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Topic:Laparotomy
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.
Effects of 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. 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: ...
Factors that influence owner consent for exploratory laparotomy in horses with colic in Australia and New Zealand. 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...
Outcome following emergency laparotomy in 33 UK donkeys: A retrospective multicentre study. 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...
Performance of predictive models of survival in horses undergoing emergency exploratory laparotomy for colic. 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:...
Incidence of Severe Hypoxemia in Anesthetized Horses Undergoing Emergency Exploratory Laparotomy. 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 ...
Predictive Models for Equine Emergency Exploratory Laparotomy in Spain: Pre-, Intra-, and Post-Operative-Mortality-Associated Factors. 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...
Standing laparoscopy combined with a conventional inguinal approach to treat extended septic funiculitis in 12 horses. 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 ...
Surgery of the Equine Urinary Tract. 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...
Risk factors associated with hypoxaemia in horses undergoing general anaesthesia: A retrospective study. 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...
Combination of end-to-end jejuno-ileal anastomosis and side-to-side incomplete ileocecal bypass (hybrid jejuno-ileo-cecal anastomosis) following subtotal ileal resection in seven horses. 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...
Comparison of single-breath continuous positive airway pressure manoeuvre with inhaled salbutamol to improve oxygenation in horses anaesthetized for laparotomy. 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...
Head and tail rope-assisted recovery improves quality of recovery from general anaesthesia in horses undergoing emergency exploratory laparotomy. 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...
[Evaluation of clinical examination parameters and a scoring system in equine colic as well as the assessment of their prognostic value]. In horses, colic is associated with relatively high mortality rates. Identification of parameters associated with poor outcome may aid in providing a more accurate prognosis. This study aimed to assess the early prognostic value towards survival of the horse based on parameters of the clinical examination. Methods: In a retrospective study (2013-2017), results of the clinical examination of horses with colic were analyzed. Obtained parameters were categorized from physiologic up to different pathophysiologic manifestations. The risk of death was calculated as odds ratios in comparison to norma...
Standing flank laparotomy for colic: 37 cases. Standing flank laparotomy can be an alternative to ventral midline laparotomy in horses with colic. Standing flank laparotomy avoids general anaesthesia, provides excellent access to some regions of the abdominopelvic cavity and costs less than ventral midline laparotomy. Objective: To report a series of cases of peritoneal and intestinal diseases other than SC diseases managed with standing flank laparotomy. Methods: Retrospective case series. Methods: Records from equids with colic subjected to standing flank laparotomy at five hospitals (2003-2020) were reviewed. Descriptive data analysis w...
Acute abdominal dehiscence following laparotomy: A multicentre, international retrospective study. Incisional complications are a common cause of morbidity following laparotomy. Although uncommon, acute abdominal dehiscence (AAD) is a potentially fatal post-operative complication. However, few AAD cases are described in the literature. Objective: To describe common features of cases of AAD following ventral midline laparotomy, management and outcomes. Methods: Retrospective case series. Methods: Hospital records of horses that underwent a ventral midline laparotomy at nine hospitals in the UK, Ireland and USA over a 10-year period (2009-2019) were reviewed. Data were collected for pre-, int...
Case report: The case of a 17 kg ovarian granulosa cell tumor in a Breton draft mare. Granulosa cell tumor (GCT) is a benign tumor which affects the mare's ovaries. In this report, a case of unilateral GCT in an ovary, which weighed 17.04 kg, of a 9-year-old Breton draft mare is described. A transrectal ultrasonography exam revealed a unilateral multi-cystic enlarged ovary. Laparoscopic ovariectomy was difficult due to enlargement of blood vessels in the ovarian broad ligament. The mare was necropsied, and the pathological changes in the GCT-affected ovary and unaffected ovary were evaluated. The ovarian mass in the GCT-affected ovary had a cribriform pattern and was positive f...
Laparoscopic closure of the vaginal rings in the standing horse using a tacked intraperitoneal slitted mesh (TISM) technique. Indirect inguinal herniation (IIH) is a potentially life-threatening condition in stallions. The ideal preventive measure for breeding stallions ensures a minimally invasive closure of the vaginal ring that avoids recurrence of IIH while preserving both testicles. Objective: To describe a minimally invasive laparoscopic tacked intra-peritoneal slitted mesh (TISM) technique in the standing horse to close the vaginal rings and to evaluate its efficacy in preventing recurrence of IIH in stallions. Methods: Retrospective case series. Methods: Medical records of 17 stallions with a history of IIH w...
Dentigerous Equine Teratoma in a Stallion: Surgical Management and Clinicopathology. Teratoma is a rare germ cell testicular cancer composed of cells that are not normally present in the site where it originates. These tumors are rarely described in horses, where they may develop due to cryptorchidism. Teratomas consist of cells originating from different germinal layers, arising from germinal multi-potential cells with differentiation defects, and can simultaneously contain several tissues from two or more embryonic layers. Testicular teratomas are described in horses, cats, dogs, wild boars, bulls, and humans. In the rare descriptions found in literature of testicular terato...
Use of Clinical Audits to Evaluate Timing of Preoperative Antimicrobials in Equine Surgery at a Veterinary Teaching Hospital. Based on human surgical guidelines, intravenous antimicrobials are recommended to be administered within 60 min of surgical incision. Achieving this target in horses is reportedly challenging and influenced by hospital policies. The objectives of this study were to evaluate and improve: (1) the timing of antimicrobial administration to surgical incision (tAB-INC), (2) contributions of anesthesia pre-induction (tPRI) and surgical preparation (tPREP) periods to tAB-INC, and the (3) completeness of antimicrobial recording. Two clinical audits were conducted before and after the policy changes (pa...
Effects of Leaving Amputated Ovaries Intra-Abdominally during Elective Bilateral Standing Laparoscopic Ovariectomy in Equids. There is risk of dropping an amputated ovary within the abdomen during standing laparoscopic ovariectomies in mares. If the ovary can no longer be directly visualized with the laparoscope, the procedure is then converted to a flank laparotomy for manual retrieval of the ovary which negates the minimally invasive nature of the laparoscopic procedure. The objective was to identify if ovaries left in the abdomen after amputation would atrophy or if they re-vascularize. Standing bilateral ovariectomies were performed in mature mares, but after transection of the ovarian pedicle, the ovaries were i...
Equine colic associated with small intestinal epiploic foramen entrapment. Intestinal epiploic foramen entrapment (EFE) is an important differential diagnosis in horses with colic, but disappointing short- and long-term outcomes are reported in the scientific literature. Many horses are euthanased during surgery due to a predicted poor prognosis or due to uncontrollable intraoperative haemorrhage. The ileum is involved in the majority of cases. Several risk factors for the development of EFE are described; crib-biting/windsucking being the most important one. The recurrence rate of EFE is low despite the described risk factors, probably due to spontaneous closure of ...
Hand-assisted laparoscopic cystotomy for cystic calculus removal in male horses (3 cases). A technique for hand-assisted laparoscopic removal of cystic calculi in male horses is described. Three cystic calculi ranging from 5 to 10 cm in diameter were removed successfully using bilateral para-inguinal laparoscopic portals assisted by a human hand within the abdomen, effectively sealing the midline incision. Long-term follow-up information obtained from referring veterinarians and owners indicated that the patients returned to their previous activity level and had no recurrence of clinical signs in the following 6 to 12 months. Key clinical message: Hand-assisted recumbent laparoscopy...
An atypical presentation of a mesenteric Meckel’s diverticulum in a 7-year-old warmblood mare: case report. Meckel's diverticula are a rare cause of small intestinal strangulation, diagnosed at laparotomy or necropsy. This congenital anomaly of the gastrointestinal tract originates from a remnant of the vitelline duct. In reported equine cases, they present as a full-thickness diverticulum on the antimesenteric border of the distal jejunum or proximal ileum. Methods: On laparotomy a Meckel's diverticulum positioned at the mesenteric side was found to be the cause of small intestinal strangulation. This position is very uncommon and to the best knowledge of the authors there is no unambiguous descrip...
Ultrasonographic evaluation of the width, thickness, and length of the normal linea alba in standing and dorsal recumbent horses. To determine the variability in length, width, and thickness of the equine linea alba (LA) and the effect of a standing vs dorsal recumbent position on these measurements. Methods: Descriptive anatomical comparative study. Methods: Standing horses (N = 75; in 30 horses, measurements were obtained in dorsal recumbency first and repeated after horses were standing). Methods: Linea alba length was measured in standing position from xiphoid to umbilicus, and transverse ultrasonographic images were obtained at five reference points to measure LA width and thickness. In 30 horses, measurements were ...
Complications associated with closure of the linea alba using a combination of interrupted vertical mattress and simple interrupted sutures in equine laparotomies. (1) Evaluate the occurrence and variables associated with incisional morbidities (IMs) after ventral median laparotomy when using interrupted vertical mattress sutures (IVMS) and (2) determine the occurrence of abdominal bandage-associated complications in horses. Methods: Occurrence of IM and bandage-associated complications were determined after single laparotomies (SL group; n=546 horses) and repeat laparotomies (RL group: multiple laparotomies within four weeks; n=30 horses) in horses that survived ≥7 days postoperatively. Univariate analysis and multivariate logistic regression were per...
Mesh closure of epiploic foramen by ventral laparotomy in 17 horses with entrapment. Epiploic foramen entrapment (EFE) of small intestine is a severe cause of strangulating small intestinal obstruction (SSI) with long-term survival seeming lower than for other causes of SSI in horses. Different techniques via laparoscopy or laparotomy for epiploic foramen (EF) closure have been developed. This study describes a technique of peroperative mesh closure of the EF in clinical cases and their long-term follow up. In the study period of 5.5 years, 36 horses were admitted to the clinic with EFE. Of these, 17 horses had peroperative mesh closure, with resection anastomosis in 4 cases a...
Retrospective Identification of Bacterial Isolates From Emergency Laparotomy Surgical Site Infections in Horses. 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...
Correlation Between Peritonitis and Incisional Infections in Horses. Surgical site infection of abdominal incisions is an important complication after laparotomy with increased risk of incisional hernia formation in horses. This study aims to evaluate the healing process of abdominal incisions and correlate peritonitis with the occurrence of surgical site infection and incisional hernias. Nine horses underwent standardized laparotomy, intestinal exploration, and induced septic peritonitis. Standardized relaparotomy was performed two (n = 3), four (n = 3), and six (n = 3) months later to evaluate the abdominal cavity for adhesions and to collect the sutured v...
Small Intestine Ultrasound Findings on Horses Following Exploratory Laparotomy, Can We Predict Postoperative Reflux? Postoperative reflux (POR) is a well-recognized complication after colic surgery in horses, particularly when presenting small intestinal pathology. Even though much has been written about the pathophysiology and management of POR, additional clinical studies are needed to better understand and anticipate this complication. The aim of the study was to provide clinical evidence of ultrasound findings in the postoperative period (three days). The study is based on transcutaneous abdominal ultrasounds of the caudoventral abdomen during the postoperative period (three days), in 58 horses, presente...
Application of a laparoscopic technique for vasectomy in standing horses. This report describes a technique for standing laparoscopic vasectomy in stallions through a prospective descriptive study. A preliminary study was carried out with two experimental intact male horses and subsequently the procedure was performed in two clinical cases. These horse owners want to keep their animals in the most possible natural way, preserving its stallion behaviour in a herd without generating offspring. The horses were sedated and restrained in stocks and laparoscopic vasectomy was performed using three portal sites in both paralumbar fossae recording surgical times. A 4-cm seg...
