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Exam block 3 > Exam 3: Lecture 26 - Principles of Minimally Invasive surgery > Flashcards

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

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2
Q

what is the definition of flexible endoscopy

A

endoscope that bents to look and/or move around corners

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3
Q

what are the components of flexible endoscopes

A

handle, insertion tube, umbilical cord, biopsy channel

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4
Q

what is the handle of flexible endoscope

A

where the scope held by operator

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5
Q

what is the insertion tube

A

part inserted into patient

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6
Q

what is the umbilical cord

A

part attaches scope to light source and video processor

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7
Q

what is the biopsy channel

A

allows instruments placement through scope

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8
Q

what are immersible scopes

A

they have handles that can be placed in water without any risk of damage

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9
Q

what is A

A

umbilical cord

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10
Q

what is B

A

handle

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11
Q

what is C

A

insertion tube

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12
Q

what is rigid endoscopy

A

plastic or metal scope that cant bend

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13
Q

what is the lens

A

at the scope tip, allows looking at various angles

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14
Q

what is the obturator

A

device placed through hollow endoscope to facilitate insertion of scope into organ

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15
Q

what is a trocar

A

obturator with sharp point to facilitate penetration through tissue

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16
Q

what is a portal

A

the insertion point through the skin of rigid endoscopy

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17
Q

what are portals defined as

A

scope inserted through scope or camera portal, power and hand tools inserted through instrument portal

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18
Q

what are cannulas

A

metal tubes that maintain portals and protect instruments

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19
Q

what is triangulation

A

visualization of instruments through scope perform biopsies or therapeutic procedures within a body cavity

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20
Q

what is gastroduodenoscopy

A

endoscopy of esophagus, stomach and duodenum

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21
Q

what is a colonoscopy

A

endoscopy of colon

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22
Q

what is ileoscopy

A

endoscopy of ileum (performed with colonoscopy)

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23
Q

what is proctoscopy

A

examination of anus and rectum

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24
Q

what is bronchoscopy

A

endoscopy of trachea and bronchi

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25
Q

what is laryngoscopy

A

examination of pharynx and larynx

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26
Q

what is rhinoscopy

A

endoscopy of anterior nares and examining nasal passages…may include exam of choanae

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27
Q

what is cystoscopy

A

endoscopy of urinary bladder

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28
Q

what is a retrograde cystoscopy

A

advancing scope through urethra into bladder

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29
Q

what is transabdominal cystoscopy

A

placing scope thru cannula thru abdominal wall and bladder wall

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30
Q

what is vaginoscopy

A

endoscopy of vagina

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31
Q

what is laparoscopy

A

endoscopy of peritoneal cavity

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32
Q

why do we do interventional laparoscopy

A

to perform minimally invasive surgery (gastropexy or jejunostomy tube placement)

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33
Q

what is a thoracoscopy

A

endoscopy of pleural cavity

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34
Q

what is arthroscopy

A

endoscopy of joint

35
Q

T/F: Arthroscopes are always used through cannulas

36
Q

what is instrumenting of arthroscopy

A

insertion of endoscope, arthroscope, or other instrument into joint

37
Q

what is triangulation during arthroscopy

A

visualization of instruments through scope to perform biopsies or therapeutic procedures in joint

38
Q

what are the steps of arthroscopy

A
  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
Q

what is second-look arthroscopy

A

repeat arthroscopy of joint previously scoped

40
Q

when is endoscopy valuable

A

only when it is successful by eliminating need for more invasive surgery

41
Q

when is endoscopy not useful

A
  1. if tissues samples inadequate for dx
  2. unacceptable trauma occurs during endoscopic removal of FB
  3. mucosal surfaces cant be adequately examined
42
Q

when should you refer patients for endoscopy

A

if not sufficiently trained or not performing procedure often enough to maintain expertise

43
Q

when should we do a gastroduodenoscopy most commonly

A

gastric and intestinal biopsy/cytology for diagnosis of infiltrative and lymphatic disorders

44
Q

when else can we do gastroduodenoscopy

A
  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
Q

when do we do esophagoscopy

A
  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
Q

when do we do proctoscopy and colonoileoscopy

A
  1. biopsy (colon, rectum, ileum, or cecum)
  2. ID of occult whipworm infestation
  3. diagnosis/removal of polyps
  4. diagnosis of cecocolic intussusception
47
Q

when do we do laryngoscopy

A
  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
Q

when do we do a cystoscopy

A
  1. diagnosis of ectopic ureters
  2. biopsy proliferative lesions in urethra and bladder
  3. injection of collagen in urethra for incontinence
49
Q

when do we do a thoracoscopy

A
  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
Q

when do we do a bronchoscopy

A
  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
Q

when do we do rhinoscopy

A
  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
Q

when do we do laparoscopy

A
  1. exam and biopsy of abdominal viscera
  2. determine if celiotomy is indicated
  3. minimally invasive interventional surgery
53
Q

what are the advantages of flexible endoscopes

A

greater access to more sites in viscous organs

54
Q

what are the advantages of rigid endoscopes

A

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
Q

what are the disadvantages of flexible endoscopes

A

more expensive than rigid scopes, easier to damage/requires training to assemble and clean, and requires substantial training to use properly

56
Q

what are the disadvantages of rigid endoscope

A

can only use in certain viscous organs (esophagus, descending colon, larynx, nose, and trachea), cant use around hard turns

57
Q

what size channels do we use the top forceps for

A

2.8-mm channel

58
Q

what size channels do we use the bottom forceps for

A

for 2.2-mm channels

59
Q

what is the name of the top forceps

A

shark tooth forceps

60
Q

what is the name of the middle forceps

A

rat’s tooth forceps

61
Q

what is the name of the bottom forceps

A

coin retrieval forceps

62
Q

what are the top retrieval forceps called and why do they work well

A

four-wire basket

works well due to flexible wires

63
Q

what are the bottom retrieval forceps called and why are they not as good as the top

A

it is also a four-wire basket

they do not open as widely and the wires are firm

64
Q

what are the top forceps called

A

human uterine biopsy forceps, clamshell, or double-spoon forceps

65
Q

what are the bottom forceps called and used for

A

punch biopsy forceps

smaller upper punch fits into lower cup with shearing scissor-like cut

66
Q

what should we NEVER do with endoscopes

A

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
Q

what are the 4 basic principles we can apply to most endoscopic procedures

A
  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
Q

what are advantages of endoscopic FB removal

A
  1. faster than sx
  2. less stressful to patient
  3. reduce tissue trauma, morbidity, and recovery time
  4. reduced cost to client
69
Q

what are disadvantages of endoscopic FB removal

A
  1. cannot removal all objects
  2. can hurt patient with careless technique
  3. requires assortment of expensive FB retrieval devices
70
Q

what are the 2 most commonly performed arthroscopically procedures

A

osteochondritis dessicans removal (OCD lesions) and fragmented coronoid process (FCP)

71
Q

why is arthroscopy superior to rads in diagnosis of joint disease

A
  1. allows direct visualization of cartilage and soft tissue structures
  2. provides magnification
  3. enables biopsy of virtually all structures within joint
72
Q

what is the most significant advantage of arthroscopy

A

ability to assess condition of cartilage surface

73
Q

what is A, B, C, D of this normal shoulder joint

A

A. glenoid cavity
B. medial collateral ligament
C. subscapularis ligament
D. humeral head

74
Q

2 most common diagnosis of carpus with arthroscopy

A
  1. OA
  2. chip fractures
75
Q

4 most common diagnosis of hip with arthroscopy

A
  1. OA
  2. labral tearing and avulsion
  3. tearing of ligament of femoral head
  4. neoplasia
76
Q

4 most common diagnosis of stifle with arthroscopy

A
  1. OCD
  2. cruciate disease/damage
  3. OA
  4. Meniscal disease/damage
77
Q

2 most common diagnosis of tarsus with arthroscopy

A
  1. OCD
  2. chip fractures
78
Q

What size arthroscope is A

A

1.9-mm short

79
Q

what size arthroscope is B

A

2.3-mm short

80
Q

what size is arthroscope C

A

2.7-mm long

81
Q

what is A

A

grasping forceps

82
Q

what is B

A

right angle probe

83
Q

what is C

A

microcurette

84
Q

what 2 things should we remember as arthroscopist

A
  1. you may not be able to successful remove all fragments
  2. be prepared to performed an arthrotomy

Exam block 3 (35 decks)

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