title: Evaluation of transcutaneous pulmonoscopy for examination and biopsy of the lungs of ball pythons and determination of preferred biopsy specimen handling and fixation procedures.
abstract: OBJECTIVE
  To establish a safe and effective technique for the endoscopic examination and biopsy of snake lungs by use of a 2.7-mm rigid endoscope system.
  
  
  METHODS
  Clinical trial.
  
  
  METHODS
  17 adult ball pythons (Python regius).
  
  
  METHODS
  The right lung of each anesthetized snake was transcutaneously penetrated at a predetermined site. Endoscopic lung examination was objectively scored, and 3 lung biopsies were performed. Tissue samples were evaluated histologically for diagnostic quality. One year later, 11 of the 17 snakes again underwent pulmonoscopy and biopsy; specimens were placed in various fixatives to compare preservation quality. All 17 snakes were euthanatized and necropsied.
  
  
  RESULTS
  No major anesthetic, surgical, or biopsy-associated complications were detected in any snake. In 16 of 17 pythons, ease of right lung entry was satisfactory to excellent, and views of the distal portion of the trachea; primary bronchus; intrapulmonary bronchus; cranial lung lobe; and faveolar, semisaccular, and saccular lung regions were considered excellent. In 1 snake, mild hemorrhage caused minor procedural difficulties. After 1 year, pulmonoscopy revealed healing of the previous transcutaneous lung entry and biopsy sites. Important procedure-induced abnormalities were not detected at necropsy. Diagnostic quality of specimens that were shaken from biopsy forceps into physiologic saline (0.9% NaCl) solution before fixation in 2% glutaraldehyde or neutral-buffered 10% formalin was considered good to excellent.
  
  
  CONCLUSIONS
  By use of a 2.7-mm rigid endoscope, lung examination and biopsy can be performed safely, swiftly, and with ease in ball pythons. Biopsy specimens obtained during this procedure are suitable for histologic examination.
authors.affiliation: Stahl Exotic Animal Veterinary Services, 111A Center St S, Vienna, VA 22180, USA.
authors.forename: Scott J
authors.initials: SJ
authors.lastname: Stahl
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Hernandez-Divers
authors.forename: Tanya L
authors.initials: TL
authors.lastname: Cooper
authors.forename: Uriel
authors.initials: U
authors.lastname: Blas-Machado
mesh_terms: D000818:Animals; D001706:Biopsy / Q000379:methods / Q000592:standards / Q000662:veterinary*; D017821:Boidae; D019723:Endoscopes / Q000009:adverse effects / Q000662:veterinary; D004724:Endoscopy / Q000009:adverse effects / Q000379:methods / Q000592:standards / Q000662:veterinary*; D005260:Female; D008168:Lung / Q000473:pathology*; D008297:Male; D013048:Specimen Handling / Q000379:methods / Q000662:veterinary*