TECHNIQUE

Endoscopic Removal of Foreign Bodies from the Gizzard (Disease Investigation & Management - Treatment and Care)

Foreign bodies being removed endoscopically. Click here for full-page view with caption Foreign bodies seen on X-ray and removed. Click here for full-page view with caption Forign bodies removed from a crane. Click here for full-page view with caption

Summary Information
Type of technique Health & Management / Disease Investigation & Management / Techniques:
Synonyms and Keywords  
Description In cranes:
  • Provide only water, no food, for 48 hours to try to empty the proventriculus and ventriculus of food.
  • Anaesthetise the crane:
    • Isoflurane 4-5% by mask for induction.
    • Intubate, inflate the cuff of the tube with 1-2 mL air to minimise the risk of gastric fluids entering the trachea.
    • Maintain at 1-3% isoflurane in oxygen at 2 L/minute.
  • Introduce the endoscope (an Olympus 4 channel gastric endoscope, Olympus America, Melville, New York, USA was used for whooping cranes) into the gizzard.
    • A video monitor can be used for viewing.
  • Retrieve foreign objects; grasping forceps or basket forceps may be appropriate.
  • If necessary, roll the crane from side to side to shift the gastric material and make foreign objects accessible to the forceps.
  • If necessary (ingesta still present is obscuring foreign bodies) flush the proventriculus with warm water to improve visualisation of foreign bodies to be removed.
  • Once all objects have been removed, rinse the bird's mouth out.
  • Bring the anaesthesia to an end.
  • Give 100-120 mL fluids either half intravenously and half subcutaneously or all subcutaneously.
  • Once the patient is able to stand unaided, place in a hospital pen.
  • After several hours or overnight, return the bird to its home pen.

(P87.8.w6)

Appropriate Use (?)
  • To remove potentially injurious or toxic objects from the gizzard after their presence has been confirmed using radiography. (B115.8.w4, P87.8.w6)
Notes
  • Removes the need for Ventroculostomy. (P87.8.w6)
  • It is preferable to avoid ingestion of foreign objects. Pens should be checked thoroughly (by sight and using a metal detector) for foreign objects after construction or repair/maintenance work, particularly if outside contractors have been used who may not fully understand the chances of, and risks associated with, foreign body ingestion. (P87.8.w6, V.w5)
Complications/ Limitations / Risk
  • Risks associated with general anaesthesia. (P87.8.w6)
  • Risk of gastric fluid leakage into the trachea. (P87.8.w6)
    • This can be minimised by gentle inflation of the cuff of the endotracheal tube. (P87.8.w6)
Equipment / Chemicals required and Suppliers
  • Standard anaesthetic equipment and consumables.

  • Appropriate endoscope with grasping and basket forceps.

Expertise level / Ease of Use This is a veterinary procedure. This procedure should only be carried out by an individual with appropriate clinical training and practical experience.
Cost/ Availability

The costs of a surgical operation include those associated with: (J15.30.w1)

  • Pre-operative diagnostics (e.g. radiography, ultrasonography, blood tests)
  • Anaesthesia.
  • Perioperative medication (e.g. analgesics, antibiotics, fluids).
  • Surgical preparation (of the operating theatre and the patient, including staff time).
  • Consumables and equipment.
  • Time of the surgeon and assistant(s).
  • Post-operative hospitalisation.
Legal and Ethical Considerations In some countries there may be legislation restricting the use of this type of technique to licensed veterinarians. For example in the UK: "The Veterinary Surgeons Act 1966 (Section 19) provides, subject to a number of exceptions, that only registered members of the Royal College of Veterinary Surgeons may practice veterinary surgery." (See: LCofC1 - RCVS Guide to Professional Conduct 2000 - Treatment of Animals by Non-Veterinary Surgeons).
Author Debra Bourne MA VetMB PhD MRCVS (V.w5)
Referee  
References B115.8.w4, P87.8.w6

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