Veterinary Endoscopy for the Small Animal Practitioner. Группа авторов

8.457 The gastropexy seromuscular incision in the pyloric antrum with...Figure 8.458 A continuous suture line is started at the center of the crania...Figure 8.459 The completed gastropexy site seen from the inside with the abd...Figure 8.460 A healed laparoscopic‐assisted gastropexy site seen during lapa...Figure 8.461 Identification of a ping pong ball gastric foreign body during ...Figure 8.462 Grasping the ping pong ball with Vulsellum forceps for removal....Figure 8.463 A small residual gastric foreign body seen with re‐examination ...Figure 8.464 A gastric foreign body seen with laparoscopic‐assisted gastroto...Figure 8.465 Re‐examination of the stomach in Figure 8.464 revealing an addi...Figure 8.466 Examination of the gastric lumen was repeated to remove all eig...Figure 8.467 The small bowel grasped in normal tissue adjacent to a focal sm...Figure 8.468 The small bowel mass resected using laparoscopic‐assisted techn...Figure 8.469 The cecum with the mass elevated for evaluation to determine re...Figure 8.470 The cecum is grasped in normal tissue adjacent to the mass usin...Figure 8.471 The exteriorized cecum and mass with a stay suture placed ready...Figure 8.472 Resection of the cecal mass with an open surgical stapling devi...Figure 8.473 Operating room setup for laparoscopic cholecystectomy with the ...Figure 8.474 Four‐portals are used for performing laparoscopic cholecystecto...Figure 8.475 Three operative portals are placed using the telescope in the i...Figure 8.476 Grasping a flaccid gall bladder wall for stabilization to allow...Figure 8.477 Following cystocentesis of the gall bladder in Figure 8.476 wit...Figure 8.478 For the top down dissection technique, the gall bladder is gras...Figure 8.479 A blunt probe gently applied as a retractor to move the adjacen...Figure 8.480 Curved 5 mm diameter Metzenbaum scissors are used to cut the ti...Figure 8.481 A free gall bladder prior to extraction from the abdomen with m...Figure 8.482 Irregular rough liver surface after dissection of the gall blad...Figure 8.483 Applying an Endoclip with a 10 mm clip applier to the isolated ...Figure 8.484 Three Endoclips applied to the isolated cystic bile duct after ...Figure 8.485 Two Endoclips applied to the isolated cystic duct that are too ...Figure 8.486 A pretied loop ligature being placed on the common bile duct in...Figure 8.487 The tightened loop ligature after removal of the knot pusher pr...Figure 8.488 Irrigation being applied to the dissection surface of the liver...Figure 8.489 Operating room setup and patient position for performing a part...Figure 8.490 Portal placement for performing a partial pancreatectomy of the...Figure 8.491 Portal placement for performing a partial pancreatectomy of the...Figure 8.492 Portal placement for performing a partial pancreatectomy of the...Figure 8.493 An insulinoma in the caudal portion of the right lobe of the pa...Figure 8.494 The right lobe of the pancreas is isolated by incising the meso...Figure 8.495 A pretied loop ligature was used in this patient and is seen be...Figure 8.496 The pretied loop has been positioned and tightened on the pancr...Figure 8.497 After suture placement, the pancreas is cut with Metzenbaum sci...Figure 8.498 The freed pancreas segment prior to preparation for extraction....Figure 8.499 The resected pancreas segment is placed into a tissue retrieval...Figure 8.500 The tissue retrieval bag is removed through the operative cannu...Figure 8.501 A cyst in the center of the left lobe of the pancreas with an e...Figure 8.502 Aspiration of the lesion in Figure 8.501 with a 20 gauge spinal...Figure 8.503 Completion of aspiration leaving a collapsed cyst. Aspiration c...Figure 8.504 The omental grasping forceps are replaced with forceps to grasp...Figure 8.505 The cyst is opened with Metzenbaum scissors initially with an o...Figure 8.506 Resection of the cyst‐free wall is continued with Metzenbaum sc...Figure 8.507 The cyst‐free wall is completely excised leaving only the porti...Figure 8.508 Thorough lavage of the surgery site is done after excision of t...Figure 8.509 Portal placement for nephrectomy with the patient in lateral re...Figure 8.510 Operating room setup for laparoscopic adrenalectomy with the pa...Figure 8.511 Portal placement for laparoscopic adrenalectomy with the patien...Figure 8.512 Portal placement for laparoscopic adrenalectomy with the patien...Figure 8.513 Cutting the translucent avascular hepatorenal ligament with sha...Figure 8.514 Dissection of tissue off of the caudolateral portion of the rig...Figure 8.515 Application of two Endoclips on the isolated phrenicoabdominal ...Figure 8.516 Transection of the phrenicoabdominal vein between the Endoclips...Figure 8.517 The adrenal gland and mass are separated from the vena cava usi...Figure 8.518 The phrenicoabdominal arterial trunk crosses the dorsal aspect ...Figure 8.519 Dissection of the caudal pole of the adrenal gland is done with...Figure 8.520 Completion of dissection of the adrenal gland leaves the origin...Figure 8.521 Multiple Endoclips are applied to the phrenicoabdominal vein fo...Figure 8.522 The vessel is transected peripheral to the Endoclips with Metze...Figure 8.523 All Endoclips are left on the patient side of the cut to ensure...Figure 8.524 Operating room setup and patient positioning for laparoscopic e...Figure 8.525 Portal placement for laparoscopic exploration of patients with ...Figure 8.526 After exploration and definition of the shunt vessel, additiona...Figure 8.527 If indicated, the telescope is moved to the initial operative p...Figure 8.528 Operating room and patient position for laparoscopic splenectom...Figure 8.529 Portal placement for urethral occluder implantation with an umb...Figure 8.530 The apex of the bladder is grasped with Babcock forceps and the...Figure 8.531 The medial ligament of the bladder and its extension caudally v...Figure 8.532 The translucent avascular lateral ligaments of the bladder wher...Figure 8.533 This is a mockup of the first step for the method of laparoscop...Figure 8.534 A Babcock grasping forceps is passed into one of the caudal ope...Figure 8.535 The long monofilament nonabsorbable suture loop is pulled throu...Figure 8.536 Babcock forceps are reinserted into the 6 mm cannula and passed...Figure 8.537 The Babcock forceps and the loop of suture through the occluder...Figure 8.538 The occluder in position in a patient after completion of the s...Figure 8.539 A mockup picture with the suture passed through the second eyel...Figure 8.540 The occluder in a patient after the end of the monofilament non...Figure 8.541 A mockup of placing an extracorporeal knot to secure the occlud...Figure 8.542 In a patient, the suture ends have been tightened to pull the o...Figure 8.543 Occluder position is checked after the suture is tied and the a...Figure 8.544 The actuating tube in the abdomen seen with the telescope in an...Figure 8.545 Short areas of tissue were present surrounding the actuating tu...Figure 8.546 Multiple significant adhesions were present with omentum attach...Figure 8.547 Adhesions of the bladder to the abdominal wall.Figure 8.548 Division of the omental adhesions to the abdominal wall with sh...Figure 8.549 Division of adhesions of the bladder to the abdominal wall with...Figure 8.550 Tissue attachment points of the actuating tube were divided wit...Figure 8.551 The actuating tube was exposed as far caudally as was reasonabl...Figure 8.552 Endoclips were applied to the actuating tube for occlusion to m...Figure 8.553 Portal placement for laparoscopic‐assisted cystoscopy with the ...Figure 8.554 The exact site for operative portal placement is determined by ...Figure 8.555 Once the site is selected for portal placement and an appropria...Figure 8.556 The operative portal cannula is placed using a blunt obturator ...Figure 8.557 The apex of the bladder is grasped with 5 mm Babcock or other a...Figure 8.558 The grasped bladder is elevated to the cannula. In some patient...Figure 8.559 The bladder is pulled through the abdominal wall portal to perf...Figure 8.560 A closed cystotomy incision after return of the bladder to the ...Figure 8.561 Portals for laparoscopic‐assisted cystopexy. An umbilical teles...Figure 8.562 Cranial traction is applied to the apex of the bladder from the...Figure 8.563 The bladder wall site for cystopexy is grasped with Babcock or ...Figure 8.564 The completed cystopexy with a continuous suture pattern attach...Figure 8.565 The healed cystopexy site in the previous patient seen nine mon...

      9 Chapter 9Figure 9.1 Reusable trocar–cannulas used for thoracoscopy in small animals: ...Figure 9.2 Disposable plastic cannulas used for thoracoscopy in small animal...Figure 9.3 Adequate lung collapse for thoracoscopy in a patient using the se...Figure 9.4 Noncompliant lungs in a dog with pericardial effusion that did no...Figure 9.5 Pleural insufflation used in a dog for a right caudal lung lobect...Figure 9.6 Paraxiphoid telescope portal with the patient in dorsal recumbenc...Figure 9.7 The ventral mediastinum is visible as a complete or incomplete cu...Figure 9.8 When there is a complete mediastinum the pneumothorax produced is...Figure 9.9 A patient with a complete mediastinum that is shifted to the left...Figure 9.10 A natural fenestration visible in the ventral mediastinum that a...Figure 9.11 Cutting a hole in a complete mediastinum to provide access to th...Figure 9.12 Cutting a hole in an incomplete mediastinum without a visible fe...Figure 9.13 A thickened ventral mediastinum covered with reactive pleural ti...Figure 9.14 Cutting a normal mediastinum off of the sternum using sharp diss...Figure 9.15 Cutting through a normal ventral mediastinum where there is a bl...Figure 9.16 A ventral mediastinum with increased number and size of blood ve...Figure 9.17 Cutting the mediastinum off of the