Endoscopy involves using specialized cameras to evaluate areas of the body in a minimally invasive manner. It is commonly used for diagnostic purposes to visualize abnormalities and obtain biopsy samples. Some advantages of endoscopy include it being nonsurgical, allowing direct visualization and sampling, and in some cases performing therapeutic procedures. Common types of endoscopy discussed in veterinary medicine include laparoscopy, arthroscopy, cystoscopy, and rigid endoscopy of various organs.

1. Principles of Small Animal Endoscopy
Prof. Dr. Awad Rizk
Prof. of Veterinary Surgery, Anesthesiology and Radiology
Faculty of Veterinary Medicine, Mansoura University, Mansoura, Egypt
Ph.D. University of Veterinary Medicine Hannover, Germany
Guest Prof. University of Leipzig, Leipzig, Germany
Prof.Dr.Awad Rizk

3. ❑Endoscopy is the use of specialized video cameras to
evaluate areas within the body in a minimally invasive
manner.
❑ In most instances, endoscopy is performed for
diagnostic purposes allowing visualization and sampling
of abnormalities.
❑Endoscopy can also be used for therapeutic purposes as
well, termed interventional endoscopy.

4. Advantage of endoscopy
Diagnostic
✓ Evaluating the digestive system is that it is nonsurgical.
✓ The technique allows for visualization of the lining of the
digestive system
✓ Direct Biopsy samples can take from organs.
✓ Many foreign bodies in the esophagus and stomach may be
removed via endoscopy.
✓ Specialized video camera with high resolution to evaluate is
now available in market for better and accurate diagnosis

5. In surgical procedure (interventional endoscopy)
✓Endoscopies are almost painless although they may
still cause some discomfort.
✓Compared with stress experienced by the body in a
full surgical procedure
✓an endoscopy is simple, low risk, and cost effective.
Other advantages include:
✓no scar – as a natural body opening is used
✓ quick recovery time
✓ less time in hospital, often, no time in hospital is
required as the procedure is performed in the
doctor’s rooms, and early detection of
postoperative re-occurrence

6. other advantages of endoscopy
✓less in morbidity and mortality
✓minimally invasive
✓can be inserted into the natural openings of the body
such as the mouth or anus.
✓ Also, they can be inserted into small incisions.
✓Its application in veterinary medicine has great role
for the diagnosis and they can be used to examine
visually or assist in surgery such as an arthroscopy
and in therapeutic procedure.

7. Disadvantage of endoscopy
✓ Necessity to give general anesthesia to the patient
✓ Adequate laboratory testing and radiology is required before
an endoscopy
✓ Evaluation of blood test before giving anesthesia is
important for confirmation of patient is ready to take
anesthetic risk or not
✓ Fasting of animals are at least 12 hours before an elective
endoscopy
✓ A mouth gag is used to prevent damage to the endoscope.
✓ If lower part is to be examine it requires fasting more than
24 hrs to 48 hrs.
✓ Enemas are important to clean the intestines
✓ Care should be required at the time of endoscopy like
tearing of intestine; perforation wound otherwise immediate
surgery is required to correct the problem.

9. To avoid damage of endoscope
1. Mouth gag
2. Never force scope –avoid sharp bend
3. Inadequate anesthesia

10. Limitation of endoscopy in veterinary medicine
✓ Cannot assess functional disease luminal diameter, wall thickness
✓ Cannot identify disease in most of the small intestine
✓ Cannot detect disease in the deep submucosa, muscularis or
serosa
✓ Not appropriate if bowel perforation is suspected
✓ Not ideal if pet not adequately prepared,
✓ Cannot assess or biopsy lymph nodes, Biopsy samples are
very small, need multiple
✓ It requires experience and knowledge
✓ Requires regular cleaning

11. ➢ Endoscopy has become very important just as radiology or
ultrasonography for veterinary specialist.
➢ Endoscopy is a valuable tool to peer view into interiors of the body.
➢ A basic knowledge of the normal appearance of the various luminal
surfaces, and the underlying anatomy is essential.
➢ The use of endoscopy requires proficiency in anesthetic techniques,
patient preparation, and in-depth knowledge of luminal affections in
canines.
➢ Many gastrointestinal lesions have a polymorphic appearance, so biopsy
is mandatory for definitive diagnosis.
➢ Endoscopic surgery results in less surgical morbidity,
➢ less postoperative pain and faster recovery.

12. History of endoscopy
✓ 1902: Georg Kelling of Dresden: performed the first laparoscopic
procedure on dogs.
✓ 1910: Hans Christian Jacobaeus of Sweden: the first laparoscopic
operation on humans.
✓ 1980: Patrick Steptoe, performed laparoscopic procedures in the
operating room under sterile conditions.
✓ 1982: The first solid state camera was introduced and this was the
start of video laparoscopy.
✓ 1983- First laparoscopic appendicectomy Semm, a German
gynecologist.
✓ 1985- First Lap Cholecystectomy Erich Muhe a German surgeon. •
1987- First Laparoscopic repair of inguinal hernia by Ger.
✓ 1989- First lap hysterectomy, Reich

13. Types of Endoscopy
Flexible endoscopy:
• Bronchoscopy: an exam of the lower airways.
• Colonoscopy:an exam of the transverse colon, ascending colon, cecum, large
bowel, and rectum.
• Endoscopy: an exam of the esophagus, stomach, and upper intestines.
Rigid endoscopy:
• Arthroscopy: an exam of soft tissue structures and joint cartilage, which is
not visible on radiographs. Decreased damage to the joint and shortened
recovery times are two advantages of arthroscopy over arthrotomy (surgical
exam of the joint). Disadvantages include its limitation during diagnostic and
corrective surgical procedures in small patients.
• Cystoscopy: an examination of the vagina, urethral opening, urethra,
bladder, and ureteral openings.
• Laparoscopy: an exam of the abdominal cavity performed through a small
incision in the wall of the abdomen or through the navel. It is done in
veterinary medicine to obtain hepatic (liver) and renal (kidney) biopsy
samples.
• Proctoscopy: An exam of the large bowel and rectum.
• Rhinoscopy: an exam of the nasal cavity and nasopharynx (junction between
the nasal area and the back of the throat).
• Thoracoscopy: an examination of the chest cavity. This is currently not
performed frequently in veterinary medicine.

16. • Endoscopy is performed with either a rigid or
flexible fiber optic instrument.

17. • ENDOSCOPY EQUIPMENT BASICS
The basic endoscope consists of the:
Insertion tube—depend on the mechanism for image
transmission:
Fiberoptic glass bundles (fiberscope) or charge-coupled
device (CCD) chip (videoendoscope)
Biopsy/suction channel
Irrigation/insufflation channel
Deflection control cables
Handpiece—Includes the:
Deflection control knobs
Accessory channel entrance
Irrigation/insufflation
Suction valves
Umbilical cord—Responsible for light transmission

19. FLEXIBLE ENDOSCOPES
• There are 2 main types of flexible endoscopes:
the fiberscope and videoendoscope.
• The key differentiating feature is the mechanism
by which an image is sensed and transmitted for
viewing.
• Flexible endoscopes are used predominately for
navigating the complex anatomy of the GI tract.

20. • Flexible endoscopes
such as those used in the examination of the
stomach consist of a long, flexible insertion tube
with a bending tip at the end that enters the
body, an eyepiece, and a control section.

21. • The tip of the endoscope is manipulated using a
control knob in the hand piece.
• In addition to the fiber bundles which provide
the light source, two channels are present within
the endoscope.

22. ❖One channel permits various endoscopic tools to
be passed and fluids to be suctioned or samples
taken.
❖The other allows air or water to be passed into the
stomach/intestine to insufflate (inject air into the
area), or wash away mucus from the viewing port.
❖Special video cameras can be attached to the
endoscopes which allow viewing of the exam on a
television screen, as well as recording the exam
on video.

26. • The rigid endoscope cannot be used in some
areas, such as the stomach because it does not
have the bending tip, so it cannot be flexed to
allow examination of all parts of the stomach.

27. The Equipment
1. Laparoscope/video system
2. Light source
3. Insufflator
4. Diathermy /coagulation:cutting system
5. Suction irrigation system
6. Specialized hand instruments

29. 2- Monitor 1-Trolley
3-Endoscopic
Camera 4-Light Source
6-Suction-Irrigation
5-Insufflator
7-High Frequency
Unit

30. The Equipment
1. Laparoscope/video system
There are two types:
• Telescopic rod lens system, that is connected to a
video camera (single chip or three chip) or
• A digital laparoscope where the charge-coupled
device[CCD] is placed at the end of the laparoscope,
eliminateing the rod lens system.

31. Telescopic rod lens system
There are three important structural differences
in telescope available in the market.
• 6 to18 rod lens system telescopes
• 0 to 120 degree telescopes
• 1.5 mm to 15 mm of telescopes

32. Telescopic rod lens system

33. Video camera
Single chip VS three chip
Three primary colours (Red,Blue, Green).
In single chip camera all these 3 primary colours are
sensed by single chip.
In three chip camera there are 3 CCD- Chips for
separate capture and processing of 3 primary
colours—High resolution

34. Video camera

36. Monitor
• No different from the T.V.
• Basic principle of image reproduction is
horizontal beam scanning on the face of the
picture tube.

37. The existing television systems in use differ
according to the country.
• The U.S.A uses the NTSC (National Television
System Committee) system.
• In European countries the PAL (Phase Alternation b
Line) system is in use.
• French system called SECAM (Sequential color and
memory).

38. Light source
A fiber optic cable system connected to a 'cold'
light source (halogen or xenon), to illuminate
the operative field,

39. Light source

40. Fiber optic cable

41. Insufflator
The abdomen is insufflated with carbon dioxide gas
[pneumoperitomeum] to create a working and viewing
space.
Elevates the abdominal wall above the internal organs
like a dome.
Gasless surgery –with mechanical wall elevators

43. Specialized hand instruments
5-10mm diameter instruments
• Trocars & Ports---access devices
• Graspers
• Scissors
• Dissectors
• Clip applier,Knotting devices,Staplers
• Cutting /coagulation –
hooks,spatulas,balls,forceps
• Irrigation suction tubes
• Retrieval instruments

44. Disposable vs Reusable instruments
Conventional vs.
Needle scopic /miniaturized
instruments—2mm size

45. Veress Needles

47. Trocars

49. Scissors

50. Dissectors

51. Graspers

52. Hook & spatula

53. Diathermy/harmonic dissector

54. Clip applicator

55. • Staplers
• Knotting devices
• Suturing devices

56. Irrigation suction instruments

57. Irrigation suction instruments

58. Irrigation suction instruments

59. Retrieval instruments

60. Retrieval instruments

61. Retrieval instruments
Extractor

63. Rigid type endoscope

64. • The equipment used during laparoscopy includes:
an optical system
• consists of an endoscope, a light source, and a light cable.
an insufflation system
• Automatic, high-flow insufflators (10 L/min) usually are used to insufflate
the abdomen.
adapted surgical instruments

65. Diagnostic laparoscope (A), light cable (B), and video camera (C) used for
laparoscopy.

66. • Carbon dioxide (CO2) is the most widely used gas for
insufflation because:
❑ it is inexpensive
❑ is the least likely to cause gaseous emboli compared with
nitrous oxide, air, and helium.
• The primary disadvantage of CO2 ;
✓ is the production of postoperative discomfort when it turns
into carbonic acid on the moist peritoneal surfaces.
• This complication is reported frequently in people and has
been observed in horses

67. Trocar-cannula system
❑ A trocar-cannula system is used to penetrate the body wall and
allow introduction of the laparoscope and surgical instruments
into the abdominal cavity
❑ Cannulas have a lateral Luer-Lok connector for the attachment of
the insufflation tubing system
❑ They also contain a one-way valve that allows for entry and exit of
instruments with maintenance of the pneumoperitoneum

68. Disposable cannula
(A) and trocar
(B) used for laparoscopy.
Nondisposable cannula (A) and
trocar (B) used for laparoscopy

69. Disposable laparoscopic Kelly forceps (A), Babcock forceps (B), and Metzenbaum
scissors (C).

70. Non-disposable disassembled laparoscopic claw forceps

71. Veress needle (A) connected to an insufflator by a tubing system (B) is inserted through the
body wall (C) to create a pneumoperitoneum before the laparoscopic cannula is inserted

72. During a laparoscopic procedure, laparoscopic retractors (A) and bowel clamps (B) are used
to manipulate the surrounding tissue and organs away from the surgical site.

73. • When the laparoscopic examination is complete, the
endoscope is removed, and the surgeon releases the CO2
gas/air via the open cannulas
• The portal sites are not sutured until the end of the
procedure, after all gas has been evacuated;
this limits subcutaneous emphysema around the surgical sites
and allows the maximal amount of CO2 to escape and helps
prevent postoperative discomfort.

85. Laparoscopy

86. Surgical operations performed with laparoscopic
methods are characterized by:
✓Their low invasiveness,
✓Small percentage of complications
✓ Low mortality.
✓To shorten significantly patients’ hospitalization
time
✓ Faster recovery and entailing a higher level of
satisfaction in their owners.

87. • The most common indications to laparoscopy in
animals are:
▪ Biopsy of abdominal organs or abdominal tissue masses
▪ Surgical operations such as:
✓ Ovariohysterectomy
✓ Vasoligation
✓ nephrectomy,
✓ Cholecystectomy
✓ Cystotomy
✓ Thoracotomy

88. • Although laparoscopy is a low-invasive
procedure, not every patient can be subjected
to it.
• Laparoscopic operations should not also be
performed in obese animals, ones with
abdominal dropsy, or in general bad condition
• Pyometra is also listed as a contraindication to
laparoscopy

90. ✓ Laparoscopic unit. From top to bottom:
monitor
✓ Printer
✓ Camera
✓ insufflator
✓ DVD recorder
✓ source of light
Basic elements of equipment necessary to
perform laparoscopic operations include:
❖ a laparoscope (a telescope)
❖ a trocar
❖ a source of light
❖ a Veress needle
❖ an insufflator (a laparofflator)
❖ and a video camera

91. Canine Laparoscopy

92. Rigid endoscopy:
• Laparoscopy
• Ovariectomy
• Cystoscopy
• Arthroscopy

93. Laparoscopy

94. Origins
• First laparoscopic
procedure performed in
1902 by Georg Kelling of
Dresden, Germany in a
dog.
• 1910-First laparoscopic
procedure performed in a
human by Hans Christian
Jacobaues of Sweden.
Hans Christian Jacobaeus

95. • The surface between the pubic bone and 5 cm cranially to the
umbilicus was shaved and scrubbed including 10 cm to each
side and Lidocaine 2% was infiltrated at the sites of trocars
placement.

96. Carbon Dioxide Gas and Laparoscopy
• Before the laparoscopic procedure is
performed, the abdomen is insufflated or
blown up like a balloon with carbon dioxide
gas.
• This causes elevation of the abdominal wall
above the internal organs like a dome to
create a working and viewing space.

97. Three portal sites were used:
• portal 1(primary port) for the laparoscope
• portals 2-3 (secondary portals) for surgical
instruments

98. • Portal 1 was located 2-3 cm cranial to the umblicus.
• Portals 2 and 3 were distal to the laparoscope insertion site and
4-6 cm bilaterally from the ventral midline.
• A 10mm skin incision was made at portal site 1, and then a
Veress needle inserted perpendicular to the abdominal wall.
• After an aspiration and injection test using a 5mL syringe
containing 5mL sterile saline solution to verify that the needle
was within the peritoneal cavity
• An automatic high-flow CO2 insufflator was connected to the
Veress needle and used to insufflate the abdominal cavity at the
rate of 1L/min with a pressure gradient of 12– 15 mmHg
according to the dogs' size.

99. • After complete pneumoperitoneum has been established, the
Veress needle was replaced with a 10/11mm trocar-cannula unit
• The trocar removed and the Co2 gas tube connected to the lure
lock of the cannula and the insufflators was set to maintain an
intra-abdominal pressure of 12-15mmHg during laparoscopy.
• A rigid type telescope connected to a light source.
• a high resolution one chip digital camera was then introduced
through the cannula to transmit the scene to the video monitor.

105. Laparoscopic ovariectomy and OHE
• Advantages of laparoscopy over conventional surgery
include:
➢ Reduced pain from the surgical wounds – the pet is more
comfortable post-operatively
➢ Smaller surgical wounds
➢ Fewer stitches
➢ A faster return to normal activity, due to improved patient
comfort and reduced scar tissue formation

108. • All patients are positioned in dorsal recumbency and clipped
from xiphoid to pubis and dorsally past the level of the 13th
rib.
• A wide clip is necessary to accommodate placement of the
trans-abdominal suspension suture or weighted hook.
• The abdomen is aseptically prepared as for traditional
laparotomy.

109. • A skin incision no larger than the size of the intended cannula
is made using a surgical blade.
• The subcutaneous tissues are dissected down to the linea.

110. • The Hasson technique is performed by creating a mini-
laparotomy.
• A 5.5-mm cannula with blunt trocar is preferred.
• The size of the skin and linea incision is no larger than the
intended camera port (usually 5 mm).
• Stay sutures are placed on both sides of the linea incision to allow
traction during insertion of the blunt trocar.

111. • The trocar is inserted at an approximate 30-degree angle, towards
the right caudal abdomen, to avoid iatrogenic injury to the
spleen.
• Once the cannula is inserted, the obturator is removed and the
CO2 tubing attached.
• The abdomen is insufflated to a pressure of 10 mm Hg.
• All subsequent instrument trocars are placed under direct
laparoscopic visualization to avoid intra-abdominal visceral injury.
• A two-port laparoscopic OVE/OHE technique will be used.

112. • Dorsal recumbency is most commonly performed by
ovariectomy, because both ovarian pedicles can be visualized
without moving the patient.
• The table can also be tilted from side to side to help
manipulation and visualization
• Mechanical ventilation is suggested because of the intra-
abdominal insufflation pressure and the weight of the organs
on the diaphragm
• Vascular stapler is utilized if the ovarian pedicle is extremely
wide.

113. • If the ovarian artery and vein are larger than 3 mm, endoscopic
clips can be used.
• A Babcock forceps was inserted into the 12 mm cannula to grasp
the right ovary.
• The ovary was lifted from the surrounding tissue and brought to
the abdominal wall, which allowed percutaneous advancement
of a transabdominal suspension suture with a round needle to
maintain exposure of the ovarian pedicle.

114. Laparoscopic graspers. From the top to bottom:
Babcock forceps
Reddic-Olsen forceps
Kelly forceps.

115. Laparoscopic Assisted OHE
Laparoscopic-assisted OHE is performed similarly to laparoscopic
OVE with the exception that the caudal cannula be placed in a
more caudal location (over the uterine body)
and the uterine body is ligated extracorporeally via the caudal
port site.
Because the uterine body is ligated extracorporeally, we prefers to
use an 11.5-mm cannula in the caudal location for larger (>10 kg)
dogs.

117. • The general location for the caudal cannula should be
approximately 1/3 of the distance between the umbilicus and the
pubis.
• The cranial cannula can be placed 2–3 cm cranial to the umbilicus
as for laparoscopic OVE.
• Once the cannulas have been placed, the dog is repositioned into
lateral-oblique recumbency and both ovarian pedicles ligated
and divided as described for laparoscopic OVE.

118. • Dissection of the broad ligament to approximately midway
between the ovarian pedicle and uterine body is all that is
typically required prior to elevation from the caudal cannula site.
• Once both ovarian pedicles have been divided and the broad
ligament dissected, the dog is positioned in dorsal recumbency
and the left proper ligament is grasped with the Babcock forceps
and brought to the base of the caudal cannula.
• If needed, the caudal port incision is lengthened directly over the
cannula while maintaining the grasp of the proper ligament.

119. • The cannula is then removed over the Babcock forceps and the
ovary and uterine horn extracted from the abdomen.
• The contralateral uterine horn and ovary is easily traced and
extracted similarly to the left.
• Once the uterine body has been well exposed the uterine body
can be ligated in standard fashion.
• The uterine stump is inspected for bleeding and returned to the
abdominal cavity.
• The port sites are closed according to the guidelines described for
laparoscopic OVE.

120. Complications
• Complications from laparoscopic ovariectomy and
ovariohysterectomy are rare but can include:
➢ Hemorrhage
➢ subcutaneous emphysema
➢ visceral organ injury (e.g., spleen
➢ inability to complete the procedure requiring conversion to
laparotomy, pain, seroma formation, and rarely infection.

121. Canine Cystoscopy

122. 3.5mm with cystoscope-urethroscope sheath and telescope
bridge

123. 2.7mm Telescope with operating sheath and forceps

124. Fiberscope

125. What is cystoscopy?
• Cystoscopy is a procedure that allows specially trained veterinarians to look inside the
urinary bladder and the urethra (tube connecting bladder to outside body) using a
special instrument.
• Cystoscopy is endoscopy of the bladder and urethra performed with a thin lighted tube
called a cystoscope.
• This procedure is performed in a sterile manner under anesthesia in dogs and cats.
• This procedure does not require an incision as the camera, scope and
instruments are passed through the penis in males or the vulva in females.

126. When would cystoscopy be needed?
Cystoscopy could be helpful to determine the cause
of:
✓Blood in the urine
✓Urine leakage (urinary incontinence)
✓Urinary blockages
✓Complicated urinary tract infections
✓When abnormalities in the bladder have been
noted on radiographs (x-ray) or ultrasound

127. • Patient positioning in female dogs varies with the clinician's
preference.
• Most endoscopists favor right or left lateral recumbency with
the hind end as close to the end of the table as possible.
• Ventral-dorsal can also be utilized.
• Male dogs are always in lateral recumbency.

128. Cystoscopy Procedure in Dogs
• The dog is anesthetized intravenously.
• The bladder is filled with sterile saline and distended,
allowing the scope to enter.
• A flexible optic instrument will be inserted in the
urinary tract for male dogs, a rigid optical instrument
will be used on female dogs(no incision is required).
• The scope is placed through the urethra to obtain a
visual of the bladder and urethra.
• A video recording is often taken.
• Biopsies of tissues can also be taken.
• If bladder stones are found, they can then be
removed with grasping forceps.

129. • Cystourethroscopy is a technique used to gain access to the
lower genitourinary tract
(urethra, urinary bladder, ureteral orifices, vagina).
In most cases, cystourethroscopy is used as a diagnostic tool to
visually assess the lower urinary tract if routine diagnostic
evaluation (blood work, urinalysis, urine culture, radiography,
ultrasonography) does not yield a definitive diagnosis

131. Indications for cystoscopy
Dog with urinary tract infection and urinary bladder wall pustules.

132. Dog with struvite and calcium
phosphate carbonate uroliths.

133. Cystoscopic image with a transitional
cell carcinoma at the trigone.

134. Cystoscopic image from a 10-year-old female spayed dog with polypoid
cystitis.

135. Cystoscopic image from a female spayed dog having urethrolith
retrieved by graspers.

136. ➢ A variety of cystoscopes is needed to perform transurethral
cystoscopy in both male and female dogs and cats because of
anatomic variations and marked variability in urethral
diameter.
➢ A rigid cystoscope can be used in female dogs and cats.
➢ Flexible cystoscopes are required in male dogs and cats for
complete evaluation of the urethra and urinary bladder.

137. • What is lithotripsy?
• Lithotripsy is the physical breaking of stones
formed by the body within the urinary tract of cats
and dogs.
• Lithotripsy is usually performed within the body
using a laser fiber via surgery or cystoscopy with a
shock wave applied to the stones.
• When would lithotripsy be needed?
Lithotripsy can be helpful at treating:
✓Bladder stones (in certain cases)
✓Problematic kidney stones (causing infection,
kidney damage, obstruction of urine flow)
✓Urethral stones

138. what happens once the stones are broken?
• In the bladder, the stones are broken and
removed with a small basket.
• Once kidney stones have been broken, a
specialized wand is used to suction the large
stone fragments. A stent (plastic tube) is then
placed in the ureter to ensure flow of urine from
kidney to bladder and avoid obstruction by small
pieces of stone.

139. https://www.karlstorz.com/lb/en/bcplayer.htm?
vid=3664541227001

140. Arthroscopy

141. • Arthroscopy is a technique for examining the inside of
a joint using a tiny camera
• To allow a detailed assessment of the joint in a
minimally invasive fashion

142. ➢Arthroscopy has numerous advantages over
arthrotomy for diagnosis and treatment of
joint disease.
➢Arthroscopy entails less disruption of the
periarticular soft tissue. Typically, two or three
one-centimeter long skin incisions are required
in conjunction with a 5-millimeter diameter
tunnel through the underlying soft tissue and
into the joint.
➢Decreased soft tissue disruption leads to less
pain and less chance for infection.

143. ➢In most cases, return to use of the limb is
quicker because of less surgically induced pain.
➢This is especially true when multiple joints are
involved and are operated arthroscopically
under the same anesthetic episode.
➢Examples of disease conditions where multiple
joints are commonly treated under the same
anesthetic episode include fragmented medial
coronoid process of the elbow and OCD of the
shoulder.

144. • Arthroscopy may be employed in a diagnostic,
therapeutic or combined modality.
• Using arthroscopy as an exploratory procedure
may prevent the necessity for an arthrotomy and
is an important advantage in cases where a
surgically treatable lesion is not found.
• Visualization of the joint typically is better with
arthroscopy than with an arthrotomy.
• In joints like the shoulder and elbow, arthroscopy
allows inspection of areas of the joint that is not
visible without performing multiple
arthrotomies. `

145. • In addition, the magnification that occurs with
arthroscopy in combination with the fluid medium
within the joint allows one to see joint pathology
that cannot be appreciated with an arthrotomy.
• Visualization of synovial membrane and cartilage
pathology, in particular, is better appreciated with
arthroscopy than with arthrotomy.
• With practice and development of proficiency, the
length of an arthroscopic procedure is often less
than an arthrotomy procedure.
• Cosmetic appearance of the dog is typically better
after arthroscopy compared to arthrotomy. For
some owners, cosmetic appearance is very
important.

152. Thank you for attention !!!!!!!!