Lec 26: Principles of Minimally Invasive Surgery

Question 1

the use of an instrument to visualize the interior of an organ or body cavity that cannot be examined without surgery, this is called ___.

Answer 1

endoscopy

Question 2

an endoscope that can bend to look and/or move around corners is called _____ endoscopy.

Answer 2

flexible

(ability to make bends more than 180 degrees is typical for most flexible scopes)

Question 3

____ endoscopes have a
handle
insertion tube
umbilical cord
biopsy channel
immersible scope

Answer 3

flexible

Question 4

identify the parts of the flexible gastroduodenoscope

Answer 4

A - umbilical cord (attaches scope to light source)
B - handle
C- insertion tube (introduced into the patient)

Question 5

a ____ _____ is part of a flexible endoscope which is a passage to place instruments through scope (ex: biopsy forceps, body retrieval forceps, aspiration tubes, cytology brushes) and aspirate air or liquids.

Answer 5

biopsy channel

Question 6

_______ scopes have handles placed in water without risk of damage.

Answer 6

immersible

Question 7

a _____ endoscopy is a plastic or metal scope that cannot bend.

Answer 7

rigid

Question 8

a ____ endoscope has an obturator and trocar.

Answer 8

rigid

Question 9

a/an ____ is a device placed through hollow endoscope to facilitate insertion of scope into an organ (ex: esophagus, colon)

Answer 9

obturator

Question 10

a/an ____ is an obturator with a sharp point to facilitate penetration through tissue.

Answer 10

trocar

Question 11

a _____ endoscope is inserted into the body through skin & soft tissue or a natural orifice through portals.

Answer 11

rigid

Question 12

rigid endoscope portals are defined by use.

• scope inserted through scope or ____ portal
• power hand hand tools inserted through _____ portal

Answer 12

camera ; instrument

Question 13

_____ are metal tubes that maintain portals and protect instruments in rigid endoscopy

Answer 13

cannulas

Question 14

______ is visualization of instruments through scope to perform biospies or therapeutic procedures within the body cavity.

Answer 14

triangulation

Question 15

a _____ is endoscopy of the peritoneal cavity.

Answer 15

laparoscopy

Question 16

arthroscopes are always used through _____

Answer 16

cannulas

Question 17

________ is the insertion of an endoscope, arthroscope or other instrument into a joint

Answer 17

instrumenting

Question 18

in arthroscopy, ______ is visualization of instruments through a scope in a manner to perform biopsies or therapeutic procedures within a joint.

Answer 18

triangulation

Question 19

____ or ingress is fluid flowing into a joint.

Answer 19

inflow

Question 20

outflow or ____ is fluid flowing out of the joint

Answer 20

egress

Question 21

second look arthroscopy is a _____ arthroscopy of joint previously scoped.

Answer 21

repeat

Question 22

endoscopy is _____ only when successful, and eliminates the need for more invasive surgery.

Answer 22

valuable

Question 23

if not sufficiently ______ or not performing ____ often enough to maintain expertise, patients should be referred for endoscopy.

Answer 23

trained ; procedure

Question 24

indications for _________ include: gastric and intestinal biopsy/cytology for diagnosis of infiltrative and lymphatic disorders.

• mass, ulceration, erosion, lymphangiectasia, Physaloptera infestation
• removal of FB
• placement of gastrostomy tube
• find location of a lesion (ulcer)
• remove gastric polyps

Answer 24

gastroduodenoscopy (endoscopy of esophagus, stomach and duodenum)

Question 25

indications for a ________ include: * removal of FB * dx and dilation of strictures * aid in placing stents * dx of esophagitis * biopsy tumors

Answer 25

esophagoscopy

Question 26

indications for _______ include: * biopsy of colon, rectum, ileum, cecum for infiltrative disorders * identification of whipworm infestations * dx/removal of polyps * dx of cecocolic intussusception

Answer 26

protoscopy/colonoscopy

Question 27

indications for a _______ include: * identifying lar par, elongated soft palate and or everted laryngeal saccules * removal of FB * biopsy a mass or other infiltrative lesions

Answer 27

laryngoscopy

Question 28

indications for a ______ include: * dx of ectopic ureters * biopsy proliferative lesions in urethra/bladder (carninomas) * inj of collagen into urethra to control incontinence

Answer 28

cystoscopy

Question 29

indications for a ______ include: * ID/biopsy of masses/infiltrative lesions (incl. lung biopsy) * chest tube placement for animals w/ severe pyothorax * to see if thoracotomy is appropriate & what approach to use * pericardectomy, ligation/resection of PRAA

Answer 29

thoracoscopy

Question 30

indications for a ____ include: * ID lesions (collapsed trachea) * bronchoalveolar lavage or brushing of trachea/broncus for cytology * removal of FB * ID lung lobe torsion * biopsy mucosa * placement of stents

Answer 30

bronchoscopy

Question 31

indications for a _____ include: * removal of FB * biopsy/cytology of mass lesions & mucosa for infiltrative disorders * ID & biopsy of aspergillomas * ID source of epistaxis/chronic nasal discharge

Answer 31

rhinoscopy

Question 32

indications for _____ examination * removal of FB * cytology/culture of caudal nares * ID of & biopsy of prolif disorders * ID, dilation & stenting of nasopharyngeal stenosis * ID of nasal mites

Answer 32

posterior nares (choanal)

Question 33

indications for \_\_\_\_\_\_\_: * exam & biopsy of abdominal viscera * determine if celiotomy is warranted * gastropexy, jejunostomy tube, OVH, removal of retained testicle

Answer 33

laparoscopy

Question 34

indications for: \_\_\_\_\_\_\_ * ID/biopsy of lesions * removal of loose bodies (cartilage/bone fragments, torn meniscus) * topical management of osteoarthritis - abrasion arthroplasty, microfracture * joint lavage for sepsis * assisted fracture repair * assisted joint stabilization

Answer 34

arthroscopy

Question 35

**flexible endoscopes** in comparison to rigid scopes * ______ (less/greater) access to sites in viscous organs * \_\_\_\_\_(less/more) expensive than rigid scopes * \_\_\_\_\_\_(easier/harder) to damage & requires training to assemble and clean without damaging * requires substantial training to use properly

Answer 35

greater more easier

Question 36

**rigid endoscopes** in comparison to flexible endoscopes * \_\_\_\_\_(less/more) expensive than flexible scopes * \_\_\_\_\_(less/more) durable * \_\_\_\_\_(easier/harder) to learn to use * capable of larger biopsies

Answer 36

less more easier

Question 37

we should always use a ____ gag in endoscopic procedures.

Answer 37

mouth

Question 38

never subject flexible scopes to \_\_\_\_, especially autoclaving

Answer 38

heat

Question 39

advance your scope only if you can ____ where you are going!

Answer 39

see

Question 40

if you cannot see what is happening, ____ scope out a little, OR ____ air/infuse some ____ into lumen.

Answer 40

back ; insufflate ; fluid

Question 41

aim the scope towards the ____ of the lumen

Answer 41

center (UNLESS looking at a specific lesion)

Question 42

do not insert an endoscope into your patient any _____ than you would want a physician to insert it into you!

Answer 42

harder

Question 43

advantages of using endoscopy to remove foreign objects * ____ than surgery * less ____ to patient * reduced tissue \_\_\_\_, morbidity & recovery time * reduced ____ to client

Answer 43

faster ; stressful ; trauma ; cost

Question 44

disadvantages of endoscopy removal of foreign objects * cannot remove __ objects * can hurt patient with ____ technique * requires assortment of _____ FB retrieval devices

Answer 44

ALL ; careless ; expensive

Question 45

the most common arthroscopically performed procedure is _____ removal.

Answer 45

fragment

Question 46

arthroscopy is ____ (superior/inferior) to radiography in dx of joint disease

Answer 46

SUPERIOR

Question 47

arthroscopy allows _____ visualization of cartilage & soft tissue structures, provides magnification, and enables biopsy of ___ structures within the joint.

Answer 47

direct ; all

Question 48

the most significant diagnostic advantage of arthroscopy is the ability to assess the condition of the _____ surface.

Answer 48

cartilage

Question 49

common diagnoses with arthroscopy of the stifle are:

Answer 49

cruciate & meniscal disease

Question 50

common arthroscopic procedures in the stifle include ____ tear treatment, and ____ ligament debridement.

Answer 50

meniscal ; cruciate

Question 51

as a beginning arthroscopist, you may not be able to remove ___ fragments. be prepared to perform a \_\_\_\_\_.

Answer 51

ALL ; arthrotomy