Page 25 - Clinical Manual of Small Animal Endosurgery

Rigid Endoscopy 13

Accessories

Numerous accessories can be added to the basic endoscopic kit to
increase diagnostic and therapeutic capabilities, and to perform more
specialised techniques, such as laparoscopy and thoracoscopy. They
include sheaths, devices for insufflation, irrigation and suction (Fig.
1.12), tools to control haemorrhage and a variety of grasping (Fig. 1.13)
and biopsy (Fig. 1.11) instruments and trocars. Sheaths are tubes that
lock on to the endoscope to protect it and to provide a channel for the
passage of gas, fluids or instruments used in the specific procedure. They
are commonly used for cystoscopy, otoscopy, arthroscopy and, some-
times, rhinoscopy.
With a minimally invasive approach, the presence of working space is
essential to obtain adequate access to the structures examined. Often a
potential space has to be created with specific techniques, according to
the area in question; for instance, a liquid medium is used to create an
optical cavity in arthroscopy and cystoscopy, whereas gas insufflation is
exploited in laparoscopy and in flexible endoscopy.
Irrigation and suction units are also used to keep the operating
field clean, by removing blood, accumulated fluid and debris, thus allow-
ing better visualisation and minimising postoperative inflammation.

Fig. 1.12 Irrigation/suction device: multipurpose tool with irrigation and
suction capabilities.

Fig. 1.13 Babcock grasping forceps.