Diagnostic Imaging :Endoscopy

Sterile theatre - arthroscopy

Endoscopes

Endoscopes are like thin telescopes that can be inserted into the body. AMCRS has a large selection of different types of endoscopes for its clinicians to choose from. These range from extremely fine urethroscopes to large proctoscopes and delicate arthroscopes to robust operating laparoscopes. The picture on the right shows the view inside a dog's shoulder joint.

For the safety of both the patient and the equipment, endoscopy requires a short general anaesthetic. This stops the animal from feeling anything and ensures that it remains still during the procedure. All anaesthetised patients are monitored closely by either a vet or a nurse, who are not involved in the procedure itself, throughout anaesthesia and recovery.

a flexible endoscope

Video endoscopy

Most endoscopes require a high power light source, the light being transmitted to the end of the scope to illuminate the area of interest. The image may be viewed directly through the scope or through a camera to be displayed on a monitor. The system in use in the picture below is one of our four video endoscopy units. These allow all those involved to see what is going on, and they also permit video recording of what has been seen .

Gastrointestinal investigations can be performed by passing gastroscopes by mouth (as seen on th eright here) or proctoscopes per rectum. Inflation with gas separates the walls of the gut permitting viewing of the inner lining. Endoscopic biopsies can then be obtained of any suspicious areas.

The image on the left was obtained during bronchoscopy of a dog with lung disease. In order to obtain samples from inside the small airways and alveoli for laboratory investigation a broncheo-alveolar lavage is performed. A catheter is passed through the endoscope and into the smaller bronchi and sterile saline flushed in to loosen discharge, cells and debris and aspirated back into a syringe. Investigation of airway problems by "tracheal wash" is similar but of little value if the problem is actually deeper in the airways.

Use of combined diagnostic methods

Endoscopy is often used in combination with other diagnostic techniques. The contrast study radiograph shown below was used to identify the location of the problem and urethroscopy confirmed the presence of a tumour and allowed biopsy without the need for major surgery to reach the area.

Certain types of bladder tumour, including some bladder tumours, can be controlled using medical treatment, but it is important to identify them accurately in order to plan the most appropriate therapy.

Not all masses are cancerous. The large nasopharyngeal polyp visible in the radiograph below originated in one of the cat's eustachian tubes. A flexible endoscope was used to confirm the site of attachment and to assist with removal of the mass (seen below).

Laparoscopy and thoracoscopy

By making a small incision rather than using the natural openings of the body, it is possible to use endoscopes for examination and surgical procedures in the abdominal (below) and thoracic cavities, plus many joints.

Techniques such as this do not just permit viewing and sampling for diagnosis, they can often be use for performing treatment as well.