This module will cover the history of endoscopy and the development of instrumentation to current day including current applications of endoscopy and minimally invasive surgery in human and veterinary surgery. The structure, function and care of the rigid and flexible endoscope will be covered in detail together with advice on suitable instrumentation for different situations in general practice. Accessory instrumentation will also be discussed in detail and available for use in a dry lab environment. Special attention will be given to the use of electrosurgery and electrosurgical equipment in Minimally Invasive Surgery (MIS) as this is an important means of haemostasis and requires special care in this field. Finally advice on incorporating endoscopy into general practice will enable you to realise a realistic return on your investment.

Key Learning Objectives:

• Review the history and current applications of endoscopy in human surgery and relate this to current veterinary practice
• Endoscopic instrumentation including rigid and flexible endoscopes
• Discuss the application of accessory instrumentation and electrosurgery for rigid and flexible endoscopy
• Learn how to incorporate endoscopy into a veterinary practice
• Become familiar with how to clean and care for the equipment
• Understand the use and application of electrosurgery to minimally invasive technique

 Speaker: Philip Lhermette BSc (Hons) CBiol FRSB BVet Med FRCVS

Philip Lhermette

BSc (Hons) CBiol FRSB BVet Med FRCVS

Philip is the principal of Elands Veterinary Clinic, near Sevenoaks in Kent where he runs a referral service in minimally invasive surgery. After completing an Honours Degree in Animal Physiology at the University of Nottingham in 1977, Philip went on to complete his BVetMed at the Royal Veterinary College, London, in 1982. Philip has a particular interest in surgery – and more specifically, minimally invasive (keyhole)surgery using both rigid and flexible endoscopes. Philip trained with human minimally invasive surgeons in the UK and veterinary endoscopists in the USA since 1995 and he pioneered laparoscopic bitch spays and laser endosurgery in veterinary medicine in the UK since 2001. Philip is also author and editor of the BSAVA Manual of Canine and Feline Endoscopy and Endosurgery and has contributed to numerous other publications. He is currently Special Lecturer in Endoscopy and Endosurgery at the University of Nottingham School of Veterinary Medicine

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By using a mixture of didactic, video-based and hands-on practical teaching, this module will cover the techniques of using and caring for flexible endoscopes based on an understanding of their construction and capabilities. Instruction in diagnostic lower gastrointestinal flexible endoscopy will cover patient preparation and endoscopic techniques using a model. The module will enhance your abilities to recognise abnormalities and obtain diagnostic samples.

Key learning objectives:

• Discuss the indications for lower gastrointestinal endoscopy
• Understand the possible complications of lower gastrointestinal endoscopy
• Review patient preparation and general endoscopic technique
• Appreciate the normal endoscopic appearance of ileum, colon, caecum and rectum
• Practise techniques using anatomical models

 Speaker: Ed Hall VetMB MA,PhD,DipECVIM-CA MRCVS

Ed Hall

VetMB MA,PhD,DipECVIM-CA MRCVS

Ed Hall is Professor of Small Animal Internal Medicine at the University of Bristol’s School of Veterinary Sciences. He has clinical and research interests in small animal gastroenterology and regularly performs flexible gastrointestinal endoscopy. He wrote two chapters in their BSAVA Manual of Canine and Feline Endoscopy & Endosurgery.

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By using a mixture of didactic, video-based and hands-on practical teaching, this course will cover the techniques for diagnostic upper gastrointestinal flexible endoscopy, using anatomical models, and will cover patient preparation and endoscopic techniques. The module will enhance your abilities to intubate the duodenum and to recognise abnormalities in the upper GI tract and to obtain diagnostic samples.

Key learning objectives:

• Discuss the indications for upper gastrointestinal endoscopy
• Revise the possible complications of upper gastrointestinal endoscopy
• Understand patient preparation and general endoscopic technique
• Appreciate the normal endoscopic appearance of oesophagus, stomach and duodenum
• Review biopsy techniques
• Practise techniques using anatomical models

 Speaker: Ed Hall VetMB MA,PhD,DipECVIM-CA MRCVS

Ed Hall

VetMB MA,PhD,DipECVIM-CA MRCVS

Ed Hall is Professor of Small Animal Internal Medicine at the University of Bristol’s School of Veterinary Sciences. He has clinical and research interests in small animal gastroenterology and regularly performs flexible gastrointestinal endoscopy. He wrote two chapters in their BSAVA Manual of Canine and Feline Endoscopy & Endosurgery.

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By using a mixture of didactic, video-based and hands-on practical teaching, this module will cover the techniques of using flexible end, with practice in models. It will cover patient preparation and endoscopic techniques. The module will enhance your abilities to recognise abnormalities and obtain diagnostic samples. Therapeutic uses of endoscopy, including removal of foreign bodies and placement of feeding tubes will also be demonstrated.

Key learning objectives:

• Discuss the indications for respiratory tract endoscopy
• Be aware of the possible complications of respiratory tract endoscopy
• Review patient preparation and general endoscopic technique for examination of upper and lower respiratory tracts
• Understand normal endoscopic appearance of nasal cavity, larynx, trachea and bronchi
• Consider sample collection techniques
• Improve your abilities in foreign body retrieval and feeding tube placement techniques
• Practise techniques using anatomical models

 Speaker: Ed Hall VetMB MA,PhD,DipECVIM-CA MRCVS

Ed Hall

VetMB MA,PhD,DipECVIM-CA MRCVS

Ed Hall is Professor of Small Animal Internal Medicine at the University of Bristol’s School of Veterinary Sciences. He has clinical and research interests in small animal gastroenterology and regularly performs flexible gastrointestinal endoscopy. He wrote two chapters in their BSAVA Manual of Canine and Feline Endoscopy & Endosurgery.

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The basic technique for efficient rhinoscopic examination of the nasopharynx, nose and para-nasal sinuses will be discussed in detail along with biopsy techniques and common nasal pathology including neoplasia. Laser debulking of nasal masses will be discussed and diagnosis and treatment of nasal aspergillosis using a minimally invasive technique will also be covered. Endoscopic examination of pharyngeal stick injuries and other traumatic wounds and fistulas will also be discussed. There will be ample opportunity to practise these techniques in a wet-lab environment.

Key learning objectives:

• Understand the range of rigid endoscopic equipment available for examination of the upper respiratory tract
• Perform a thorough endoscopic examination of the upper respiratory tract using a rigid endoscope
• Examine the frontal sinuses
• Recognise common nasal pathology and treat nasal aspergillosis
• Discuss other ‘oscopies’ including exploration of stick injuries and fistulae
• Practise the above techniques in a wet-lab environment

 Speaker: Philip Lhermette BSc (Hons) CBiol FRSB BVet Med FRCVS

Philip Lhermette

BSc (Hons) CBiol FRSB BVet Med FRCVS

Philip is the principal of Elands Veterinary Clinic, near Sevenoaks in Kent where he runs a referral service in minimally invasive surgery. After completing an Honours Degree in Animal Physiology at the University of Nottingham in 1977, Philip went on to complete his BVetMed at the Royal Veterinary College, London, in 1982. Philip has a particular interest in surgery – and more specifically, minimally invasive (keyhole)surgery using both rigid and flexible endoscopes. Philip trained with human minimally invasive surgeons in the UK and veterinary endoscopists in the USA since 1995 and he pioneered laparoscopic bitch spays and laser endosurgery in veterinary medicine in the UK since 2001. Philip is also author and editor of the BSAVA Manual of Canine and Feline Endoscopy and Endosurgery and has contributed to numerous other publications. He is currently Special Lecturer in Endoscopy and Endosurgery at the University of Nottingham School of Veterinary Medicine

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The module will cover basic video-otoscopy techniques including the examination of the external ear canal and tympanic bulla. The technique of myringotomy will be discussed in detail together with collection of diagnostic samples from the ear. Examination of the lower urinary tract of the bitch and queen will be covered in detail including instrumentation and technique. Diagnosis and treatment of common pathology including paramesonephric remnants, ectopic ureters, urinary sphincter mechanism incontinence and transitional cell carcinoma will also be covered and there will be ample opportunity to practise these techniques in a wet lab environment.

Key learning objectives:

• Discuss the indications for otoendoscopy, urethrocystoscopy and vaginoscopy
• Understand the possible complications of the above examinations
• Review patient preparation and general endoscopic techniques for the above examinations in male and female dogs and cats
• Familiarise yourself with the normal endoscopic appearance of the ear, vagina, urethra and bladder
• Learn biopsy and sampling techniques as well as the treatment of some common conditions
• Practise techniques in a wet-lab environment

 Speaker: Philip Lhermette BSc (Hons) CBiol FRSB BVet Med FRCVS

Philip Lhermette

BSc (Hons) CBiol FRSB BVet Med FRCVS

Philip is the principal of Elands Veterinary Clinic, near Sevenoaks in Kent where he runs a referral service in minimally invasive surgery. After completing an Honours Degree in Animal Physiology at the University of Nottingham in 1977, Philip went on to complete his BVetMed at the Royal Veterinary College, London, in 1982. Philip has a particular interest in surgery – and more specifically, minimally invasive (keyhole)surgery using both rigid and flexible endoscopes. Philip trained with human minimally invasive surgeons in the UK and veterinary endoscopists in the USA since 1995 and he pioneered laparoscopic bitch spays and laser endosurgery in veterinary medicine in the UK since 2001. Philip is also author and editor of the BSAVA Manual of Canine and Feline Endoscopy and Endosurgery and has contributed to numerous other publications. He is currently Special Lecturer in Endoscopy and Endosurgery at the University of Nottingham School of Veterinary Medicine

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The module will cover the basic approach and principles of laparoscopy in the dog and cat. Basic laparoscopic procedures will be covered and several laparoscopic procedures will be covered in detail including liver, pancreas and other organ biopsy techniques, full thickness bowel biopsy, laparoscopic gastropexy and GI foreign body removal, jejunostomy tube placement and cryptorchidectomy. Laparoscopic assisted cystoscopy will also be covered and there will be ample opportunity to practise laparoscopic techniques and instrument handling in a dry and wet-lab environment.

Key learning objectives:

• Discuss the indications for laparoscopy
• Understand the possible complications of laparoscopy
• Review patient preparation and general endoscopic technique for laparoscopy
• Become familiar with normal endoscopic appearance of the abdominal cavity and its organs
• Consolidate your organ biopsy techniques
• Practise techniques in a wet-lab environment

 Speaker: Philip Lhermette BSc (Hons) CBiol FRSB BVet Med FRCVS

Philip Lhermette

BSc (Hons) CBiol FRSB BVet Med FRCVS

Philip is the principal of Elands Veterinary Clinic, near Sevenoaks in Kent where he runs a referral service in minimally invasive surgery. After completing an Honours Degree in Animal Physiology at the University of Nottingham in 1977, Philip went on to complete his BVetMed at the Royal Veterinary College, London, in 1982. Philip has a particular interest in surgery – and more specifically, minimally invasive (keyhole)surgery using both rigid and flexible endoscopes. Philip trained with human minimally invasive surgeons in the UK and veterinary endoscopists in the USA since 1995 and he pioneered laparoscopic bitch spays and laser endosurgery in veterinary medicine in the UK since 2001. Philip is also author and editor of the BSAVA Manual of Canine and Feline Endoscopy and Endosurgery and has contributed to numerous other publications. He is currently Special Lecturer in Endoscopy and Endosurgery at the University of Nottingham School of Veterinary Medicine

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Minimally invasive surgery has transformed the way surgical procedures have been performed over the past twenty years and many veterinary clinics are now performing many or all of their bitch spays laparoscopically. The benefits are self-evident and the procedure is well received, indeed sought out, by clients. Many clinics already own flexible endoscopy equipment and thus have much of the basic equipment necessary for rigid endoscopy and laparoscopy. Additional equipment and training is required to perform laparoscopy and this expense must be justified.

Most surgeons starting laparoscopy would consider the bitch spay as the core procedure and main reason for investing in the equipment. It is a routine procedure that is done on an almost daily basis and will therefore provide a return on investment as well as providing sufficient practise in technique to enable surgeons to do other, more advanced techniques and expand their repertoire.

Key learning objectives:

• Review the instrumentation necessary for sterilisation surgeries
• Understand the techniques and possible complications of laparoscopic sterilisation procedures
• Consider the choice between ovariohysterectomy / ovariectomy and the benefits of a minimally invasive approach
• Revise the use of electrosurgery devices for haemostasis and cutting
• Discuss the economics of incorporating laparoscopic spays into private practice
• Practise the above techniques in a wet-lab environment

 Speaker: Philip Lhermette BSc (Hons) CBiol FRSB BVet Med FRCVS

Philip Lhermette

BSc (Hons) CBiol FRSB BVet Med FRCVS

Philip is the principal of Elands Veterinary Clinic, near Sevenoaks in Kent where he runs a referral service in minimally invasive surgery. After completing an Honours Degree in Animal Physiology at the University of Nottingham in 1977, Philip went on to complete his BVetMed at the Royal Veterinary College, London, in 1982. Philip has a particular interest in surgery – and more specifically, minimally invasive (keyhole)surgery using both rigid and flexible endoscopes. Philip trained with human minimally invasive surgeons in the UK and veterinary endoscopists in the USA since 1995 and he pioneered laparoscopic bitch spays and laser endosurgery in veterinary medicine in the UK since 2001. Philip is also author and editor of the BSAVA Manual of Canine and Feline Endoscopy and Endosurgery and has contributed to numerous other publications. He is currently Special Lecturer in Endoscopy and Endosurgery at the University of Nottingham School of Veterinary Medicine

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Key learning objectives:

• Consider the instrumentation necessary for arthroscopic procedures
• Discuss common joint pathology
• Understand the indications for arthroscopy
• Review patient preparation and the creation of portals for approaching the elbow, shoulder and stifle joints
• Practise the above techniques in a wet-lab environment

 Speaker: Hannes Bergmann DrMedVet DipECVS MRCVS

Hannes Bergmann

DrMedVet DipECVS MRCVS

Hannes graduated from the University of Veterinary Medicine, Vienna in 2001 and completed an internship at the School of Veterinary Medicine Hannover. Following research in perioperative pain therapy he achieved his Doctorate degree in 2003. After one year in small animal practice he started a three year residency in Small Animal Surgery at the University of Berne, Switzerland. Hannes has worked in referral practice in the UK since 2007 and became a Diplomate of the European College of Veterinary Surgeons in July 2008.

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Key learning objectives:

• Perform an arthroscopic examination of the elbow, shoulder and stifle joints
• Complete some simple arthroscopic surgery of the elbow and shoulder
• Understand the possible complications of the above procedures
• Practise the above techniques in a wet-lab environment

 Speaker: Hannes Bergmann DrMedVet DipECVS MRCVS

Hannes Bergmann

DrMedVet DipECVS MRCVS

Hannes graduated from the University of Veterinary Medicine, Vienna in 2001 and completed an internship at the School of Veterinary Medicine Hannover. Following research in perioperative pain therapy he achieved his Doctorate degree in 2003. After one year in small animal practice he started a three year residency in Small Animal Surgery at the University of Berne, Switzerland. Hannes has worked in referral practice in the UK since 2007 and became a Diplomate of the European College of Veterinary Surgeons in July 2008.

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Exploratory thoracotomy is rarely performed in practice due to patient morbidity and mortality. However, thoracoscopy provides better surgical exposure, a magnified well illuminated image and greatly decreased morbidity and mortality making exploratory thoracoscopy a useful diagnostic and therapeutic tool for the general practitioner. The indications for thoracoscopy will be discussed and the basic principles and approach to the thoracoscopic examination of the chest will be covered. The benefits of the paraxiphoid transdiaphragmatic approach and the intercostal approach will be compared in relation to some common surgical procedures. Biopsy techniques and pericardectomy will be covered in some detail and other thoracoscopic procedures will be reviewed. Instrument handling techniques will be practised in a dry lab environment before practicing actual procedures in a wet lab.

Key learning objectives:

• Review the instrumentation necessary for thoracoscopy procedures
• Describe the indications for diagnostic thoracoscopy
• Revise the approaches to the thoracic cavity – telescope portals
• Understand the techniques for an exploratory thoracoscopy, lung and lymph node biopsies and pericardectomy
• Consider the possible complications of thoracoscopy
• Practise some of the above techniques in a wet-lab environment

 Speaker: Philip Lhermette BSc (Hons) CBiol FRSB BVet Med FRCVS

Philip Lhermette

BSc (Hons) CBiol FRSB BVet Med FRCVS

Philip is the principal of Elands Veterinary Clinic, near Sevenoaks in Kent where he runs a referral service in minimally invasive surgery. After completing an Honours Degree in Animal Physiology at the University of Nottingham in 1977, Philip went on to complete his BVetMed at the Royal Veterinary College, London, in 1982. Philip has a particular interest in surgery – and more specifically, minimally invasive (keyhole)surgery using both rigid and flexible endoscopes. Philip trained with human minimally invasive surgeons in the UK and veterinary endoscopists in the USA since 1995 and he pioneered laparoscopic bitch spays and laser endosurgery in veterinary medicine in the UK since 2001. Philip is also author and editor of the BSAVA Manual of Canine and Feline Endoscopy and Endosurgery and has contributed to numerous other publications. He is currently Special Lecturer in Endoscopy and Endosurgery at the University of Nottingham School of Veterinary Medicine

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Lasers are becoming more common in first opinion veterinary practice and diode lasers in particular lend themselves extremely well to minimally invasive procedures as the laser light is delivered via a flexible fibre that can be passed down the instrument channel of the endoscope. This enables the surgeon to resect tissue, de-bulk tumours and provide haemostasis with extreme precision.

The module will include discussion of the types of laser equipment available as well as the techniques and application of lasers in endoscopy including the treatment of GI, nasal and bladder tumours and for the resection of ectopic ureters. There will be several lasers available for practise of these techniques in the wet lab.

Key Learning Objectives:

• Review the equipment available for laser surgery in animals
• Discuss the use of lasers in conjunction with endoscopy
• Understand how to perform laser de-bulking of tumours in the GI tract, nose and bladder plus resection of ectopic ureters
• Consider the possible complications of laser surgery
• Practise some of the above techniques in a wet-lab environment

 Speaker: Philip Lhermette BSc (Hons) CBiol FRSB BVet Med FRCVS

Philip Lhermette

BSc (Hons) CBiol FRSB BVet Med FRCVS

Philip is the principal of Elands Veterinary Clinic, near Sevenoaks in Kent where he runs a referral service in minimally invasive surgery. After completing an Honours Degree in Animal Physiology at the University of Nottingham in 1977, Philip went on to complete his BVetMed at the Royal Veterinary College, London, in 1982. Philip has a particular interest in surgery – and more specifically, minimally invasive (keyhole)surgery using both rigid and flexible endoscopes. Philip trained with human minimally invasive surgeons in the UK and veterinary endoscopists in the USA since 1995 and he pioneered laparoscopic bitch spays and laser endosurgery in veterinary medicine in the UK since 2001. Philip is also author and editor of the BSAVA Manual of Canine and Feline Endoscopy and Endosurgery and has contributed to numerous other publications. He is currently Special Lecturer in Endoscopy and Endosurgery at the University of Nottingham School of Veterinary Medicine

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