Laparotomy in horses refers to a surgical procedure involving an incision into the abdominal cavity. It is performed for diagnostic or therapeutic purposes, such as exploring the abdomen, addressing colic, or removing foreign bodies. The procedure requires general anesthesia and is typically conducted in a sterile surgical environment. Post-operative care is critical to ensure proper healing and to monitor for potential complications, such as infection or adhesions. This page compiles peer-reviewed research studies and scholarly articles that explore the techniques, outcomes, and post-operative management associated with laparotomy in equine patients.
Pilati N, Pressanto MC, Beccati F, Pepe M, Venditti R, Gialletti R.The aim of this study was to compare ultrasonographic findings of the ventral midline incision after exploratory laparotomy for colic in horses with and without surgical site infection (SSI). Ultrasonographic examination of the surgical wound was performed on postoperative day 5 (D5) and day 10 (D10) to assess the presence of fluid accumulation, suture sinus formation, hyperechogenic spots and fistulous path. Clinical evaluation of the wound was used to classify horses with and without SSI. The accuracy, sensitivity, specificity and positive and negative predictive values of the ultrasonograph...
Xue C, Segabinazzi L, Hall A, Dzikiti TB, French H, Gilbert R.Clinically, flunixin meglumine (FM) and phenylbutazone (PBZ) are preferentially selected for the treatment of visceral and musculoskeletal pain, respectively, in horses. In donkeys, there is no information to support or refute this conventional conjecture. Objective: To compare postoperative outcomes in a group of jennies treated with intravenous FM or oral PBZ. Methods: Fourteen jennies unilaterally ovariectomised by standing left flank laparotomy. Methods: Retrospective cohort study. Methods: Data from medical records of ovariectomised jennies (case details, weight, non-steroidal anti-inflam...
Fernandez-Barrientos MA, Flynn H, Ratliff B, Kilcoyne I.To highlight the use of procainamide as a potential alternative treatment modality in cases of ventricular tachycardia that are refractory to lidocaine and magnesium sulfate. Methods: 1 adult horse weighing 380 kg. Unassigned: A 25-year-old Arabian gelding presented with severe colic signs. Due to persistent pain, it was elected to carry out an exploratory laparotomy. During the procedure a diagnosis of severe, unstable ventricular tachycardia was made based on the ECG findings, with an initial heart rate of 195 beats per minute and severe hypotension. Results: Initial treatment consisted of d...
Scilimati N, Cerullo A, Nannarone S, Gialletti R, Giusto G, Bertoletti A.Small colon impaction can result in accumulation of ingesta, gas, and fluid orally to the impaction site in horses. Large colon tympany, which is caused by ingesta fermentation, can be a predisposing factor for intestinal displacement. The aim of this study is to report the history, clinical, and surgical findings of horses and ponies referred for abdominal pain not responsive to drugs where a right dorsal displacement (RDD) or large colon volvulus (LCV), together with a small colon faecalith (SCF), were diagnosed during surgery. This study included a total of five horses and five ponies. Base...
Kauter A, Brombach J, Lübke-Becker A, Kannapin D, Bang C, Franzenburg S, Stoeckle SD, Mellmann A, Scherff N, Köck R, Guenther S, Wieler LH....Horse clinics are hotspots for the accumulation and spread of clinically relevant and zoonotic multidrug-resistant bacteria, including extended-spectrum β-lactamase producing (ESBL) Enterobacterales. Although median laparotomy in cases of acute equine colic is a frequently performed surgical intervention, knowledge about the effects of peri-operative antibiotic prophylaxis (PAP) based on a combination of penicillin and gentamicin on the gut microbiota is limited. Unassigned: We collected fecal samples of horses from a non-hospitalized control group (CG) and from horses receiving either a pre-...
Givan SA, Estell KE, Martinez-Lopez J, Brown JA, Wong DM, Werre SR.Diagnosis of colitis has been shown to impact morbidity and mortality in hospitalised horses. There are no studies to date that describe the incidence of infectious colitis after exploratory laparotomy. Objective: To investigate risk factors associated with the development of colitis and infectious colitis post-exploratory laparotomy. Methods: Retrospective case-control. Methods: Medical records of equids admitted from 2011 to 2020 were reviewed. The primary outcome was a diagnosis of colitis following exploratory laparotomy. Bivariable associations between colitis and risk factors were assess...
Shanklin AJ, Archer DC, Baldwin CM.Mesodiverticular bands (MDBs) are an embryonic remnant of the vitelline artery. Information about the clinical significance of equine MDBs is currently limited. Objective: To report the clinical features, surgical findings and outcomes of horses undergoing exploratory laparotomy where a MDB was identified. Methods: Retrospective case series. Methods: Case records of horses undergoing exploratory laparotomy for colic over a 14-year period (2009-2022) were reviewed. MDBs identified at laparotomy were classified as the primary or contributory cause of abdominal pain, or as incidental. Results: MD...
Verhaar N, Kopp V, Pfarrer C, Neudeck S, König K, Rohn K, Kästner S.Pharmacological preconditioning with dexmedetomidine has been shown to ameliorate intestinal ischaemia reperfusion injury in different species, including horses. However, it remains unknown if this effect is related to alpha2 adrenoreceptor activity. Therefore, the aim of this study was to determine the effect of dexmedetomidine preconditioning with and without the administration of the peripheral alpha2 antagonist vatinoxan. This prospective randomized experimental trial included 12 horses equally divided between two treatment groups. Horses in group Dex received a bolus of dexmedetomidine fo...
Munsterman AS, VanderBroek AR, Kottwitz JJ, Watson VE.To compare a novel suture loop method for intestinal biopsies (SLB) with a two-layer, hand-sutured biopsy (HSB) technique in equine small and large intestines. Methods: Experimental, randomized, ex vivo study. Methods: Eight healthy adult horses. Methods: The duodenum, aboral jejunum, and ventral and dorsal large colon were harvested after euthanasia and divided into three sections each. The sections were randomized to SLB, HSB, or control (C, no biopsy) groups. Tissue samples were excised after placement of a suture loop formed by a 4S Roeder knot and oversewn with a Cushing pattern using bar...
Portela DA, Di Franco C, Chiavaccini L, Araos J, Romano M, Otero PE, Biedrzycki AH, Schramel JP.To evaluate the impact of a 30% end-inspiratory pause (EIP) on alveolar tidal volume (V), airway (V) and physiological (V) dead spaces in mechanically ventilated horses using volumetric capnography, and to evaluate the effect of EIP on carbon dioxide (CO) elimination per breath (Vcobr), PaCO and the ratio of PaO-to-fractional inspired oxygen (PaO:FiO). Methods: Prospective research study. Methods: A group of eight healthy research horses undergoing laparotomy. Methods: Anesthetized horses were mechanically ventilated as follows: 6 breaths minute, tidal volume (V) 13 mL kg, inspiratory-to-expir...
Gandini M, Giusto G.Accurate reporting of postoperative complications is paramount to understanding procedural outcomes, comparing procedures and assuring quality improvement. Standardising definitions of complications in equine surgeries will improve the evidence of their outcomes. To this end, we proposed a classification for postoperative complications and applied it to a cohort of 190 horses undergoing emergency laparotomy. Methods: A classification system for postoperative complications in equine surgery was developed. Medical records of horses that underwent equine emergency laparotomy and recovered from an...
Terschuur JA, Coomer RPC, Handel I, Pressanto MC, McKane SA.Skin closure of laparotomy incisions using topical 2-octyl cyanoacrylate (2-OCA) mesh provides a secure bactericidal barrier in humans, which may reduce the risk of postoperative incisional complications. However, the benefits of using this mesh have not been objectively assessed in horses. Methods: From 2009 to 2020, three methods of skin closure were used following laparotomy for acute colic, including metallic staples (MS), suture (ST) and cyanoacrylate mesh (DP). The closure method was not randomised. Owners were contacted 3 months or more after the surgery to record any postop...
Gehlen H, Klein KS, Merle R, Lübke-Becker A, Stoeckle SD.Evaluation of the role of indicator pathogens in equine surgical site infection (SSI) and other infection-promoting factors. Cross-sectional study. Horses presenting with an open injury or surgical colic during 1.5 years. A nasal swab and a faecal sample were collected from every patient upon admission. Furthermore, a wound swab was collected from wounds of injured horses. Details on the wounds and procedures were documented. Laparotomy incisions and injuries were monitored for signs suggesting infection. In total, 156 horses presented because of a surgical colic (n = 48) or open injuries (n...
Vitoria A, Romero A, Barrachina L, Fuente S, Gil L, de Blas I, Vázquez Bringas FJ.Most previously described techniques for laparoscopic inguinal hernioplasty (IH) in horses require advanced laparoscopic skills. Our objective was to describe a new laparoscopic IH technique using a surgical anchoring system. Methods: Standing laparoscopic IH was performed unilaterally in eight experimental stallions, using the contralateral inguinal canal (IC) as a control. A polyether ether ketone harpoon was anchored in the craniolateral aspect of the vaginal ring, and an extracorporeal knot was used to fix the device. Clinical evaluation, including testicular palpation and lameness examina...
Vázquez FJ, Vitoria A, Gómez-Arrue J, Fuente S, Barrachina L, de Blas I, Romero A.First cannulation is a critical manoeuvre in equine laparoscopy. This retrospective study aimed at the comparison of the frequency and type of complications detected when using different human laparoscopy devices for laparoscopic access in standing horses, and the influence of body condition in such complications. Forty-four procedures were included, and retrieved data comprised cannula insertion technique, body condition, and type and frequency of complications. Laparoscopic access techniques were classified into five groups: P: pneumoperitoneum created using Veress needle prior to cannulatio...
Pezzanite LM, Griffenhagen GM, Bass L, Okudaira M, Larson B, Hendrickson DA.Liposomal local anaesthetic solutions may provide extended-duration analgesia postoperatively but have not been assessed following intra-peritoneal local infiltration in any species. Objective: To evaluate two doses of 1.33% liposomal bupivacaine (LB) versus 0.75% bupivacaine HCL (BHCl) for analgesia following laparoscopic ovariectomy in mares. Methods: Prospective cohort study. Methods: Fifteen healthy Quarter Horse mares (age 2-20 years) with normal bilateral ovarian palpation and appearance were enrolled. Horses were restrained in standing stocks and administered an α-2 agonist, butorpha...
Poulsen L, Henriksson FV, Dahl M, Honoré ML, Olsen SN, Leifsson PS, Staerk-Østergaard J, Jacobsen S, Pihl TH.Horses with non-strangulating intestinal infarction (NSII) are often misdiagnosed with idiopathic peritonitis or acute colitis. Early diagnosis is essential to ensure early surgical intervention and improve survival. Clinical and laboratory data from horses admitted to the University of Copenhagen Large Animal Teaching Hospital with NSII, idiopathic peritonitis or acute colitis between 2009 and 2018 were used for univariate comparisons and a multivariable logistic regression model for prediction of NSII. Two hundred and thirty-one horses were included. A multivariable model for the prediction ...
Cerullo A, Gandini M, Giusto G.Laparoscopy is a common approach in equine surgery and has the advantage of improved visibility and diagnostic accuracy, decreased morbidity and hospitalization time. However, despite the numerous benefits, there can be intraoperative and postoperative complications which could have important welfare and economic consequences. The aim of this study was to perform a scoping review to identify current evidence on the occurrence, definition and classification of intra and postoperative complications in equine laparoscopy. A scoping review was conducted in scientific databases. Peer-reviewed scien...
Melo UP, Palhares MS, Ferreira C, Leme FOP, Gheller VA.This study aimed to evaluate the effects of the total parenteral nutrition associated with glutamine, enteral fluid therapy with or without glutamine, and fluid therapy on the acid-base and electrolyte balance of horses starved after exploratory laparotomy. Sixteen healthy male and female adult horses of mixed breed, aged between 4 and 14 years, and having a mean body weight of 248.40 ± 2.28 kg and a body score index of 3-4 (scale of 1-5) were divided into four groups with four animals per group. After an adaptation period of 30 days, they were randomly divided into four experimental groups: ...
Averay K, Wilkins C, de Kantzow M, Simon O, van Galen G, Sykes B, Verwilghen D.Horse owners' motivators and barriers for consent to exploratory laparotomy are poorly understood. Objective: To (1) determine the proportion of Australian and New Zealand horse owners who would consent to exploratory laparotomy and (2) identify motivators and barriers for consent. Methods: Cross-sectional survey. Methods: A questionnaire was developed and distributed online. Descriptive statistics were calculated by tabulating respondents by their answers to whether they would consent to exploratory laparotomy. Univariate and multivariate analyses were used to identify variables associated wi...
Merridale-Punter MS, Prutton JSW, Stefanovski D, Worsman FCF, Payne RJ, Wylie CE, Archer DC, Menzies-Gow NJ, Coles L, McGovern KF, Parker RA.Emergency laparotomies in donkeys are infrequently performed and there is limited literature on the subject. Objective: To determine findings and associated outcomes of exploratory laparotomies in donkeys. Methods: Descriptive retrospective study. Methods: Donkeys undergoing emergency exploratory laparotomy for investigation and treatment of colic at seven UK referral hospitals between 2005-2017 were included. Data were retrieved from available hospital records. Descriptive statistics and inferential statistical analysis of outcomes of interest was performed in three steps. Results: Thirty-thr...
Bishop RC, Gutierrez-Nibeyro SD, Stewart MC, McCoy AM.To evaluate previously published predictive survival models in a population of horses undergoing colic surgery in the midwestern United States. Methods: Retrospective cohort study; single referral hospital. Methods: A total of 260 horses met the inclusion criteria. Methods: Medical records of horses undergoing surgical treatment for colic were reviewed. Previously published models were applied to cohort data to predict outcome. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy for prediction of short-term survival were calculated. Results:...
Marchese GA, Crystal J, Louro LF.Prevalence and risk factors of severe hypoxemia in anesthetized horses undergoing emergency exploratory laparotomy are sparsely documented. The aim of this study was to report incidence of severe hypoxemia ( PaO2 < 60 mmHg) in horses undergoing emergency exploratory laparotomy and identify potential risk factors for this complication. A single center retrospective cross sectional designed was used. Clinical data of 714 horses undergoing general anesthesia for emergency explorative laparotomy were reviewed. A backward stepwise elimination procedure was used to determine the final multivariable ...
Iglesias-García M, Rodríguez Hurtado I, Ortiz-Díez G, De la Calle Del Barrio J, Fernández Pérez C, Gómez Lucas R.The extrinsic and intrinsic characteristics of an equine population may influence the onset of gastrointestinal lesions and affect the survival rate of patients. The equine population in Spain has been the focus of a small number of studies, none of which have involved more than one surgical center. In this retrospective cohort study, we aimed to analyze the survival rate, identify the variables that influenced death, and generate multivariate models using clinical variables. Data were collected from the clinical records of two surgical referral centers in the same region, and a total of 566 h...
Comino F, Röcken M, Gorvy D.To describe a 2-step surgical procedure combining standing laparoscopy with a conventional inguinal approach to treat deep intra-abdominal funiculitis (extended septic funiculitis) after castration. Methods: Retrospective case series. Methods: Twelve client-owned horses. Methods: Medical records of horses treated for extended septic funiculitis with the 2-step surgical procedure were reviewed. Data collected included the initial castration technique, number of surgical interventions for septic funiculitis prior to presentation, clinical signs, diagnostic and surgical procedure, and short-term ...
Fubini SL, Delco M.Urinary surgery in the horse may be challenging. More straightforward procedures, such as urinary bladder or urachal defects, do not usually require specialized equipment or imaging, although laboratory work is helpful. Congenital or acquired conditions of the ureters or kidneys may necessitate advanced diagnostic work-ups including advanced imaging /or and minimally invasive procedures. Some surgery of the lower urinary tract is done in the sedated, standing adult horse. Surgery involving the kidney typically requires general anesthesia. Laparoscopy and associated tools are frequently used. A...
Hovda T, Love L, Chiavaccini L.Hypoxaemia is a common concern during equine general anaesthesia. The prevalence and predictors of hypoxaemia in horses undergoing elective anaesthesia in particular are poorly documented. Objective: To determine and compare the prevalence of hypoxaemia (defined as PaO2 ≤ 80 mm Hg, on the lowest value recorded) in horses undergoing anaesthesia for exploratory laparotomy and elective procedures, and to identify risk factors in both subpopulations. Methods: Retrospective cohort study. Methods: Data were collected from 774 records of 708 horses undergoing general anaesthesia between April 2...
Gandini M, Giusto G.7 horses (3 geldings, 2 mares, and 2 stallions) were examined because of acute colic caused by small intestinal obstruction involving the aborad portion of the jejunum and orad portion of the ileum. All horses underwent a routine colic examination on arrival and had a diagnosis of strangulating obstruction of the small intestine. All horses underwent emergency exploratory laparotomy, in which the affected aborad portion of the jejunum and orad portion of the ileum were resected; in 5 horses, a hand-sewn end-to-end jejuno-ileal anastomosis was combined with a hand-sewn incomplete ileocecal bypa...
Dupont J, Gougnard A, Salciccia A, Detilleux J, Serteyn D, Sandersen C.To compare the efficacy of single-breath continuous positive airway pressure manoeuvre (CPAP-M) with inhaled salbutamol, and a combination of both. Methods: Randomized, clinical study. Methods: A total of 62 client-owned horses (American Society of Anesthesiologists status III-V) anaesthetized for laparotomy. Methods: Horses were premedicated with intravenous (IV) xylazine (0.4-0.6 mg kg), anaesthesia was induced with midazolam (0.06 mg kg IV) and ketamine (2.2 mg kg IV) and maintained with isoflurane in oxygen using volume-controlled ventilation without positive end-expiratory pressure. If Pa...
Louro LF, Robson K, Hughes J, Loomes K, Senior M.In equine anaesthesia, the recovery period is critical, accounting for most anaesthesia-related fatalities reported. Horses may recover unassisted or may be assisted, for example, using a head and tail rope recovery method. Objective: To compare the impact of head and tail rope and unassisted recovery method on quality of recovery in horses undergoing colic surgery under general anaesthesia (GA). Methods: Single centre retrospective cross-sectional study, with prospective model performance analysis. Methods: Clinical data were obtained from horses undergoing emergency exploratory laparotomy ov...
Graubner C, Gerber V, Doherr M, Spadavecchia C.The aim of this study was to refine a multi-dimensional scale based on physiological and behavioural parameters, known as the post abdominal surgery pain assessment scale (PASPAS), to quantify pain after laparotomy in horses. After a short introduction, eight observers used the scale to assess eight horses at multiple time points after laparotomy. In addition, a single observer was used to test the correlation of each parameter with the total pain index in 34 patients, and the effect of general anaesthesia on PASPAS was investigated in a control group of eight horses. Inter-observer variabilit...
Galli C, Crotti G, Notari C, Turini P, Duchi R, Lazzari G.Embryo production by in vitro techniques has increased steadily over the years. For cattle where this technology is more advanced and is applied more, the number of in vitro produced embryos transferred to final recipients was over 30,000 in 1998. An increasing proportion of in vitro produced embryos are coming from oocytes collected from live donors by ultrasound-guided follicular aspiration (ovum pick up, OPU). This procedure allows the repeated production of embryos from live donors of particular value and is a serious alternative to superovulation. Ovum pick up is a very flexible technique...
Lorena SE, Luna SP, Lascelles BD, Corrente JE.The objective of this study was to assess the use of analgesics, describe the attitudes of Brazilian veterinarians towards pain relief in horses and cattle and evaluate the differences due to gender, year of graduation and type of practice. Methods: Prospective survey. Methods: Questionnaires were sent to 1000 large animal veterinarians by mail, internet and delivered in person during national meetings. The survey investigated the attitudes of Brazilian veterinarians to the recognition and treatment of pain in large animals and consisted of sections asking about demographic data, use of analge...
Isgren CM, Salem SE, Archer DC, Worsman FC, Townsend NB.Surgical site infection (SSI) is an important cause of post operative morbidity following laparotomy. Objective: To investigate risk factors for SSI, including effect of season and surgery performed outside normal working hours, and to report bacterial isolates and antimicrobial resistance patterns. Methods: Retrospective cohort study. Methods: Data were obtained from horses that had undergone exploratory laparotomy over a 3-year period (2010-2013) in a UK hospital population. SSI was defined as any purulent or serous discharge from the laparotomy incision of >24 h duration that developed duri...
Smith LJ, Mellor DJ, Marr CM, Reid SW, Mair TS.Post operative complications following exploratory laparotomy can be potentially life-threatening, increase post operative morbidity and result in an increase in the length of hospitalisation of the affected individual. No study has evaluated the efficacy of specific strategies to reduce the incidence of post operative incisional complications. Objective: The use of an abdominal bandage following colic surgery through a celiotomy incision would significantly reduce the prevalence of post operative incisional complications. Methods: A controlled, randomised clinical trial to test the hypothesis...
Hendrickson D.Laparoscopic surgery has become commonplace in the field of equine urogenital surgery. As with most surgical procedures, the limiting factors in developing new surgical techniques are limited to the patient size and demeanor, the skills of the surgeon, and the available equipment. Some of the greatest benefits of laparoscopic surgery in the horse include better visualization of the important structures; tension-free amputation of the testes or ovaries,which generally leads to less postoperative pain; and the ability to evaluate the transected stump carefully to make sure there is no hemorrhage...
Alonso Jde M, Alves AL, Watanabe MJ, Rodrigues CA, Hussni CA.Intra-abdominal adhesions constitute a significant clinical and surgical problem that can lead to complications such as pain and bowel occlusion or subocclusion. These adhesions are frustrating and potentially fatal, representing a major postoperative complication in abdominal surgery. It is estimated that 32% of horses undergoing laparotomy will present clinical symptoms due to adhesions, but the true prevalence is not known because a large proportion of animals with postoperative recurrent colics are medically treated or submitted to euthanasia without necropsy. Adhesions are highly cellular...
Röcken M, Mosel G, Seyrek-Intas K, Seyrek-Intas D, Litzke F, Verver J, Rijkenhuizen AB.To evaluate surgical techniques, perioperative complications and outcome of laparoscopic surgery for unilateral and bilateral ovariectomy in mares. Methods: Retrospective multicenter case series. Methods: Mares (n = 157). Methods: Indications for surgery were neutering, fertility problems, elimination of hormone-related abnormal behavior, ovarian tumors as well as nonregressive ovarian hematomas or cysts. Ovariectomy (n = 206) were performed by a standard laparoscopic procedure in 157 standing sedated mares. Dissection and hemostasis were achieved by using either (1) a linear stapling device, ...
McConachie EL, Giguère S, Rapoport G, Barton MH.To describe heart rate variability (HRV) in horses with acute gastrointestinal disease that undergo exploratory laparotomy. We hypothesized that horses with ischemic gastrointestinal disease will have reduced HRV compared to horses with nonischemic lesions. We further hypothesized that a reduction in HRV will be associated with nonsurvival. Methods: Prospective, clinical, observational study. Methods: University veterinary teaching hospital. Methods: Horses presented for acute colic (n = 57) or elective surgical procedures (n = 10) were enrolled. Methods: Admission heart rate (HR) was recorded...
Costa-Farré C, Prades M, Ribera T, Valero O, Taurà P.Decreased tissue oxygenation is a critical factor in the development of wound infection as neutrophil mediated oxidative killing is an essential mechanism against surgical pathogens. The objective of this prospective case series was to assess the impact of intraoperative arterial partial pressure of oxygen (PaO2) on surgical site infection (SSI) in horses undergoing emergency exploratory laparotomy for acute gastrointestinal disease. The anaesthetic and antibiotic protocol was standardised. Demographic data, surgical potential risk factors and PaO2, obtained 1h after induction of anaesthesia w...
Hendrickson DA.Minimally invasive surgery in the human was first identified in mid 900's. The procedure as is more commonly practiced now was first reported in 1912. There have been many advances and new techniques developed in the past 100 years. Equine laparoscopy, was first reported in the 1970's, and similarly has undergone much transformation in the last 40 years. It is now considered the standard of care in many surgical techniques such as cryptorchidectomy, ovariectomy, nephrosplenic space ablation, standing abdominal exploratory, and many other reproductive surgeries. This manuscript describes the hi...
Colbath AC, Patipa L, Berghaus RD, Parks AH.Incisional complications following exploratory celiotomy increase morbidity, extend hospitalisation and increase cost. Retrospective studies seek to identify risk factors and measures for prevention of surgical site infection. The relatively high incidence of incisional complications following exploratory laparotomy necessitates identification of ideal surgical closure methods. Objective: The study sought to identify the incidence of incisional drainage within our hospital population, and to identify risk factors for incisional complications while determining surgical practices that reduce the...
Reichert C, Kästner SB, Hopster K, Rohn K, Rötting AK.To evaluate the use of a micro-lightguide tissue spectrophotometer for measurement of tissue oxygenation and blood flow in the small and large intestines of horses under anesthesia. Methods: 13 adult horses without gastrointestinal disease. Methods: Horses were anesthetized and placed in dorsal recumbency. Ventral midline laparotomy was performed. Intestinal segments were exteriorized to obtain measurements. Spectrophotometric measurements of tissue oxygenation and regional blood flow of the jejunum and pelvic flexure were obtained under various conditions that were considered to have a potent...
Gorvy DA, Barrie Edwards G, Proudman CJ.The objectives of this study were (1) to determine the prevalence of pathological abdominal adhesion formation following exploratory laparotomy; (2) to establish the site of adhesion formation and its relationship to the initial lesion; (3) to ascertain whether the development of intra-abdominal adhesions decreases long-term survival and (4) to identify risk factors for adhesion formation. Of 1014 horses treated surgically for acute gastrointestinal disease, 113 (10.1%) were subjected to repeat laparotomy, with surgical records available for 99 of these cases. Pathological adhesions were the m...
Desmaizières LM, Martinot S, Lepage OM, Bareiss E, Cadoré JL.To report our experience and complications associated with different cannula insertion techniques for laparoscopy in standing horses. Methods: Retrospective study. Methods: Forty horses that had laparoscopy for diagnostic or surgical purposes. Methods: After a physical examination, including rectal palpation, standing laparoscopy was performed in 40 sedated horses. Local anesthetic was injected at each site of cannula insertion in the left flank. Horses were divided into 5 groups: Pneumoperitoneum was induced before cannula insertion using a Verres needle (group 1, n = 3) or a 12-g catheter (g...
Coomer RP, Mair TS, Edwards GB, Proudman CJ.Incisional drainage and suppuration occurs commonly following exploratory laparotomy; any technique with the potential to reduce the incidence of this complication warrants investigation. Objective: To determine if abandoning the use of subcutaneous sutures in laparotomy wound closure is safe and whether it reduces the risk of suppuration. Methods: A randomised controlled study was carried out at 2 referral hospitals in the UK, involving 309 horses undergoing exploratory laparotomy; 150 horses underwent '2-layer' closure without a subcutaneous suture, while 159 underwent conventional '3-layer'...
Dziubinski N, Mählmann K, Lübke-Becker A, Lischer C.Surgical site infection (SSI) with multiresistant bacteria is an important cause of postoperative morbidity after laparotomy in horses. The objective of this study was to identify bacteria isolates and their antibiotic resistance patterns associated with the development of wound infection in horses after laparotomy. This is a retrospective case series. Medical records of horses that underwent ventral midline exploratory laparotomy in a four-year period at one equine hospital were reviewed. Results of microbiologic culture and susceptibility testing are described. The study group consisted of 1...
McCoy AM, Hackett ES, Wagner AE, Mama KR, Hendrickson DA.To characterize pulmonary gas exchange and arterial lactate in horses with gastrointestinal disease undergoing anesthesia, compared with elective surgical horses, and to correlate these variables with postoperative complications and mortality. Methods: Prospective clinical study. Methods: Horses undergoing emergency laparotomy for acute intestinal disease (n = 50) and healthy horses undergoing elective surgery in dorsal recumbency (n = 20). Methods: Arterial blood gas analysis was performed at predetermined intervals on horses undergoing a standardized anesthetic protocol. Alveolar-arterial ox...
Bishop RC, Gutierrez-Nibeyro SD, Stewart MC, McCoy AM.To evaluate previously published predictive survival models in a population of horses undergoing colic surgery in the midwestern United States. Methods: Retrospective cohort study; single referral hospital. Methods: A total of 260 horses met the inclusion criteria. Methods: Medical records of horses undergoing surgical treatment for colic were reviewed. Previously published models were applied to cohort data to predict outcome. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy for prediction of short-term survival were calculated. Results:...
Dabareiner RM, White NA, Donaldson LL.To determine whether intraluminal distention and subsequent decompression of the equine jejunum affects intestinal blood flow, hemodynamics, and microvascular permeability. Methods: 5 healthy adu t horses. Methods: Horses were anesthestized and underwent exploratory laparotomy. Two jejunal segments were identified as sham-operated or instrumented segments. After baseline values were obtained, intraluminal distention was created in the experimental segment to induce an ntraluminal pressure of 18 cm H2O. After 120 minutes of distention, the intestine was decompressed for 120 minutes. Mesenteric ...
Palmer SE.Laparoscopic laser instrumentation and endoscopic stapling techniques were used to perform 10 unilateral ovariectomy procedures on 5 standing Thoroughbred mares. In all instances, mares had a clinically normal reproductive tract and estrous cycle, and ovariectomy was performed to eliminate regular estrous behavior. All procedures were accompanied by minimal trauma and uncomplicated postoperative recovery. Mares were able to resume normal activity 2 weeks after surgery. Regular estrous behavior was eliminated in all 5 mares, although 1 mare continued to have signs of estrous behavior occasional...
Smith LJ, Mair TS.It is a clinical impression that horses diagnosed with a right dorsal displacement (RDD) of the large colon, are more likely to suffer from recurrent episodes of colic post operatively, compared to other forms of nonstrangulating large colon displacement. Objective: To investigate whether the type of nonstrangulating large colon displacement identified at exploratory laparotomy would influence long-term outcome. Objective: Horses identified with a RDD of the large colon at exploratory laparotomy would be more likely to experience recurrent episodes of post operative colic than other types of d...
Mair TS, Hillyer MH, Taylor FG.The clinical signs in 21 adult horses affected by peritonitis (unassociated with gastrointestinal rupture or surgical interference of the abdomen) included colic (18 cases), pyrexia (15 cases), weight loss (six cases) and diarrhoea (five cases). The diagnosis was based on a nucleated cell count in peritoneal fluid greater than 10(10)/litre. Haematological abnormalities (either neutropenia or neutrophilia) were present in 17 animals, and hyperfibrinogenaemia was identified in 14. Twelve of the 21 horses survived after intensive antibiotic therapy; the other nine were destroyed either at explora...
Ragle CA, Schneider RK.Eleven mares and four mules were ovariectomized by a ventral abdominal laparoscopic technique. This approach required tilting the operative table about 30 degrees elevating the pelvis to allow observation of the ovaries. A triangulation technique with a single laparoscopic portal and four instrument portals was used. The ovarian pedicles were ligated and the ovaries were removed through a single enlarged instrument portal. Females ranged in age from 5 months to 18 years. Mean operative time was 44 minutes (range 20 to 90 minutes); mean operative time of the last seven animals was 26 minutes. S...
Hendrickson DA.This article describes surgical complications associated with laparoscopy, how to avoid them, how to recognize them if they do happen, and how to deal with them in the most expedient method possible. Complications of sedation, anesthesia, positioning, the general surgical approach, and complications associated with specific surgical procedures are examined. The best defense against surgical complications is a thorough training program and an understanding of anatomy that will help the surgeon work in the three-dimensional environment while being limited to two dimensions on the monitor. The au...
Wilderjans H, Meulyzer M, Simon O.To describe a standing laparoscopic peritoneal flap hernioplasty (PFH) technique for closure of the vaginal ring, and to evaluate its effect on prevention of recurrent herniation in stallions, previously treated for acquired strangulating inguinal hernia (SIH). Methods: Case series. Methods: Stallions (n = 30) aged 3-15 that had previous acquired SIH. Methods: Bilateral standing laparoscopic PFH was performed on 30 stallions that had previous acquired SIH treated without castration. The vaginal rings were approached from 3 portals, 2 in the paralumbar fossa and a 3rd between the 17th and 18th ...
Colbath AC, Hackett ES, Lesser CS, Hendrickson DA.To develop a novel technique for left paralumbar laparoscopic bilateral ovariectomy in standing, sedated mares. Methods: Prospective descriptive clinical study. Methods: Twelve client-owned mares. Methods: Healthy mares with normal ovarian palpation and ultrasonographic appearance were enrolled. Horses were restrained in standing stocks and administered a variable rate infusion of sedation. A left paralumbar bilateral ovariectomy was performed with 1 laparoscopic and 3 instrument portals. Access to the right ovary was facilitated by retracting the descending colon and associated mesentery with...
Elarbi MM, Ragle CA, Fransson BA, Farnsworth KD.OBJECTIVE To develop and validate a simulation model for laparoscopic ovariectomy in standing horses. DESIGN Prospective cohort study. SAMPLE 15 third-year veterinary students and 4 equine surgeons with experience in laparoscopy. PROCEDURES A simulation model that mimicked laparoscopic ovariectomy in standing horses was developed. Face validity of the model was determined with a questionnaire completed by the equine surgeons. Construct validity was determined by comparing performance scores (based on time to completion and accuracy completing various operative tasks) for simulated laparoscopic...
Cokelaere SM, Martens AM, Wiemer P.To describe use of a polyamide tie-rap to ligate the mesovarium during standing laparoscopic ovariectomy in mares. Methods: Prospective study. Methods: Ten mares. Methods: Bilateral ovariectomy was performed in 10 mares. Standing laparoscopic ovariectomy was performed using 3 portals in the paralumbar fossa. A commercial polyamide tie-rap was prepared as a loop and marked with 4 colored lines close to the buckle, to enable us to check whether the loop was tightened securely. The ovary was grasped with forceps and after the mesovarium was minimally transected cranially and caudally, the loop of...
