Veterinary Endoscopy for the Small Animal Practitioner. Группа авторов

      Acknowledgments

      This work would not have been possible without a great number of people and animals who collectively made this attainable. I simply put it to paper.

      First to my parents for bringing me into this world and for their unending support, encouragement, and love.

      To Dr. Don and Betty Bailey for introducing me to Veterinary Medicine, for getting me into Veterinary School, and for their continued support throughout my career.

      To all my teachers and professors, from my first‐grade teacher Mrs. Mathews, through high school and college for their efforts to educate and stimulate me but especially to Drs. Jim Creed, Glenn Severin, Pat Chase, Harry Gorman, and Henry Swan.

      To my colleagues who referred the cases that provided me with the material for learning these techniques. And to the clients who entrusted me with their beloved pets.

      To Mr. Karl Storz, his daughter Ms. Sible Storz, and his grandson Dr. Karl‐Christian Storz for their interest in Veterinary Medicine and support of our profession. To all the staff of the Veterinary Division of the Karl Storz Endoscope Company for their educational endeavors and instrumentation development for our profession. Especially to Dr. Christopher Chamness for his support, encouragement, and friendship.

      To all the younger veterinarians who have picked up the reins and are driving all aspects of endoscopy forward at an ever‐increasing rate. I am thrilled that I now only see smoke and taillights. It is a thrill to watch.

      And most importantly to my wife and son for their patience and for allowing me the time to complete this project.

      About the Companion Website

      This book is accompanied by a website at:

      www.wiley.com/go/mccarthy/endoscopy

      The website includes:

       Videos

      Note: The videos are clearly signposted throughout the book. Look out for

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1 Introduction and History of Endoscopy

       Timothy C. McCarthy

       Veterinary Minimally Invasive Surgery Training (VetMIST), Beaverton, OR, USA

1.1 Introduction

      When I first started talking about my use of endoscopy in small animal practice, I described it as “a quantum leap forward in our diagnostic and therapeutic capabilities.” This continues to be true. A few years ago, I started stating in lectures that “A patient comes into every small animal veterinary practice every day that would benefit from a minimally invasive procedure.” This is true and whenever I am in any practice, I can find a patient who would benefit from endoscopy for diagnostic or therapeutic indications. I also believe that I can push this statement a little further to “Every patient that comes into every small animal practice every day would benefit from a minimally invasive procedure.” Unreasonable? Not really. Otoscopy is indicated as part of a proper physical examination of every patient. Why not video endoscopy on every patient so the client can see what you see?

      

By benefitting the patient, endoscopy allows us to practice better medicine and this makes us feel better about what we are doing, so we enjoy our work more. Endoscopy also has the same effect on all of the staff when they see the procedures on the video monitors. The only downside is that you may find the entire staff watching what you are doing while oohing and aahing. This does generate enthusiasm in the staff and encourages them to promote endoscopy to clients. Clients love to have minimally invasive procedures performed on their pets. Endoscopy is also the best burnout protection you can buy allowing us to see what we have never seen before, magnified and in color (Videos 1.1–1.7). So you can see that this is a win, win, win from all directions. Endoscopy is fun and exciting. Oh, and endoscopy does make money.

1.2 The History of Endoscopy

      Reviewing the history of endoscopy is an interesting but frustrating endeavor. Most names and dates listed are taken from publications citing other publications without finding, reading, or confirming the original work. Publications from different modern specialties reference different people and dates for events for early endoscopes and procedures with conflicts over who did what and when to advance the development of instrumentation. A few important dates are listed from a consensus of historical reviews and original references are listed if they were found. I cheated like everyone else in taking listed early references from more recent publications. I did go to the original publications in a few cases where this was possible and found interesting disagreements. As an example, the French Academy of Sciences does not have any listing for A.J. Desormeaux in 1853, the year listed for presentation of his endoscope design in many references. This presentation was actually published in 1855 (Desormeaux 1855). I would attempt to find all the original early references to confirm their accuracy but researching this is far beyond the scope of this publication and would delay its publication beyond my life expectancy.

Endoscopy was first suggested on Egyptian papyruses before 1000 years BCE and was first reported in “modern” human medicine over 200 years ago. In 1805, the first endoscope was designed by a German physician Phillip Bozzini using a candle and a mirror to project light into a metal tube for examination (Figure 1.1) with the first endoscopic procedure using this instrument, examination of the lower urinary tract, reported in 1806 (Bozzini 1806). He named the instrument “lichtleiter” or light conductor. This concept was criticized so severely that further development of endoscopy was delayed for 50 years. The next attempt at an endoscope design was made by a French surgeon Antonin Jean Desormeaux in 1855 using a system of mirrors and lenses with an alcohol turpentine mix for a light source (Desormeaux 1855). A rigid gastroscope was developed in 1868 by Adolf Kussmaul (Killian 1901) using the alcohol turpentine mixture for a light source with sword swallowers as test patients. The first successful cystoscope was designed by German Physician Maximilian Nitze and he is considered the father of cystoscopy (Nitze 1879). This system added telescopic lenses to improve the image with light from an exposed heated wire and a cooling mechanism to decrease thermal damage from the heated wire. Shortly after Edison invented the light bulb, this technology was used for endoscopes. This was a major and significant step with a light bulb placed at the tip of rigid endoscopes to improve illumination and reduce thermal injury (Figure 1.2). This technology still produced limited illumination and risk of thermal injury to tissue from the heat of the bulb. This advance allowed endoscopy to progress in some areas but was significantly impaired in others by inability to deliver adequate lighting. This design was state‐of‐the‐art for almost 100 years.

Figure 1.1 The first rigid endoscope, built by Bozzini in the early 1800s. The light source was a candle directed