy of pleural cavity
34
what is arthroscopy
endoscopy of joint
35
T/F: Arthroscopes are always used through cannulas
true!
36
what is instrumenting of arthroscopy
insertion of endoscope, arthroscope, or other instrument into joint
37
what is triangulation during arthroscopy
visualization of instruments through scope to perform biopsies or therapeutic procedures in joint
38
what are the steps of arthroscopy
1. scope inserted through scope or camera portal
2. power and instruments inserted through instrument portal
3. fluid flows into joint (inflow or ingress)
4. fluid flows out of the joint (outflow or egress)
5. second-look arthroscopy
39
what is second-look arthroscopy
repeat arthroscopy of joint previously scoped
40
when is endoscopy valuable
only when it is successful by eliminating need for more invasive surgery
41
when is endoscopy not useful
1. if tissues samples inadequate for dx
2. unacceptable trauma occurs during endoscopic removal of FB
3. mucosal surfaces cant be adequately examined
42
when should you refer patients for endoscopy
if not sufficiently trained or not performing procedure often enough to maintain expertise
43
when should we do a gastroduodenoscopy most commonly
gastric and intestinal biopsy/cytology for diagnosis of infiltrative and lymphatic disorders
44
when else can we do gastroduodenoscopy
1. ID of mass, ulceration, erosion, lymphangiectasia, or physaloptera infestation
2. ID and removal of FB
3. placement of G-tube
4. location of lesions
5. removal of gastric polyps with clinical signs
45
when do we do esophagoscopy
1. ID/removal of FB
2. diagnosis and dilation of strictures
3. aid in stent placement
4. diagnosis of esophagitis
5. biopsy of tumors
46
when do we do proctoscopy and colonoileoscopy
1. biopsy (colon, rectum, ileum, or cecum)
2. ID of occult whipworm infestation
3. diagnosis/removal of polyps
4. diagnosis of cecocolic intussusception
47
when do we do laryngoscopy
1. ID of laryngeal paralysis
2. ID of elongated soft palate and/or everted laryngeal saccules
3. location and removal of FB
4. biopsy mass or other infiltrative lesions
48
when do we do a cystoscopy
1. diagnosis of ectopic ureters
2. biopsy proliferative lesions in urethra and bladder
3. injection of collagen in urethra for incontinence
49
when do we do a thoracoscopy
1. ID/biopsy of masses or other infiltrative lesions
2. placing chest tubes in animals with pyothorax
3. determine if thoracotomy is indicated
4. performance of minimally invasive surgery
50
when do we do a bronchoscopy
1. ID of lesions
2. bronchoalveolar lavage for cytology/culture
3. ID/removal of FB
4. ID of lung lobe torsion
5. biopsy of mucosa
6. placement of stents/eval of stents previously placed
51
when do we do rhinoscopy
1. ID/removal of foreign objects
2. biopsy/cytology of mass lesions and mucosa for infiltrative disorders
3. ID/biopsy of aspergillomas
4. ID of course of epistaxis or chronic nasal discharge
52
when do we do laparoscopy
1. exam and biopsy of abdominal viscera
2. determine if celiotomy is indicated
3. minimally invasive interventional surgery
53
what are the advantages of flexible endoscopes
greater access to more sites in viscous organs
54
what are the advantages of rigid endoscopes
less expensive than flexible scopes, used in peritoneal, pleural, and joint spaces, usually more durable, easier to learn, capable of larger biopsies, excellent for removal of FB and protecting mucosa
55
what are the disadvantages of flexible endoscopes
more expensive than rigid scopes, easier to damage/requires training to assemble and clean, and requires substantial training to use properly
56
what are the disadvantages of rigid endoscope
can only use in certain viscous organs (esophagus, descending colon, larynx, nose, and trachea), cant use around hard turns
57
what size channels do we use the top forceps for
2.8-mm channel
58
what size channels do we use the bottom forceps for
for 2.2-mm channels
59
what is the name of the top forceps
shark tooth forceps
60
what is the name of the middle forceps
rat's tooth forceps
61
what is the name of the bottom forceps
coin retrieval forceps
62
what are the top retrieval forceps called and why do they work well
four-wire basket
works well due to flexible wires
63
what are the bottom retrieval forceps called and why are they not as good as the top
it is also a four-wire basket
they do not open as widely and the wires are firm
64
what are the top forceps called
human uterine biopsy forceps, clamshell, or double-spoon forceps
65
what are the bottom forceps called and used for
punch biopsy forceps
smaller upper punch fits into lower cup with shearing scissor-like cut
66
what should we NEVER do with endoscopes
never introduce insertion tube into the mouth of an unanesthetized animal (use a mouth gag)
NEVER subject a flexible scope to heat especially autoclaving
67
what are the 4 basic principles we can apply to most endoscopic procedures
1. advance scope only if you an see where you are going
2. if you cannot see what is happening back the scope out rather than advancing or insufflate a little air
3. aim scope toward center of lumen unless looking at a specific lesion
4. do NOT insert endoscope into patient any harder than you would want a physician to insert it into you
68
what are advantages of endoscopic FB removal
1. faster than sx
2. less stressful to patient
3. reduce tissue trauma, morbidity, and recovery time
4. reduced cost to client
69
what are disadvantages of endoscopic FB removal
1. cannot removal all objects
2. can hurt patient with careless technique
3. requires assortment of expensive FB retrieval devices
70
what are the 2 most commonly performed arthroscopically procedures
osteochondritis dessicans removal (OCD lesions) and fragmented coronoid process (FCP)
71
why is arthroscopy superior to rads in diagnosis of joint disease
1. allows direct visualization of cartilage and soft tissue structures
2. provides magnification
3. enables biopsy of virtually all structures within joint
72
what is the most significant advantage of arthroscopy
ability to assess condition of cartilage surface
73
what is A, B, C, D of this normal shoulder joint
A. glenoid cavity
B. medial collateral ligament
C. subscapularis ligament
D. humeral head
74
2 most common diagnosis of carpus with arthroscopy
1. OA
2. chip fractures
75
4 most common diagnosis of hip with arthroscopy
1. OA
2. labral tearing and avulsion
3. tearing of ligament of femoral head
4. neoplasia
76
4 most common diagnosis of stifle with arthroscopy
1. OCD
2. cruciate disease/damage
3. OA
4. Meniscal disease/damage
77
2 most common diagnosis of tarsus with arthroscopy
1. OCD
2. chip fractures
78
What size arthroscope is A
1.9-mm short
79
what size arthroscope is B
2.3-mm short
80
what size is arthroscope C
2.7-mm long
81
what is A
grasping forceps
82
what is B
right angle probe
83
what is C
microcurette
84
what 2 things should we remember as arthroscopist
1. you may not be able to successful remove all fragments
2. be prepared to performed an arthrotomy
