Integrated Courses** | College of Veterinary Medicine

Two integrated courses are available for individuals desiring hands-on training. Both include comprehensive online training, which occurs during a set timeframe leading up to the course and must be completed prior to the onsite laboratories. Onsite laboratories focus on maximizing ‘scope time’, with lecture limited to group debriefing sessions. A mixture of dry, cadaveric and live animal laboratories are used to facilitate mastery of presented material, with the expectation that participants will be ready to ‘Scope On!’ upon course completion.

The summer offering includes 4 days (approximately 36 hours) of onsite training, during which participants cultivate proficiency in flexible and rigid scope and instrument handling and cleaning; laser physics, handling and safety; laser lithotripsy; cystoscopy, rhinoscopy, bronchoscopy, upper and lower gastrointestinal endoscopy, and associated advanced procedures. The spring offering includes 1 additional day of laboratory, devoted to laparoscopy, resulting in a total of 5 days (approximately 44 hours) of onsite training.

See below for details on the comprehensive online training and onsite laboratories. Each course includes breakfast, lunch and snack during the laboratories. If the minimum number of registrants is not met, the course will be cancelled and all registration fees will be refunded.

Spring offering (includes 5 days of onsite training), 64 CE hours – full.
- Please contact Barbara Campbell @ bcampbe4@utk.edu if you would like to be placed on a waitlist for the Spring session.
Summer offering (includes 4 days of onsite training), 56 CE hours – register online now.

Online Modules

Online training is administered in approximately 15- to 30-minute modules that may be replayed individually for integration into the typical clinician’s busy lifestyle. Information covered includes equipment required, case selection and anesthetic considerations, procedural techniques, tips and tricks, and complications. After each topic is completed, a quiz will be given to assess the participant’s learning.

The Flexible Endoscope: Anatomy of the Flexible EndoscopeBasic scope function and anatomy will be reviewed, with special attention given to selection considerations and troubleshooting.
The Flexible Endoscope: Other InstrumentationAppropriate scope handling and manipulation will be reviewed. The trifecta of patient, tower, and endoscopist positioning – and its impact on procedure outcome – will also be discussed.
The Flexible Endoscope: Handling and ManipulationAppropriate scope handling and manipulation will be reviewed. The trifecta of patient, tower, and endoscopist positioning – and its impact on procedure outcome – will also be discussed.
The complex task of scope disassembly and cleaning will be broken down into easy to understand and manage steps. Cleaning of flexible instruments will also be reviewed.
Flexible Endoscope Final Exam

The Rigid Endoscope: Anatomy of the Rigid Endoscope and Other InstrumentationBasic scope function and anatomy of the rigid endoscope, variations in scope tower components, and rigid endoscope instruments will be discussed.
The Rigid Endoscope: Handling, Manipulation, and CleaningEssentials of successful rigid scope handling and common areas of disaster are broken down, followed by a step by step review of cleaning of rigid equipment.
The Rigid Endoscope Final Exam

Ancillary Equipment: Laser Physics, Handling and SafetyFundamentals of laser design and physics are discussed with focus on clinical application and laser selection. Finally, core tenets of laser handling , safety, and maintenance are reviewed.
Ancillary Equipment: Ancillary EquipmentThis module will reviewed supplemental equipment commonly used for laparoscopic and thoracoscopic procedures with a focus on ideal technique.
Ancillary Equipment Final Exam

Cystoscopy: Overview and Transurethral Cystoscopy in the FemaleGeneral advantages, disadvantages and indications for cystoscopy are reviewed, after which the particulars of transurethral cystoscopy in the female are described.
Cystoscopy: Transurethral Cystoscopy in the Male, Prepubic CystoscopyPerformance of cystoscopy in the male dog will be reviewed with attention given to both use of a standard transurethral versus a perineal approach. Non-urethral approaches for cystoscopy will also be described.
Cystoscopy: Special ProceduresUrethral bulking, ectopic ureter correction, laser lithotripsy, and urethral stents are discussed. Indications, advantages, disadvantages and particulars of procedure performance are covered.
Cystoscopy Final Exam

Rhinoscopy: Overview and Retrograde RhinoscopyGeneral advantages, disadvantages and indications for rhinoscopy are reviewed, after which the particulars of retrograde rhinoscopy is described.
Rhinoscopy: Antegrade RhinoscopyNavigation of the dorsal, middle and ventral meatuses during antegrade rhinoscopy will be explained, as well discussion of keys to procedure performance and collection of diagnostic samples.
Rhinoscopy: Special Rhinoscopic ProceduresManagement of sinonasal aspergillosis and nasopharyngeal stenosis are discussed, with special discussion of cases with concurrent nasal conditions.
Rhinoscopy Final Exam

Bronchoscopy: Overview and TracheoscopyGeneral advantages, disadvantages, indications and complications of bronchoscopy are discussed, with particular attention given to patient oxygenation. Tracheoscopy technique and grading of tracheal collapse then are reviewed.
Bronchoscopy: BronchoscopyOxygenation during bronchial intubation, navigation and evaluation of the bronchi, and the impact of rotation control are dissected.
Bronchoscopy: Bronchoscopic ProceduresBronchoalveolar lavage (BAL), the keystone bronchoscopic procedure, is thoroughly reviewed. Discussion of BAL is followed by details on airway biopsy, tracheal mass resection and foreign body retrieval, as well as a detailed tutorial on tracheal stenting.
Bronchoscopy Final Exam

Esophagogastroduodenoscopy: Overview and Basic TechniqueGeneral indications, advantages, disadvantages, and complications of upper gastrointestinal endoscopy are discussed, followed by details on exploring the esophagus, stomach and duodenum.
Esophagogastroduodenoscopy: Diagnostic SamplingCriteria for ideal forceps selection under differing biopsy conditions are briefly reviewed. This is followed by a discussion of the differing techniques for biopsy collection, important sample handling considerations, and the impact of staining on diagnostic capability.
Esophagogastroduodenoscopy: Foreign body retrievalLocation of foreign bodies, risk factors, and impact of timing of retrieval on outcome are broken down, followed by discussion of techniques with examples given of retrieval of differing types and locations of objects.
Esophagogastroduodenoscopy: Esophageal stricture correctionTheoretical advantages and disadvantages of bougienage and balloon dilation are contrasted. Management of initial esophageal strictures, recurrent strictures, and panesophageal strictures is presented, with cases used to highlight key factors in procedure performance.
Esophagogastroduodenoscopy: Feeding tube placementPlacement of homemade gastrostomy tubes, one-step buttons, and replacement gastrostomy tubes is described and illustrated using cases. Jejunostomy, nasojejunostomy and esophagojejunostomy tubes are also discussed. Particular attention is given to contraindications and complications of tube placement… read more
Esophagogastroduodenoscopy Final Exam

Colonoscopy, plus: Overview and patient preparationGeneral indications, advantages, disadvantages, and complications of colonoscopy and ileoscopy are reviewed. Equipment necessary for colonoscopy is reviewed with anatomy and use of proctoscopy included. Keys to achieve optimal preparation of the lower bowel are also discussed.
Colonoscopy, plus: Basic TechniqueDiagnostic colonoscopy and ileoscopy are described, with particular attention given to discussion of common navigational challenges, anatomic factors that contribute to them, and adjustments in technique to maximize success. Sampling techniques unique to the descending colon are demonstrated.
Colonoscopy, plus: Capsule endoscopyGeneral indications, limitations and complications of capsule endoscopy are reviewed. The specifications of different types of endoscopy capsules are broken down, along with their advantages and disadvantages, to allow selection of the capsule endoscopy system best suited to the endoscopist’s needs…. read more
Colonoscopy, plus Final Exam

Laparoscopy: Basic Overview and Restraint
Indications and contraindications for laparoscopy, necessary instrumentation, and important anesthetic considerations are presented.

Laparoscopy: Patient positioning and entry techniques
Patient preparation, commonly used positions, and types of laparoscopic approach will be presented with special attention paid to selecting of the best approach for each procedure.

Laparoscopy: Laparoscopic Explore
First entry and placement of cannulae, along with complications, are reviewed. Several examples of general exploration are presented, followed by a discussion of closure steps and tips/tricks for laparoscopy.

Laparoscopy: Laparoscopic Procedures
Biopsy of liver, pancreas, and spleen are presented. Application of Gelfoam and performance of cholecystocentesis are also discussed.

Laparoscopy: Laparoscopic Procedures, part 2
Performance of renal biopsy and full-thickness intestinal biopsy are discussed, followed by review of jejunostomy feeding tube placement. The module concludes with a discussion of tips and tricks.

Laparoscopy Final Exam

Onsite Laboratories*

(Day 5 is for Spring Courses only)

Time	Day 1	Day 2	Day 3	Day 4	Day 5 Spring Course Only
8:00 am				Breakfast & day overview
8:30 am	Breakfast & day overview			Gastrointestinal endoscopy	Laparoscopy
9:00 am	Scope Handling and Stereotactics	Laser Training and Rhinoscopy	Cystoscopy, part 2 (plus Rhinoscopic Odds and Ends)
10:00 am
11:00 am
12:00 pm	Lunch
1:00 pm	Scope Cleaning (plus Handling & Stereotactics)	Cystoscopy, part 1 (Laser Training continues)	Bronchoscopy
2:00 pm
3:00 pm				Lunch
4:00 pm	Wrap-up			Feeding tube placement	Feeding tube placement
5:00 pm		Wrap-up	Wrap-up	Wrap-up	Wrap-up

*Lab times may vary slightly between offerings

In this laboratory, participants will learn the different components of flexible and rigid endoscopy towers; connect and power up a tower, fiberoptic scope, videoscope and rigid telescope; properly hold and manipulate rigid and flexible scopes (and what happens when proper technique is not used); navigate simulated airway and intestinal tracts and practice foreign body retrieval and biopsy; and use laparoscopic instruments for performance of rigid endoscopic skills.

During this laboratory, participants will identify and correctly name rigid endoscopy instruments; learn proper disassembly, cleaning, and reassembly techniques for flexible and rigid scopes; and continue developing of handling and stereotactic skills.

In this laboratory, participants will review laser physics and safety; learn to safely operate a laser as a team and maintain laser fibers; apply appropriate technique for tissue resection and urolith disruption in a trainer; connect and power up a tower for rhinoscopy; performed retrograde and antegrade rhinoscopy in dog and cat cadavers, including practicing a variety of biopsy techniques; and apply previously learned skills to appropriately disassemble and clean endoscopic equipment.

During this laboratory, participants will continue laser training by group; connect equipment and power up a tower for cystoscopy; perform cystoscopy and vaginoscopy (± stone retrieval and laser lithotripsy) in dog and cat cadavers; and apply previously learned skills to appropriately disassemble and clean endoscopic equipment.

In this laboratory, participants will connect equipment and power up a tower for cystoscopy; perform and observe cystoscopy in a female dog with special attention devoted to ureteral localization and normal ureteral peristalsis; document vaginoscopic and cystoscopic findings, and apply previously learned skills to appropriately disassemble and clean endoscopic equipment. After completion of the live animal portion of the laboratory, participants will perform infraorbital nerve blocks, apply instrumentation necessary for sinonasal antifungal infusions, and participate in or observe cystoscopic-assisted cystotomy in a cadaveric dog.

During this laboratory, participants will perform bronchoscopy in a systematic manner using bronchoscopic maps, collect bronchoalveolar lavage samples, perform or observe endoscopically captured laryngeal function examinations, and apply previously learned skills to appropriately disassemble and clean endoscopic equipment.

In this laboratory, participants will perform upper gastrointestinal endoscopy, remove foreign bodies and collect gastrointestinal biopsies, perform lower gastrointestinal endoscopy, and apply previously learned skills to appropriately disassemble and clean endoscopic equipment. After completion of the live animal portion of the laboratory, participants will have the opportunity to perform PEG or esophagojejunostomy tube placement in a cadaveric dog.

During this laboratory, participants will drape in a patient for laparoscopy; perform Veress needle placement, insufflation, and sharp cannula introduction in lateral recumbency; using high pressure pneumoperitoneum; perform camera-monitored sharp or blunt cannula placement in lateral, dorsal or both recumbencies; complete a basic laparoscopic exploration in both lateral and dorsal recumbency; biopsy liver, pancreas, kidney +/- intestine, lymph node, spleen; perform laparoscopic-assisted cholecystocentesis and jejunostomy tube placement (if desired), and apply previously learned skills to appropriately disassemble and clean endoscopic equipment. After completion of the live animal portion of the laboratory, participants will have the opportunity to perform PEG or esophagojejunostomy tube placement in a cadaveric dog.