Figure 3.2 Rigid endoscopes used in laparoscopy and thoracoscopy. From bottom to top: 4 mm 30°; 5 mm 0°; 10 mm 0° and 10 mm ENDOCAMELEON variable angle laparoscope.
Source: © KARL STORZ SE & Co. KG, Germany.
Standard surgical telescopes come in a variety of sizes (Figure 3.2). The most versatile and popular rigid telescopes used in small animal laparoscopy and thoracoscopy are 5 mm in diameter and approximately 30 cm in length. Smaller rigid endoscopes, 2.7 or 3 mm in diameter and 14–18 cm long are ideal for cats, puppies, and toy breeds. With a smaller diameter and shorter shaft, these are easier to maneuver in smaller patients but too short in larger patients, and their light‐carrying capacity may be inadequate in larger cavities, due to the small diameter of the telescope. Telescopes larger than 5 mm in diameter have decreased in popularity, mostly because of the improvements in image size and brightness of 5‐mm and smaller telescopes [1–5, 8, 9].
Conversely, the 10 mm diameter operating laparoscope has become popular. It contains optics similar to that of a 5‐mm telescope but has an integrated working channel that allows passage of 5‐mm instruments down the same shaft. Operating scopes are available in two types: right angled or oblique (Figure 3.3). Some surgeons prefer this style of telescope for certain routine procedures such as biopsies, ovariectomies, and lately natural orifice translumenal endoscopic surgery (NOTES) because the instruments are always under visual control. For this reason, an operating telescope may also be recommended for novice endoscopic surgeons [1–5].
Figure 3.3 Operating laparoscopes. (A). Right angled. (B). Oblique.
Source: © KARL STORZ SE & Co. KG, Germany.
The viewing angle of a telescope is an important consideration because it affects both orientation and visual access (Figure 3.4). Standard forward‐viewing telescopes (0°) provide the simplest spatial orientation, centered on the axis of the telescope, but they present a relatively limited viewing field. A 30° distal tip angle allows the surgeon to view a larger area by simply rotating the shaft of the telescope on its longitudinal axis [8, 9]. With experience, the operator becomes proficient at using angled telescopes, thus gaining a wider viewing field. Telescopes with more acute tip angulations are also available (70, 90, and 120°), but they are rarely used in small animal laparoscopy and thoracoscopy [1–5].
Relatively new dynamic‐range rigid telescopes are available with a variable viewing angle, allowing the surgeon to control angulation from 0 to 120°, with a mechanical twisting mechanism near the eyepiece: ENDOCAMELEON – Karl Storz SE & Co. (Figure 3.5). These newer telescopes are currently used for selected procedures, mainly because of their versatile viewing abilities [10–12].
Figure 3.4 Telescope viewing angles. (A). 0°. (B). 30°.
Source: © KARL STORZ SE & Co. KG, Germany.
Figure 3.5 ENDOCAMELEON® telescope with variable viewing angle, adjusted by turning the collar on the eyepiece.
Source: © KARL STORZ SE & Co. KG, Germany.
These variable angle scopes are available in 4 and 10 mm diameter, for different size patients, the smaller size also being used for arthroscopy in humans. These newer scopes provide the surgeon with the ability to evaluate more thoroughly and maneuver the scope more easily, with an emphasis on thoracoscopic surgery. A recent study
