Veterinary Endoscopy for the Small Animal Practitioner. Группа авторов

8.331 Operating room setup and portals for laparoscopic liver biopsy ...Figure 8.332 Two styles of 5 mm apposing cup or clam shell biopsy forceps us...Figure 8.333 Obtaining a liver biopsy from the margin of a liver lobe with t...Figure 8.334 Biopsy forceps positioned for taking a biopsy from the center o...Figure 8.335 Biopsy of a liver mass using the 5 mm apposing cup forceps with...Figure 8.336 The biopsy forceps are closed with moderate pressure and the fo...Figure 8.337 The appearance of the liver biopsy site after removal of the fo...Figure 8.338 Performing cholecystocentesis using a 3.5″ long 20 gauge spinal...Figure 8.339 Cholecystocentesis where the gall bladder was emptied for decom...Figure 8.340 Operating room setup and patient positioning for pancreatic bio...Figure 8.341 Operating room setup and patient positioning for pancreatic bio...Figure 8.342 Pancreatic biopsy in a cat using apposing cup biopsy forceps ap...Figure 8.343 An Endoclip applied to a blood vessel at the biopsy site of Fig...Figure 8.344 Operating room setup and patient positioning for kidney biopsy ...Figure 8.345 When the kidney to be biopsied is known prior to the procedure ...Figure 8.346 Biopsy of the right kidney with the patient in lateral recumben...Figure 8.347 Biopsy of the right kidney with the patient obliqued from dorsa...Figure 8.348 A pledget of Gelfoam placed on a kidney biopsy site with contin...Figure 8.349 The appearance of the kidney biopsy site and Gelfoam several mi...Figure 8.350 Active bleeding from a kidney biopsy site after sample collecti...Figure 8.351 Application of HemaBlock powder to the actively bleeding biopsy...Figure 8.352 Immediately following application of the HemaBlock powder to th...Figure 8.353 Operating room setup and patient position for laparoscopic‐assi...Figure 8.354 Operating room setup and patient position for laparoscopic‐assi...Figure 8.355 Grasping the antimesenteric border of the jejunum adjacent to a...Figure 8.356 Running the bowel using two 5 mm atraumatic forceps to select a...Figure 8.357 A loop of jejunum selected for biopsy that has been elevated to...Figure 8.358 To enlarge an operative portal for exteriorization of a loop of...Figure 8.359 An intestinal biopsy site that has been returned to the abdomen...Figure 8.360 Biopsy of the margin of the spleen using opposing cup biopsy fo...Figure 8.361 Minimal bleeding from the splenic biopsy site of the case in Fi...Figure 8.362 More significant bleeding from a splenic biopsy site in the cen...Figure 8.363 Spontaneous hemostasis of the biopsy site shown in Figure 8.362...Figure 8.364 A Gelfoam pledget placed in a splenic biopsy site to aid hemost...Figure 8.365 Operating room setup for laparoscopic ovariectomy and ovariohys...Figure 8.366 An alternative operating room setup for laparoscopic ovariectom...Figure 8.367 Telescope portal placement for single‐port ovariectomy using an...Figure 8.368 The left ovary visible between the spleen at the lower left of ...Figure 8.369 The left ovary grasped with 5 mm diameter Babcock forceps passe...Figure 8.370 The ovary is elevated away from the surrounding tissue to provi...Figure 8.371 A TT ovariectomy hook is passed through the abdominal wall at t...Figure 8.372 The telescope portal site on the ventral midline at or caudal t...Figure 8.373 The telescope portal site on the ventral midline at or caudal t...Figure 8.374 The ovary positioned against the abdominal wall with the Mouret...Figure 8.375 Babcock forceps are removed leaving the ovary in place fixed to...Figure 8.376 Initial placement of a 5 mm LigaSure vessel sealing device on t...Figure 8.377 The ovarian pedicle in Figure 8.376 after sealing and cutting t...Figure 8.378 Placement of the vessel sealing device on the uterine horn to c...Figure 8.379 The vessel sealing device placed in the center of the pedicle o...Figure 8.380 The ovarian pedicle site after completion of the transection us...Figure 8.381 The ovary and periovarian tissue after transection of the ovari...Figure 8.382 The ovarian package held in place with the Mouret needle after ...Figure 8.383 Grasping the utero‐ovarian ligament with reinserted Babcock for...Figure 8.384 The ovarian package is pulled up to or into the telescope cannu...Figure 8.385 Portal and needle placement for the two‐port ovariectomy techni...Figure 8.386 The left ovary seen from an umbilical telescope portal with the...Figure 8.387 The left suspensory ligament is grasped with Babcock forceps ad...Figure 8.388 The ovary is elevated away from the surrounding tissue with the...Figure 8.389 The right ovary placed against the abdominal wall in preparatio...Figure 8.390 The right ovary held against the abdominal wall with Babcock fo...Figure 8.391 After placement of the Mouret needle retractor, the Babcock for...Figure 8.392 The Babcock forceps is replaced with a vessel sealing device pa...Figure 8.393 Nearing completion of transection of the ovarian pedicle with t...Figure 8.394 Completed transection of the ovarian pedicle with the vessel se...Figure 8.395 A small ovary with limited periovarian tissue retracted up to a...Figure 8.396 A small ovarian package in a 1‐year‐old female Irish Setter aft...Figure 8.397 A medium‐sized ovary with surrounding fat in a nine‐month‐old f...Figure 8.398 A large ovarian package in a grossly overweight one‐year‐old fe...Figure 8.399 The large ovarian and periovarian tissue mass pulled tightly ag...Figure 8.400 The portal dilating device (Gall bladder extractor) placed arou...Figure 8.401 The ovarian tissue package partially extracted through the abdo...Figure 8.402 After portal placement for the three‐port technique and patient...Figure 8.403 Babcock forceps are passed through the caudal portal and the su...Figure 8.404 The ovary is elevated away from the surrounding tissue with the...Figure 8.405 If the handle of the Babcock forceps is released, the weight of...Figure 8.406 The ovarian pedicle elevated with the weight of the 5 mm Babcoc...Figure 8.407 The ovary held with Babcock forceps in preparation of ovarian p...Figure 8.408 The same ovary as in Figure 8.407 with the Babcock rotated 90° ...Figure 8.409 Transection of the ovarian pedicle using a 5 mm LigaSure vessel...Figure 8.410 Transecting the mesometrium in a thin juvenile dog using scisso...Figure 8.411 Transecting the mesometrium in an older multiparous female Labr...Figure 8.412 Cranial traction is placed on the uterine horn to elevate it aw...Figure 8.413 Tension and elevation of the caudal portion of the right uterin...Figure 8.414 Transection of the uterine horn at the uterine body bifurcation...Figure 8.415 Transection of the uterine body in a juvenile dog using a bipol...Figure 8.416 Transection of the uterine artery and vein as a separate step i...Figure 8.417 Transection through the cervix of the patient seen in Figure 8....Figure 8.418 The Babcock forceps are positioned to grasp the caudal cut end ...Figure 8.419 The ovarian remnant shown in Figure 8.298 grasped with Babcock ...Figure 8.420 Transection of the ovarian remnant pedicle using the LigaSure v...Figure 8.421 After completion of transection, the sealed incision line is ch...Figure 8.422 The resected ovarian remnant is maintained in the grasp of the ...Figure 8.423 The ovarian remnant tissue package is retracted to the end of t...Figure 8.424 Increased blood vessels in the area of left ovarian pedicle sca...Figure 8.425 Resection of the left ovarian pedicle scar with the enlarged bl...Figure 8.426 Operating room set up for laparoscopic cryptorchid castration w...Figure 8.427 Portal placement for cryptorchid castration using laparoscopic ...Figure 8.428 An intra‐abdominal cryptorchid testicle seen without any organ ...Figure 8.429 Further head down tilting of the patient in Figure 8.428 allows...Figure 8.430 A close‐up view of the gubernaculum testis indistinctly seen in...Figure 8.431 Babcock forceps grasping the head of the epididymis rather than...Figure 8.432 Babcock forceps grasping the tail of the epididymis rather than...Figure 8.433 Babcock forceps positioned to grasp the ductus deferens as anot...Figure 8.434 Transection of the pampiniform plexus and ductus deferens using...Figure 8.435 The transected patient end of the pampiniform plexus and ductus...Figure 8.436 Placement of a pretied loop ligature on the pampiniform plexus ...Figure 8.437 The ligature loop is closed and tightened around the structures...Figure 8.438 The suture and tissue are cut freeing the testicle for removal....Figure 8.439 The abdominal testicle in a unilateral cryptorchid patient that...Figure 8.440 The ligated and transected structures returned to the abdomen a...Figure 8.441 Operating room setup for laparoscopic assisted gastropexy place...Figure 8.442 Portal positions for laparoscopic‐assisted gastropexy with the ...Figure 8.443 The pyloric antrum and pylorus are identified. The pyloric antr...Figure 8.444 A dilated pyloric antrum obscuring visibility of the pylorus.Figure 8.445 A poorly visible pylorus due to position of the tissues and ang...Figure 8.446 Applying pressure to the dilated pyloric antrum seen in Figure ...Figure 8.447 Grasping the pyloric antrum and retracting it caudally allowing...Figure 8.448 The 10 mm Babcock/Duval forceps placed on the ventral surface o...Figure 8.449 The gastropexy site on the ventral wall of the pyloric antrum a...Figure 8.450 The gastropexy site on the ventral wall of the pyloric antrum a...Figure 8.451 The pyloric antrum is manipulated with the grasping forceps to ...Figure 8.452 The pyloric antrum in Figure 8.451 is manipulated with the gras...Figure 8.453 The grasped ventral wall of the pyloric antrum has been elevate...Figure 8.454 In this image, an 11 mm EndoTIP cannula is being used. This is ...Figure 8.455 Enlarging the gastropexy portal by passing a #10 scalpel blade ...Figure 8.456 The enlarged gastropexy portal from the outside