Diagnostic endoscopy of the navicular bursa using a needle endoscope by direct or transthecal approach: A comparative cadaver study.
OBJECTIVE
To compare the practicability, visualization of structures, and iatrogenic damage of direct and transthecal approaches to the navicular bursa for diagnostic needle endoscopy.


METHODS
Descriptive study.


METHODS
Equine cadaver forelimbs (n = 30).


METHODS
Direct and transthecal approaches for insertion of a needle endoscope into the navicular bursa were performed. Video recordings of endoscopic procedures were assessed to determine all structures visualized within the navicular bursa. Number of attempts to gain access to the navicular bursa and total time for insertion and examination were recorded. Distribution and severity of iatrogenic lesions were assessed and scored after dissection.


RESULTS
There were no statistical differences for number of attempts or time needed for insertion and examination between direct and transthecal approaches. The direct approach offered significantly increased visibility of the ipsilateral abaxial and proximal margins of the navicular bone, and ipsilateral collateral sesamoidean ligament. Iatrogenic lesions were superficial and focal, regardless of approach taken, or whether a blunt or sharp trocar tip was used.


CONCLUSIONS
The direct approach provided significantly better visualization of the ipsilateral structures within the navicular bursa compared to the transthecal approach. Needle endoscopy offers a reliable technique to evaluate the navicular bursa and may complement or replace other diagnostic modalities in horses with lameness localized to the navicular region.
Department of Clinical Veterinary Science, Swiss Institute for Equine Medicine, Vetsuisse Faculty University of Berne and ALP-Haras Avenches, Germany.
Kathrin
K
Mählmann
Department of Clinical Veterinary Science, Swiss Institute for Equine Medicine, Vetsuisse Faculty University of Berne and ALP-Haras Avenches, Germany.
Christoph
C
Koch
Gábor
G
Bodó
D000818:Animals; D002061:Bursa, Synovial / Q000601:surgery*; D002102:Cadaver; D002350:Carpus, Animal / Q000601:surgery*; D004724:Endoscopy / Q000295:instrumentation / Q000379:methods* / Q000662:veterinary*; D006736:Horses / Q000601:surgery*; D009339:Needles; D014741:Video Recording