Page 184 - Clinical Manual of Small Animal Endosurgery

172 Clinical Manual of Small Animal Endosurgery

cleaning as well as a pre-sterilisation examination are essential if infec-
tion or patient injury are to be avoided.

Thoracoscopy ports
Ports for thoracoscopic surgery do not need valves, as in the majority of
cases no insufflation is performed. The most suitable ports are soft and
pliable, with a blunt atraumatic trocar that is unlikely to damage struc-
tures during insertion. These soft ports protect the intercostal vessels and
nerves from trauma, and reduce the risk of leverage injuries. Threaded
ports are useful as they are not easily dislodged, and also can be fixed
with minimal shaft length protruding into the chest cavity. This is helpful
as the available operating space in some locations in the chest can be
quite small. Disposable Thoracoports (Covidien) are well suited to vet-
erinary companion animal thoracoscopy, and can be resterilised with
ethylene oxide or liquid solutions and reused a reasonable number of
times. The numbering system is slightly confusing, with the 5.5 mm
Thoracoport accommodating instruments up to 6 mm in diameter, and
the 11.5 mm Thoracoport accommodating instruments up to 12 mm in
diameter (suitable for stapler insertion) (see Fig. 6.2). The 5.5 mm port
is suitable for extraction of small endoloop lung biopsies, and the
11.5 mm port is suitable for extraction of pericardium (partial or subto-
tal pericardiectomy) in most cases.
While reusable steel laparoscopy cannulae can also be used for tho-
racoscopy there are a number of disadvantages to their use. These can-

Fig. 6.2 Soft Thoracoports are threaded but atraumatic and well suited to
thoracoscopy with 5 mm instruments. The 5.5 mm Thoracoport
accommodates instruments up to 6 mm in diameter, and the 11.5 mm
Thoracoport accommodates instruments such as endoscopic staplers up to
12 mm in diameter.