Small Animal Endoscopy and Endosurgery

• Understand how to clean and care for flexible endoscopes
• Patient preparation and general endoscopic technique
• Discuss the indications and possible complications of lower gastrointestinal endoscopy
• Understand normal endoscopic appearance of ileum, colon, caecum and rectum
• Practice techniques using anatomical models
• Select instruments that are best suited to their individual practice and patients for a variety of endoscopic techniques including upper and lower GI endoscopy and demonstrate how to use a flexible endoscope
• Describe methods and instrumentation to maximise the potential for gastric and oesophageal foreign body retrieval
• Identify the indications for feeding tube placement and describe optimal techniques and instrumentation for endoscopic placement

• The possible complications of upper gastrointestinal endoscopy
• Describe patient preparation for optimal examination technique for the upper gastrointestinal tract and general technique to enable a thorough examination including intubation of the pylorus
• Understand biopsy techniques
• Practise techniques using anatomical models
• Discuss when upper gastrointestinal endoscopy is indicated and when other techniques may be preferable. Describe what diagnostic procedures should be performed before Upper GI endoscopy
• Distinguish endoscopic appearance of oesophagus, stomach and duodenum in health and disease

• Discuss the indications and possible complications of respiratory tract endoscopy
• Patient preparation and general endoscopic technique for examination of upper and lower respiratory tracts
• Sample collection techniques
• Understand foreign body retrieval and feeding tube placement techniques
• Practise techniques using anatomical models
• Distinguish endoscopic appearance of nasal cavity, larynx, trachea and bronchi in health and disease

• Describe and identify endoscopic instrumentation including rigid and flexible endoscopes, and compare the advantages and disadvantages of each
• Explain how electrosurgery is used in minimally invasive surgery and how this differs from open surgical techniques
• Explain how to clean and care for endoscopic equipment
• Select instruments that are best suited to their individual practice and patients for a variety of endoscopic techniques including bronchoscopy, rhinoscopy, urethrocystoscopy, video-otoscopy, arthroscopy, thoracoscopy and laparoscopy
• Discuss the incorporation of endoscopy and minimally invasive surgery into a veterinary practice

• Identify the anatomy of the nasal meati and describe how to explore them endoscopically
• List the range of rigid endoscopic equipment available for examination of the upper respiratory tract and choose which is best suited to your patient
• List the indications for rigid rhinoscopy and any additional imaging techniques required.
• Demonstrate general endoscopic techniques for examination of the upper respiratory tract using a rigid endoscope.
• Describe the advantages and disadvantages of rigid vs flexible endoscopy in different areas of the upper respiratory tract.
• Outline the importance of correct biopsy technique to get diagnostic samples
• Demonstrate how to examine the frontal sinuses
• Compare normal nasal appearance and common nasal pathology
• Describe how to recognise, diagnose and treat nasal aspergillosis, nasopharyngeal stenosis and nasal tumours including laser ablation for palliation.
• Discuss other ‘oscopies’ including exotics, tracheoscopy, exploration of pharyngeal stick injuries, fistulae and bite wounds.
• Demonstrate general endoscopic techniques for examination of the upper respiratory tract using a rigid endoscope, including biopsies, effectively in a wet-lab environment

Otoendoscopy

• Identify the anatomy of the ear and in particular the sensitive structures of the middle ear
• Demonstrate proficiency at deep ear cleaning using video-otoscopy.
• List the indications for otoendoscopy, and the advantages over traditional otoscopy
• Demonstrate proficiency at myringotomy and examination of the middle ear
• Describe possible complications of otoendoscopy and outline post-operative treatment

Urethrocystoscopy

• Demonstrate proficiency in general endoscopic techniques for urogenital tract examination in the dog and cat
• Compare the appearance of the urogenital tract in health and disease
• Describe options for minimally invasive treatment of conditions such as ectopic ureters, paramesonephric remnants, urethral sphincter mechanism incompetence, strictures and transitional cell carcinoma.
• Explain when to use the laparoscopic cystoscopy approach where transurethral access is not possible or adequate (i.e. for large stones, or in the dog or tom cat)

Vaginoscopy

• Describe patient preparation for urethrocystoscopy
• Describe the normal endoscopic appearance of the vestibule, vagina, urethra and bladder

Describe biopsy and sampling techniques and demonstrate these effectively in a wet lab environment

• Describe the instrumentation necessary for arthroscopic procedures
• Describe common joint pathology in the elbow, stifle and shoulder joints and distinguish the endoscopic appearance of these joints in health and disease.
• List the indications for arthroscopy
• Describe patient preparation and the positioning and creation of portals for elbow, shoulder and stifle arthroscopy
• Demonstrate the above techniques in cadavers in a wet-lab environment

• Demonstrate proficiency at arthroscopic examination of the elbow, shoulder and stifle joints in cadavers in a wet lab environment

• Demonstrate simple arthroscopic surgery of the elbow and shoulder

• Describe the possible complications of the above procedures

• List the indications for laparoscopy and describe the advantages and disadvantages of a minimally invasive technique vs open laparotomy.
• Describe patient preparation for laparoscopy.
• Explain the anaesthetic implications of abdominal insufflation and describe optimal insufflation techniques.
• Demonstrate Veress needle placement and insufflation in a wet lab environment
• Explain the principles of port placement for ergonomic instrument use and optimal tissue handling.
• Compare the normal endoscopic appearance of the abdominal cavity and its organs in health and disease.
• List the possible complications of laparoscopy
• Explain how to set appropriate flow rates and pressures for insufflation in different sized patients for initial port placement and during the procedure
• Demonstrate abdominal organ biopsy techniques (liver, pancreas, kidney, full thickness bowel and spleen) in a wet lab environment
• Describe laparoscopic surgical techniques for gastric or intestinal foreign body removal, cryptorchid castration, laparoscopic assisted splenectomy, cholecystocentesis and laparoscopic assisted cystoscopy and briefly describe the procedure for laparoscopic cholecystectomy
• Describe laparoscopic surgical techniques for gastropexy and laparoscopic cholecystectomy for uncomplicated mucocoele

• Review the principles of haemostasis for laparoscopic surgery including electrosurgery, vessel sealing devices, clips and sutures
• Compare the advantages of ovariectomy vs ovariohysterectomy and define when it is necessary to remove the uterus.
• Compare the techniques for laparoscopic ovariectomy and ovariohysterectomy and demonstrate them in a wet lab environment.
• Compare the advantages and disadvantages of a single port, two port or three port technique for laparoscopic ovariectomy and describe the instrumentation required.
• List the possible complications of laparoscopic surgery.
• Discuss the financial viability of incorporating laparoscopic spays into private practice

• Review the instrumentation necessary for thoracoscopy procedures
• Describe the indications for diagnostic or therapeutic thoracoscopy
• Describe patient preparation and discuss anaesthetic techniques for thoracoscopic surgery
• Identify the approaches to the thoracic cavity, including positioning of telescope portals
• Describe the techniques for an exploratory thoracoscopy, lung and lymph node biopsies and pericardectomy and demonstrate these in a wet lab environment
• Describe the use of minimally invasive techniques for more advanced thoracic surgery such as lung lobectomy, mediastinal masses, PRAA, thoracic duct occlusion and pyothorax
• List the possible complications of thoracoscopy and describe how to deal with them.
• List the contraindications to thoracoscopy

• Summarize a basic understanding of laser physics and principles of use including tissue interactions, contact and non-contact mode, continuous and pulsed
• Review the equipment available for laser surgery in animals.
• Describe how to perform laser debulking of tumours in the GI tract, nose and bladder as well as resection of ectopic ureters
• Describe the possible complications of laser surgery
• Demonstrate some of the above techniques in a wet-lab environment
• Discuss the use of lasers in conjunction with endoscopy and compare the use of diode lasers with Ho:Yag lasers
• Describe how to perform laser lithotripsy