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.
Laparoscopic-assisted cystotomy and cystostomy for treatment of cystic calculus in a gelding. To report laparoscopic-assisted cystotomy and inguinal cystostomy for treating bladder urolithiasis in a gelding. Methods: Clinical report. Methods: Twelve-year-old Appaloosa gelding. Methods: A laparoscopic approach was used to locate and grasp the bladder, which was exteriorized through an enlarged instrument portal for cystotomy to remove the calculus. During withdrawal, the calculus fragmented into multiple pieces. To avoid urethral occlusion and facilitate elimination of these fragments, an inguinal cystostomy was created. The seromuscular layer of the bladder was circumferentially secure...
Small intestinal strangulation caused by a mesodiverticular band and diverticulum on the mesenteric border of the small intestine in a horse. A 4-year-old Quarter horse stallion was presented for acute abdominal pain. Exploratory celiotomy revealed a mesenteric diverticulum of the jejunum and mesodiverticular band that were associated with small intestinal strangulation. Resection and anastomosis were performed. A second celiotomy was performed due to adhesions. The horse recovered completely and returned to training. Un étalon Quarter horse âgé de 4 ans a été présenté pour une douleur abdominale aiguë. Une laparatomie exploratoire a révélé un diverticule mésentérique du jéjunum et une bande mésodiverticulaire qui on...
Septic peritonitis and uroperitoneum secondary to subclinical omphalitis and concurrent necrotizing cystitis in a colt. A 15-day-old American Quarter horse colt was presented for depression and pyrexia. Peritonitis was diagnosed following peritoneal fluid analysis. Exploratory laparotomy revealed an area of focal necrosis over the dorsal wall of the urinary bladder leading to peritonitis and uroperitoneum. The affected area of the urinary bladder was resected and the peritonitis resolved with medical treatment. Péritonite et uropéritoine septiques secondaires à une omphalite subclinique et à une cystite nécrosante concomitante chez un poulain. Un poulain American Quarter Horse âgé de 15 jours a été prÃ...
Distal aortic aneurysm presumed to be secondary to an infected umbilical artery in a foal. A 3-month-old female Warmblood foal was presented after displaying signs of colic with pyrexia for 5 days. Results: The foal continued to show signs of colic, frequently passed urine, and was pyrexic with an elevated white blood cell count. The umbilical stalk was thickened but there was no evidence of purulent material. Exploratory laparotomy revealed an enlarged left umbilical artery remnant tightly adhered to the bladder wall. The left umbilical artery continued to an aneurysm involving the distal aorta. The foal was subject to euthanasia and post-mortem examination confirmed a spherical ao...
Standing laparoscopic peritoneal flap hernioplasty technique for preventing recurrence of acquired strangulating inguinal herniation in stallions. 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 ...
Unilateral and bilateral laparoscopic ovariectomy in 157 mares: a retrospective multicenter study. 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, ...
Comparison of plasma and peritoneal indices of fibrinolysis between foals and adult horses with and without colic. To identify hemostatic imbalances indicative of an increased risk of intra-abdominal adhesion formation in foals versus adult horses. Methods: Horses with colic undergoing exploratory laparotomy or abdominocentesis as part of a clinical examination (n = 16 foals ≤ 6 months of age and 19 adults ≥ 5 years of age) and horses without colic undergoing herniorrhaphy (15 foals) or euthanasia for noninflammatory and nongastrointestinal disease (10 foals and 20 adults). Methods: Paired abdominal fluid and blood samples were collected from each horse into buffered sodium citrate and centrifuged imme...
Comparison of transvaginal natural orifice transluminal endoscopic surgery (NOTES®) and laparoscopy for elective bilateral ovariectomy in standing mares. To compare surgical trauma, perioperative pain, surgical time, and complication rate in mares undergoing standing bilateral ovariectomy by natural orifice transluminal endoscopic surgery (NOTES) or laparoscopy. Methods: Experimental study. Methods: Healthy mares (n = 12). Methods: Ovariectomy was performed with a vessel-sealing device by transvaginal NOTES (n = 6) using a flexible endoscope and specialized instruments or by bilateral flank laparoscopy (n = 6). Preoperative and postoperative complete blood count (CBC), plasma fibrinogen concentration, serum amyloid A concentration, peritoneal n...
Use of a suprapatellar pouch portal and laparoscopic cannula for removal of debris or loose fragments following arthroscopy of the femoropatellar joint of 168 horses (245 joints). To validate the safety of a suprapatellar pouch (SPP), approach to the femoropatellar joint (FPJ), and describe use of a laparoscopic cannula to remove debris or loose bodies. Methods: Retrospective case series Methods: Horses (n = 168) with osteochondritis dissecans (OCD) of the FPJ. Methods: Arthroscopy was performed on 245 FPJ with OCD. Two subpatellar portals were created, 1 axial and 1 abaxial to the lateral patellar ligament. Additionally, a SPP egress portal for lavage, was created 2 cm proximal to the most palpable dorsolateral eminence of the patellar base. A 10-mm laparoscopic cannul...
Surgical drainage and post operative lavage of large abdominal abscesses in six mature horses. Six mature horses with large abdominal abscesses (defined as an abscess >15-20 cm in at least one dimension) were treated by surgical drainage and post operative lavage. The abscess was associated with previous intestinal surgery in one horse, and with Streptococcus equi spp. equi infection in the other 5. A Foley catheter was used to drain and lavage the abscess in all cases. The abscess was accessed by a ventral midline laparotomy in 5 cases and by standing flank laparoscopy in one. Two horses were subjected to euthanasia within 7 days due to persistent or recurrent colic. The other 4 hor...
Influence of mechanical manipulations on the local inflammatory reaction in the equine colon. Large intestinal diseases in horses are characterised by inflammation, which could arise from the disease process with some contribution from intestinal manipulation. The effects of the latter are unknown but important to surgeons and could contribute to post operative complications. Objective: To characterise type and degree of intestinal inflammation induced by various mechanical stimuli in the equine ascending colon. Methods: Laparotomy was performed in 12 horses, the left dorsal colon exteriorised and 3 segments randomly exposed to different mechanical manipulations: 1) enterotomy, 2) ente...
Use of gastric balloon manometry for estimation of intra-abdominal pressure in horses. Standing laparoscopic procedures, facilitated by abdominal insufflation with carbon dioxide, are being employed to an increasingly greater extent in horses. However, a sustained increase in abdominal pressure may be life-threatening. A practical method for intra-abdominal pressure (IAP) assessment is imperative. Although indirect methods for estimating IAP have been extensively studied in man, little work has been performed in veterinary medicine. Objective: To investigate the utility of gastric manometry for purposes of evaluating IAP in horses. Methods: Gastric pressure (P(ga) ) was estimate...
Pulmonary gas exchange and plasma lactate in horses with gastrointestinal disease undergoing emergency exploratory laparotomy: a comparison with an elective surgery horse population. 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...
Colic after swimming exercise in racehorses: an investigation of incidence, management, surgical findings and outcome. The incidence of colic following swimming exercise (SC) in a racehorse population examined over 3 years was 0.08%. Following 167,977 swims, 136 cases were reported. Colic resolved spontaneously in 2 horses, medically in 129 or surgically in 5. In a separate study, 21 horses were subject to exploratory laparotomy for SC. Findings included non-strangulating displacements in 7 horses, strangulating displacements in 7, a combination of non-strangulating and strangulating displacements in 1, prominent gaseous intestinal distension in 5 and no abnormalities in 1 horse. A poor response to analgesia p...
Haemoperitoneum in horses: a retrospective review of 54 cases. This retrospective study was conducted in the UK and identifies the most frequent causes, diagnoses, treatment and prognoses for short- and long-term survival in 54 cases of horses with haemoperitoneum. Clinical signs of haemorrhagic shock and colic were common, and abdominal ultrasound was very useful for the identification of haemoperitoneum. Causes of haemoperitoneum included uterine injury (22 per cent), involvement of specific blood vessels (20 per cent), splenic injury (19 per cent), neoplasia (13 per cent) and other (4 per cent). No source was identified in 22 per cent of cases. Fifty-s...
[Diagnostic workup of chronic inflammatory bowel disease in the horse]. The present retrospective study describes the diagnostic workup and collected findings in 7 horses with chronic inflammatory bowel disease over the years 2000-2006. The diagnosis could be confirmed histologically with biopsies taken during laparoscopy or laparotomy or during post mortem examination. Weight loss and chronic diarrhoea were the most commonly reported clinical findings. Among ancillary examinations (fecal analysis, gastroscopy, abdominal ultrasonography, rectal mucosal biopsy) the D-xylose absorption test provided the most useful information. Although clinical signs and laboratory...
Laparoscopic techniques for investigating the equine oviduct. The diagnostic and therapeutic options for oviduct disorders in the mare are limited. The current best techniques require exploratory surgery under general anaesthesia or flank laparotomy. Objective: The orthograde flushing of the oviduct for diagnostic or therapeutic options is possible using laparoscopic techniques in the standing sedated mare. Methods: Development of a laparoscopic technique for catheterisation of the infundibulum and flushing of the oviduct (sterile methylene blue solution) in the standing sedated mare was examined in 2 experiments. The first involved a transvaginal laparo...
Clinical application and reliability of a post abdominal surgery pain assessment scale (PASPAS) in horses. 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...
Standing laparoscopic ovariectomy technique with intraabdominal dissection for removal of large pathologic ovaries in mares. To describe a standing laparoscopic ovariectomy technique with intraabdominal ovarian dissection inside a specimen retrieval bag for removal of large pathologic ovaries through small incisions. Methods: Case series. Methods: Mares (n=43) aged 2-21 years and weighing 380-680 kg. Methods: Unilateral laparoscopic ovariectomy was performed on 43 standing sedated mares. Ovaries were approached via 3 portal sites, 2 in the paralumbar fossa and a 3rd between the 17th and 18th ribs on the ipsilateral side. Ovaries were dissected free using either a LiNA Tripol-bipolar laparoscopic forceps or a Ligasur...
Laparoscopic removal of a large abdominal testicular teratoma in a standing horse. To describe laparoscopic removal of a large testicular teratoma in a standing horse. Methods: Clinical report. Methods: Thoroughbred horse (11 months) with a testicular teratoma. Methods: A unilateral cryptorchid testicle could not be removed by an inguinal approach under general anesthesia because of it s large size. After recovery from general anesthesia, ultrasound evaluation revealed a 24 x 19 cm fluid-filled testicular mass. The mass was removed by paralumbar fossa laparoscopy with the horse in a standing position. After fluid aspiration of the mass, the mesorchium and ductus deferens wer...
Are horses that undergo an exploratory laparotomy for correction of a right dorsal displacement of the large colon predisposed to post operative colic, compared to other forms of large colon displacement? 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...
Intrinsic innervation of the ileocaecal junction in the horse: preliminary study. In horses, morpho-functional studies related to the enteric nervous system (ENS) controlling the sphincters are lacking. Objective: To investigate immunohistochemically the morphology, distribution, density, phenotypes and projections of neurons controlling the ileocaecal junction (ICJ). Methods: Two young horses were anaesthetised and underwent midline laparotomy. The neuronal retrograde fluorescent tracer Fast Blue (FB) was injected into the wall of the ICJ. A post surgical survival time of 30 days was used. Following euthanasia, the ileum and a small portion of caecum were removed. Cryosect...
Diaphragmatic hernia in horses: 44 cases (1986-2006). To present a case series of horses diagnosed with diaphragmatic hernia, and to determine the significance of (1) historical information, examination findings, and laboratory data; and (2) exploratory laparotomy or necropsy findings on short- and long-term outcome. Methods: University Referral Hospital. Methods: Retrospective study. Methods: Forty-four horses/foals admitted between 1986 and 2006 with a diagnosis of diaphragmatic hernia made either at exploratory laparotomy or necropsy. Methods: None. Results: Information from the medical records included history, clinical examination findings a...
Laparoscopic mesh incisional hernioplasty in five horses. To report a technique for incisional hernioplasty in horses using laparoscopic placement of a prosthetic mesh. Methods: Case series. Methods: Horses (n=5) with ventral median abdominal incisional hernia. Methods: A telescope and 2 instrument portals were established bilaterally, lateral to and distant from the hernia margins. After exposure of the internal rectus sheath by removal of retroperitoneal fat with endoscopic scissors and monopolar cautery, a prosthetic mesh was introduced into the abdomen and secured intraperitoneally using transfascial sutures with or without supplemental endoscopi...
[Encephalopathy and Alzheimer type II astrocytes in a post laparotomy recumbent horse]. A 13-year-old Standardbred gelding was referred for evaluation of continuous abdominal pain. Rectal examination revealed a dislocated large colon (Dislocatio coli ad dextram). The horse showed muscle fasciculations and appeared lethargic. It was sent to surgery because of persistent colic. In transit the gelding showed an unstable walk and immediately prior to surgery a wide-based stance in the hindlimbs. Laparotomy revealed a retroflexion of the large colon and a secundary mesenterial volvulus. After surgery the horse remained recumbent. Due to the comatose state and poor prognosis the geldin...
Cardiopulmonary effects of diazepam-ketamine-isoflurane or xylazine-ketamine-isoflurane during abdominal surgery in foals. To evaluate cardiopulmonary effects of anesthetic induction with diazepam and ketamine or xylazine and ketamine, with subsequent maintenance of anesthesia with isoflurane, in foals undergoing abdominal surgery. Methods: 17 pony foals. Methods: Foals underwent laparotomy at 7 to 15 days of age and laparoscopy 7 to 10 days later. Foals were randomly assigned to receive diazepam, ketamine, and isoflurane (D/K/Iso; n = 8) or xylazine, ketamine, and isoflurane (X/K/Iso; 9) for both procedures. Results: During anesthesia for laparotomy, cardiac index, and mean arterial blood pressure ranged from 110...
Cecal rupture in foals–7 cases (1996-2006). The objective of this study was to identify risk factors and describe clinical signs in 7 foals with cecal rupture; none of the foals survived. Six foals had undergone general anesthesia; 5 for orthopedic procedures. Six of the foals were receiving nonsteriod anti-inflammatory drugs. Most foals started showing colic signs on day 2 after surgery, preceded in 3 cases by dullness. Cecal rupture occurred between 4 hours and 2 days after the first signs of colic were noticed. Intestinal motility was decreased or absent in all foals for which it was recorded.Foals undergoing general anesthesia shoul...
Complications of laparoscopic surgery. 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...