Diagnostic Imaging - Endoscopy / Arthroscopy

Dr. Hylands performing arthroscopy during cruciate repair surgery.

We are thrilled to have recently added medical scopes to our diagnostic imaging equipment. While the various potential uses for these scopes will be discussed in detail below, the overall benefit is that in many cases, we may be able to avoid invasive surgical procedures. This often results in decreased pain and faster recovery, with patients often going home within hours of the procedure.

Gastrointestinal Procedures

Endoscopy and colonoscopy are two major uses for the medical scopes. As mentioned above, they allow us to noninvasively perform procedures, including:

• Biopsies

With the use of the endoscope, we are able to thoroughly investigate the entire upper gastrointestinal tract, including the esophagus, stomach, and the first portion of the small intestine. This allows us to identify abnormal regions, and obtain biopsy samples using a device that is passed through the scope. Without the use of the endoscope, traditionally samples were either taken blindly, potentially missing important localized lesions, or required major abdominal surgery. The scopes can be used similarly throughout the entire length of the colon. This can help to diagnose such conditions as inflammatory bowel disease (IBD) and cancer, both of which can have similar clinical signs with very different treatments.

• Foreign Bodies

Loop instrument grasping battery.We all know that our pets unfortunately may eat some silly things. Some common items are plastic bags, batteries, elastics and coins. These “foreign bodies” can cause obstruction of the small intestine requiring potentially extensive abdominal surgery. (ie. They get stuck in the gut!) If caught early enough when the object is still in the stomach or at the very beginning of the small intestine, an endoscope may be used to visualize and extract the foreign object. (Unfortunately, not all objects are retrievable.) A specialized instrument is passed through the scope such as the one in the image shown here (left). Traditionally this surgery would require a large incision to remove the object from the stomach. When endoscopy is successful, there is no incision required and the patient can return home, happily eating, within a few hours.

Arthroscopic (Joint) Procedures

Arthroscopy is a hugely beneficial part of our use of medical scopes. These scopes can be used to both aid in surgical procedures, such as cruciate ligament repair, and to diagnose joint and skeletal deformations, such as OCD (osteochondritis dissecans) . OCD is a condition common in large breed dogs in which there are cracks in the cartilage, causing pain and degenerative changes such as arthritis.

• Cruciate Procedures

An arthroscopic view of the canine meniscus.Arthroscopy will greatly improve the comfort of our patients undergoing ACL (anterior cruciate ligament) repair. With the full or partial tear of a cruciate ligament, an important part of the corrective surgery is not only repairing the tear, but inspecting the knee joint for other changes. Previously, this involved making a large incision in the capsule to allow visualization of the torn cruciate pieces, and to locate the meniscus – a special cartilage band that prevents the femur and the tibia from rubbing against each other. The pieces of torn cruciate ligament must be removed, otherwise they will calcify and eventually contribute to arthritis of the knee. The meniscus must be inspected for tears, as this could cause poor recovery without treatment. Endoscopy allows this inspection using a much smaller incision than traditional surgery and, in many cases, a faster return to normal function.