Stephen J. Divers

The Demand for Improved Reptile Surgery

High owner expectations, coupled with the fact that most reptile pets weigh less than 2 kg, means that the reptile surgeon has to contend with two major obstacles:

This need for excellent visualization using a focused light source and magnification have been well-documented and have, in-part, fueled recent developments in minimally invasive endoscopic and endosurgical techniques (see endoscopy chapters).1–3 Nevertheless, we are far from being able to perform most procedures endoscopically; therefore the need for traditional, open surgical techniques in small reptiles remains of paramount importance.

Illumination and Magnification: Video Telescopic Operating Microscope

Traditionally, adequate surgical lighting has been achieved by the use of large, focused overhead light units. While magnification can be achieved with the use of operating microscopes, their expense and reduced maneuverability make them less common in most zoologic practices. Instead, headband or frame-mounted operating loupes with a dedicated light source have gained popularity because they are more affordable, versatile, and simpler to operate.

The recent development of a video telescopic operating microscope (VITOM-25, Karl Storz Veterinary Endoscopy America Inc, Goleta, Calif; www.ksvea.com) has provided another option for delivering high-quality focused illumination and magnification. The VITOM uses existing endoscopy equipment, specifically the light source, camera, and documentation hardware that is common in practices, to perform extracorporeal visualization of surgical procedures.

The VITOM 25 system is composed of a 11-cm, zero-degree rod-lens telescope that is held 25 to 60 cm above the surgical site by means of a mechanical arm that clamps to the operating table (Figure 17-1). The system provides a depth of field of 2 to 6 cm and a range of fields of view and magnifications dependent on the distance from the surgical site (Table 17-1). The articulated, mechanical arm has a single lock mechanism that controls all five joint functions, thereby facilitating easy, rapid positioning. A metal clamp holds the telescope and light guide cable in place. Illumination is controlled at the light source, while the surgeon controls zoom, focus, white balance, and photo/video documentation from the camera. The VITOM system is autoclavable and typically sterilized before placement and positioning by sterile surgical staff. The array of potential uses is vast and includes almost any situation in which microsurgery would be an advantage; however, just one example is provided here.

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