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Instrumentation

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Abstract

This chapter covers the different instruments used with flexible and rigid endoscopes, and peripheral devices such as light sources and insufflators. It also provides a detailed description of the structure and function of an array of endoscopes, including advice on selecting an endoscope.

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Figures

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2.1 Flexible video-endoscope with four-way tip deflection. (© Karl Storz SE & Co. KG)
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2.2 Flexible endoscopes without an umbilical cord. (a) Fibrescope (2.7 mm diameter, 100 cm long) with two-way tip deflection. (b) Video-endoscope with two-way tip deflection and a LED light source integrated into the handpiece. (© Karl Storz SE & Co. KG)
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2.3 Tip deflection in a gastroscope. (a) Up/down deflection. (b) Right/left deflection. (© Karl Storz SE & Co. KG)
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2.4 Video-gastroscope handpiece. (© Karl Storz SE & Co. KG)
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2.5 Leakage tester. (© Karl Storz SE & Co. KG)
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2.6 Fibrescope (5.2 mm in diameter, 85 cm long) with two-way tip deflection. (© Karl Storz SE & Co. KG)
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2.7 Video-endoscope attached to an all-in-one video system that includes a video processor, light source, monitor, digital capture system and insufflation/irrigation pump. (© Karl Storz SE & Co. KG)
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2.8 Fibreoptic image with broken fibres. (© Karl Storz SE & Co. KG)
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2.9 Flexible instruments. (Reproduced from with permission from the publisher)
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2.10 Rigid endoscopes (telescopes). (© Karl Storz SE & Co. KG)
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2.11 The HOPKINS rod-lens system and a conventional optical system. (© Karl Storz SE & Co. KG)
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2.12 Telescope viewing angles. (a) 0 degrees. (b) 30 degrees. (© Karl Storz SE & Co. KG)
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2.13 Rigid endoscopes with integrated working channels. (a) Rod-lens otoscope (5 mm diameter with a 5 Fr integrated channel). (b) Cystoscope/rhinoscope (9.5 Fr diameter with a 3 Fr integrated channel). (c) Operating laparoscope (10 mm diameter with a 5 mm integrated channel). (© Karl Storz SE & Co. KG)
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2.14 Semi-rigid endoscope (1 mm diameter, 20 cm length). (© Karl Storz SE & Co. KG)
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2.15 Multi-Purpose Rigid™ (MPR) endoscope. (a) Top to bottom: the MPR endoscope in an examination and protection sheath, an arthroscopy sheath, a laparoscopy trocar and an operating sheath. (b) Laparoscopic ovariectomy in a puppy using the MPR endoscope. (© Karl Storz SE & Co. KG)
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2.16 Laparoscope (5.0 mm diameter) (right) with a standard trocar/cannula (middle) and an ENDOTIP cannula (left). (© Karl Storz SE & Co. KG)
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2.17 (a) Canine arthroscope (2.4 mm diameter) with a snap-in sheath with two stopcocks. (b) Extended-length cystoscope (17 Fr outer diameter, 29 cm working length). (c) Rigid endoscope (2.9 mm diameter, 36 cm length) with optical grasping forceps. (© Karl Storz SE & Co. KG)
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2.18 (a) Multi-Purpose Rigid™ endoscope with operating sheath and biopsy forceps. (b) Tips of a variety of 5 Fr flexible instruments. (© Karl Storz SE & Co. KG)
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2.19 Multi-Purpose Rigid™ endoscopes (2.7 mm diameter) in an operating sheath (left) and an arthroscope sheath (right). (© Karl Storz SE & Co. KG)
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2.20 Biopsy forceps for use alongside a telescope. (© Karl Storz SE & Co. KG)
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2.21 Standard laparoscopy cannulae and trocars. (© Karl Storz SE & Co. KG)
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2.22 Telescope through cannula used for laparoscopy and thoracoscopy. (© Karl Storz SE & Co. KG)
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2.23 The ENDOTIP cannula requires no trocar for entry. (© Karl Storz SE & Co. KG)
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2.24 The SILS port is the device most commonly used by veterinary surgeons for single-port access. (All rights reserved. Used with the permission of Medtronic)
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2.25 Rigid instruments used for laparoscopy and thoracoscopy. (a) A variety of 5 mm laparoscopy instruments with different tips. (b) Laparoscopic palpation probe, grasping forceps and biopsy forceps. (© Karl Storz SE & Co. KG)
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2.26 (a) A simple fan retractor used for holding tissue through a dedicated cannula. (b) The EndoGrab™ device facilitates retraction of organs without the need for additional ports. (a, © Karl Storz SE & Co. KG; b, © STI Virtual Ports, Israel)
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2.27 LigaSure™ vessel sealer. (All rights reserved. Used with the permission of Medtronic)
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2.28 Six clips placed on the thoracic duct. (© Dr Ameet Singh, University of Guelph)
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2.29 (a) LED light source. (b) Fibreoptic light-transmitting cable. (© Karl Storz SE & Co. KG)
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2.30 The video chain starts with a light source and ends with a video monitor. (© Karl Storz SE & Co. KG)
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2.31 Light source with a built-in air pump and a connector for a gastroscope. (© Karl Storz SE & Co. KG)
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2.32 Hand-held light source attached to a rod-lens otoscope. (© Karl Storz SE & Co. KG)
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2.33 Air pump designed for insufflation during gastrointestinal endoscopy. (© Karl Storz SE & Co. KG)
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2.34 Carbon dioxide insufflator designed for laparoscopy. (© Karl Storz SE & Co. KG)
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2.35 Veress needle. (a) The blunt hollow stylet protrudes through the sharp outer needle. (b) Sharp outer needle with the spring-loaded stylet retracted. (© Karl Storz SE & Co. KG)
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2.36 VETPUMP2 suitable for insufflation, irrigation and suction. (© Karl Storz SE & Co. KG)
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2.37 A fluid pump designed for arthroscopy regulates the flow rate and pressure of sterile fluids used to distend the joint space. (© Karl Storz SE & Co. KG)
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2.38 Endo-video cameras. (a) Clockwise from lower left: camera head, video monitor, camera control unit, xenon light source with fibreoptic cable. (b) Endo-video camera attached to a rigid endoscope. (c) Endo-video camera attached to a fibrescope. (© Karl Storz SE & Co. KG)
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2.39 Digital image capture devices. (a) The AIDA (advanced image and data archiving) system. (b) The TELE PACK compact portable endoscopy system includes a camera, light source, keyboard, digital capture system and integrated flatscreen monitor. (© Karl Storz SE & Co. KG)
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2.40 An electrosurgical generator can be used for both endoscopic and open surgery. (© Karl Storz SE & Co. KG)
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2.41 LigaSure™ vessel-sealing device, (All rights reserved. Used with the permission of Medtronic)
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2.42 ROBI plus: a reusable, easily sterilized bipolar cutting and coagulation instrument. Only the blade needs to be replaced when dull. (© Karl Storz SE & Co. KG)
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2.43 Arthroscopic power shaver system with handpiece and blade. (© Karl Storz SE & Co. KG)
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2.44 Mobile endoscopy cart. Top to bottom: monitor, telescope and light cable, modular camera units, light source, CO insufflator, electrosurgical generator and VETPUMP 2 insufflation, irrigation and suction pump. (© Karl Storz SE & Co. KG)
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2.45 (a) Room set-up for gastroscopy. (b) Room set-up for laparoscopy with the patient in left lateral recumbency. (c) Room set-up for laparoscopy with the patient in dorsal recumbency. (© Karl Storz SE & Co. KG)
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2.46 Cleaning brushes for endoscopes and instruments. (© Karl Storz SE & Co. KG)
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2.47 Sterilization and storage tray for a rigid endoscope and instruments. (© Karl Storz SE & Co. KG)
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2.48 Mobile cart with a video-endoscope stored in the hanging position to maximize drainage and reduce stress on the glass fibres. (© Karl Storz SE & Co. KG)

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