Principles of Endoscopy

Diagnostic endoscopy

Removal of a foreign body from the stomach

Both rigid and flexible scopes

To inflate organs

All of the above

To wash the end of the scope

Tissue biopsies

Management of an oesophageal stricture

To allow aspiration of air and body fluids

Instruments of different sizes

Leak testing equipment

Knowing when to seek advice or refer

To diagnose megaesophagus

Always scope the duodenum/SI as well as the stomach

To perform airway fluid sampling

Consider the possible risks as well as benefits

To perform urinalysis and diagnostic imaging

Perform diagnostic imaging before the procedure

To diagnose upper airway/laryngeal obstruction

GI perforation

The principles of endoscopy include diagnostic endoscopy and therapeutic endoscopy. Diagnostic endoscopy allows the vet to look within an organ or body cavity to evaluate an area of interest and obtain diagnostic samples. Therapeutic endoscopy enables various therapeutic procedures to be performed.

Examples of diagnostic samples that can be obtained using endoscopy include airway fluid sampling/bronchoalveolar lavage and tissue biopsies of the GI tract and nasal mucosa.

Examples of therapeutic procedures that can be done using endoscopy include the removal of a foreign body from the esophagus, airway, or stomach, management of an esophageal stricture, and placement of a gastric feeding tube.

The equipment used in endoscopy includes scopes (rigid and/or flexible scopes), a bright light source (xenon, metal halide, LED), air insufflation and water irrigation systems, suction, a video monitor screen, and instruments of appropriate size for the scope channel.

The ideal light source for endoscopy is one that is bright (xenon, metal halide, LED) and suitable for all scopes, providing enough illumination in dark cavities that are being examined.

Endoscopy might be used for small animals with respiratory signs when there is a chronic cough suspected to be caused by a foreign body or when airway fluid sampling is needed for cytology or culture.

Some top tips for bronchoscopy in small animals are to always perform diagnostic imaging first (radiography or CT) and to consider the possible risks as well as benefits, especially in cats where the airway is small.

Some top tips for GI endoscopy in small animals are to rule out other causes that would not require endoscopy to reach a diagnosis before scoping, to always scope the duodenum/SI as well as the stomach unless a very obvious gastric lesion is found, and to always collect biopsies from multiple sites in the abnormal GI tract.

Some top tips for urethroscopy/cystoscopy in dogs are to always perform urinalysis and diagnostic imaging first (radiography +/- ultrasound +/- contrast studies) and to consider whether the anatomy is best suited to a rigid scope (females) or a flexible scope (males).

Endoscopy might be used for horses in cases of suspected upper airway/laryngeal obstruction, investigation of abnormal respiratory noise, suspected lung disease, gastric ulceration, and urinary tract disease.

Biopsies from multiple sites in the GI tract.

Rule out other causes before scoping, always scope the duodenum/SI as well as the stomach, and collect biopsies from multiple sites.

Always perform diagnostic imaging first and consider the possible risks as well as benefits.

Always perform urinalysis and diagnostic imaging first, and consider whether the anatomy is best suited to a rigid or flexible scope.

When there is a chronic cough with suspected foreign body or for airway fluid sampling.

Diagnostic endoscopy is a minimally invasive technique for diagnosis and treatment of a variety of conditions. It allows the vet to look within an organ or body cavity to evaluate an area of interest and obtain diagnostic samples.

Some examples of diagnostic samples that can be obtained using endoscopy include airway fluid sampling/bronchoalveolar lavage and tissue biopsies (GI tract, nasal mucosa).

Therapeutic endoscopy is a means of enabling a therapeutic procedure, such as the removal of a foreign body from the oesophagus, airway, or stomach, management of an oesophageal stricture, or placement of a gastric feeding tube.

Endoscopy equipment includes scopes (rigid and/or flexible scopes), a bright light source (xenon, metal halide, LED), air insufflation and water irrigation system, suction, video monitor screen, and instruments of an appropriate size for the scope channel.

The ideal light source for endoscopy should provide enough illumination in dark cavities that we are looking into and be compatible with all scopes in the practice.