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.
The effect of motilin on the regulation mechanism of intestinal motility in conscious horses. Laparotomy was performed on seven thoroughbreds to attach a force transducer to the proximal jejunum, distal jejunum, and ileum, as well as to the serous membrane of the cecum. Following observation of intestinal motility in conscious horses, they were intravenously injected with motilin (0.6 microgram/kg) to examine its effect on intestinal motility. Strong contractions peculiar to horses were observed in small intestine. Further, motilin caused strong contractions in the proximal jejunum. The results suggested the involvement of motilin in the regulation mechanism of intestinal motility.
Ovarian torsion as a cause of colic in a neonatal foal. A 1-week-old Morgan filly was evaluated because of acute signs of abdominal pain of 7 hours' duration. On admission, physical examination findings were unremarkable; however, radiography of the abdomen revealed slight distention of the small intestine. Signs of abdominal discomfort were detected during several hours of observation. Abnormalities were not evident during gastroscopic evaluation. Therefore, exploratory laparotomy was performed. The only abnormal finding was infarction of the left ovary secondary to a 720 degrees torsion of the mesovarium. The vascular pedicle was ligated and the ...
Maintenance of anaesthesia with sevoflurane and oxygen in mechanically-ventilated horses subjected to exploratory laparotomy treated with intra- and post operative anaesthetic adjuncts. Eight healthy horses premedicated with xylazine and induced with ketamine were used to evaluate sevoflurane in oxygen for maintenance of anaesthesia during elective exploratory laparotomy. After orotracheal intubation, horses were hoisted, placed in dorsal recumbency on a padded surgery table, and received sevoflurane in oxygen for maintenance of anaesthesia. The horses were allowed to breathe spontaneously until instrumented; then, they were mechanically ventilated to maintain the PaCO2 between 35 and 45 mmHg. Systolic (SAP), diastolic (DAP), and mean (MAP) arterial blood pressures, heart rat...
Injury to abdominal wall vessels during laparoscopy in three horses. Epigastric vessels were inadvertently injured during placement of instrument portals in 3 horses undergoing laparoscopy for bilateral cryptorchidectomy, bilateral ovariectomy, and removal of electrode wires surgically implanted in the large colon. The resulting hemorrhage increased surgery time, caused hematoma formation or hemoperitoneum, and obscured the surgical field. Hemostasis was achieved by direct pressure or vessel ligation. This complication can be attributed to the high degree of vascularity of the ventral aspect of the abdominal wall.
Standing laparoscopically-aided ovariectomy in mares. Bilateral ovariectomy was performed in 11 mares and unilateral ovariectomy in 2 mares. The horses were standing and sedated for surgery. After appropriate preparation a laparoscope was inserted into the abdomen through the paralumbar fossa and the ovary was identified and anaesthetised with local anaesthetic via a custom-built needle. The ovary was then withdrawn from the abdomen through a separate flank incision and removed. The abdomen was not distended with gas before surgery. This method proved to be minimally invasive, rapid and effective.
Chronic colic in the mature horse: a retrospective review of 106 cases. The clinical features of 106 horses presenting with chronic colic examined over a 5 year period were reviewed. Chronic colic was defined as colic signs observed daily for 3 days or longer, except when masked by analgesics. The diagnosed causes of chronic colic included colonic impaction (31%), peritonitis (16%), enteritis/colitis (7%), colonic displacement/torsion (6%) and lymphosarcoma (4%). A variety of other diseases were diagnosed in a small number of cases, including intestinal adhesions, ileal obstructions, grass sickness, liver disease, caecal impactions, thromboembolic disease, intussu...
Laparoscopic adhesiolysis in a horse. The purpose of this report was to describe the use of laparoscopy as a method of treatment for abdominal adhesions in the horse. Methods: Unilateral ovariectomy for removal of a granulosa cell tumor was performed through a diagonal paramedian approach in a 14-year-old Arabian mare. Progressive incisional swelling and hemorrhage culminated in acute incisional dehiscence with herniation of ileum on the sixth postoperative day. Septic peritonitis that responded to parenteral antibiotic therapy was identified 7 days after hernia repair. Seven days later, the mare had signs of abdominal pain, and a...
Paralumbar fossa laparoscopic ovariectomy in horses with use of Endoloop ligatures. The purposes of this study were to develop a technique of paralumbar fossa laparoscopic ovariectomy using Endoloop ligatures and to avoid a laparotomy incision for ovary removal by using a 33-mm diameter muscle spreader trocar-cannula unit. Methods: Seven mares. Methods: Bilateral laparoscopic ovariectomy was performed under general anesthesia in two horses and under neuroleptanalgesia and local anesthesia in five standing mares. Ovaries were approached from the ipsilateral paralumbar fossa through two portal sites located in the paralumbar fossa and a third between the 17th and 18th ribs. Ins...
Evaluation of exploratory laparotomy in young horses: 102 cases (1987-1992). To determine, in a population of young horses, whether a variation exists among neonates, sucklings, weanlings, and yearlings regarding recovery from anesthesia, short- and long-term survival rates, and postoperative adhesion formation following exploratory laparotomy. Methods: Retrospective study. Methods: 102 horses < 25 months old that underwent exploratory laparotomy. Methods: Pre-, intra-, and postoperative information was retrieved from medical records, conversations with referring veterinarians, owners, or trainers, and race records. Survival rates (recovery from anesthesia and short- a...
Laparoscopic cryptorchidectomy in standing horses. The purpose of this study was to determine the feasibility of using laparoscopy to remove cryptorchid testes from standing horses. Methods: Prospective clinical study. Methods: Eleven client-owned horses ranging in age from 4 months to 2 years. Methods: Abdominal insufflation was initiated and maintained using a 20 F insufflation tube, attached via a stopcock, to the low pressure regulator on a standard carbon dioxide pressure tank. After trocar and laparoscope placement in the ipsilateral flank the testes were identified. Local anesthesia of the structures to be manipulated was administered t...
[Strangulation ileus of the jejunum combined with intersexuality in a horse]. An apparently unilateral cryptorchid stallion was referred to the clinic with a history of colic. In the course of laparotomy an ileus caused by strangulation of the small intestine was found and the horse was euthanized because of poor prognosis. During autopsy strictures and ectasia of the jejunum were found as well as hermaphroditism along with male phenotype. The frequency of cryptorchidism in the case of intersexuality is discussed.
Laparoscopic ovariectomy in two horses with granulosa cell tumors. Two mares were admitted for ovariectomy of unilateral granulosa cell tumors. Both mares were ovariectomized (1 unilateral and 1 bilateral) by use of a ventral abdominal laparoscopic technique. This approach required tilting the operative table 30 degrees to elevate the pelvis and to allow observation of the ovaries. Using a single laparoscopic portal and 3 to 4 instrument portals, a triangulation technique was used. The ovarian pedicles were isolated and secured via loop ligation. The ovaries then were divided from the ligated pedicle and placed within specimen bags for extraction. The specime...
Laparoscopic repair of scrotal hernia in two foals. Nonstrangulating indirect scrotal hernias were corrected in two 4-week-old Percheron foals by a laparoscopic technique. After laparoscopic reduction of herniated nonstrangulated small intestine each testes was retracted through the vaginal ring. The ligament of the tail of the epididymis was transected by electrocautery. The testicular vessels and nerves were isolated by cautery of the mesenteric portion of the mesorchium and then ligated. Staples were used to close the opening of the inguinal canal by apposing the peritoneal edges of the vaginal ring. Resection of umbilical stalk remnants via...
Instrumentation and techniques for laparoscopic and thoracoscopic surgery in the horse. Equine surgery continues to benefit from advances in laparoscopic techniques. Descriptions of the normal anatomy of the standing horse and advances in instrumentation have improved our ability to perform laparoscopic surgery in both standing and dorsally recumbent horses. The common uses for laparoscopy are diagnostic laparoscopy, cryptorchidectomy, ovariectomy, and diagnostic thoracoscopy. Other reported uses include inguinal hernia repair, ruptured bladder repair, and ventral colopexy.
Abnormalities in oxygenation, coagulation, and fibrinolysis in colonic blood of horses with experimentally induced strangulation obstruction. To measure arterial and venous blood gas, coagulation, and fibrinolysis variables in blood from isolated segments of control and ischemic large colons for the purpose of identifying variables for rapid, indirect assessment of colonic mucosal injury. Methods: Variables were determined at specific intervals during the 4-hour study (3 hours of ischemia and 1 hour of reperfusion). Methods: Seven clinically normal horses between 2 and 15 years old. Methods: Horses underwent laparotomy and occlusion of the lumen and vasculature of the mid-portion of the pelvic flexure of the large colon. During isch...
Ventral abdominal approach for laparoscopic ovariectomy in horses. 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...
Small intestinal herniation through the epiploic foramen: 53 cases (1987-1993). The incidence of epiploic entrapment of the small intestine in horses undergoing celiotomy for colic was 5%. The condition was more prevalent in older (mean 9.81 years) gelding and Thoroughbred horses. Preoperative peritoneal protein level was a good prognostic indicator as it was significantly greater in the nonsurvivor (39.4 +/- 5.10) group than in the survivor group (26.6 +/- 14.0) (P<0.05). Abdominal ultrasonography allowed earlier diagnosis and surgical intervention in nonpainful cases with inconclusive rectal findings. Surgery was completed in 46 horses and 44 horses recovered from anaes...
[Suture material and suturing of the laparotomy wound in horses and cattle]. Wound healing is discussed in the introduction. Subsequently in a review of the suture materials used in large animal laparotomies is presented. In the discussion examples are given of the suture materials that are used at the Department of General and Large Animal Surgery.
Laparoscopic repair of a bladder rupture in a foal. Ruptured bladder was diagnosed in a 90-day-old Thoroughbred colt that had suffered a open, comminuted tibial fracture 2 days earlier. The bladder rupture was identified by laparoscopic examination of the abdomen and was repaired using a laparoscopic stapling instrument. This technique provided good visualization and allowed repair of the rupture with minimal intervention. Ten months after surgery, the foal was admitted to a referral surgical practice because of colic and stanguria. A urinary calculus was removed from the penile urethra by urethrotomy. Laparoscopic repair of the bladder with no...
[Displacement and resection of the ascending colon in the horse: a literature review on the basis of 2 cases]. A review of displacements and surgery of the large colon is given on the basis of two cases. A four-year-old Dutch Warmblood mare was referred, one week before foaling, for colic of twelve hours duration. At rectal palpation a large uterus was found, but no cause for the colic. Laparotomy revealed a colonic volvulus and resection of about 75% of the large colon was necessary. A dead foal was born five days postoperatively, but the mare recovered well. A nine year-old Dutch Warmblood stallion with a history of frequent colic had been treated for nephrosplenic entrapment three times. Resection o...
Use of a bovine hemoglobin preparation in the treatment of cyclic ovarian hemorrhage in a miniature horse. Anemia that was secondary to ovarian hemorrhage in a 4-year-old miniature horse mare was treated prior to laparotomy with polymerized ultrapurified bovine hemoglobin (PUBH). Two previous whole-blood transfusions had resulted in acute transfusion reaction, and a suitable blood donor could not be found among 9 horses, necessitating use of the blood substitute. Subsequent blood typing revealed the mare to be Aa-negative, with allo-antibodies against Aa in serum. Serious adverse reactions were not observed after infusion of PUBH, and the mare recovered. Although the safety and efficacy of using PU...
Retrospective analysis of the results of 151 exploratory laparotomies in horses with gastrointestinal disease. Of 149 horses that underwent 151 exploratory laparotomies for gastrointestinal disorders from September 1987 to May 1991, 107 (72%) were discharged from the hospital: 100 (66%) survived for > 7 months, 94 of which returned to their intended use. Survival rate (64/80) for horses with caecum/large colon obstruction was significantly (P = 0.003) higher than for horses with small intestinal obstruction (33/64). Prolonged surgery was associated with significantly (P < 0.001) lower survival rates than short surgical time. In the large intestine, survival rate (15/29) for strangulated obstructions wa...
Standing laparoscopic laser technique for ovariectomy in five mares. 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...
Paravertebral thoracolumbar anaesthesia in 10 horses. The caudal border of the last rib was used as a reliable point of orientation while performing paravertebral thoracolumbar anaesthesia (PTLA) on 10 horses undergoing standing flank laparotomy. The local anaesthetic in all horses was 2% lidocaine. The PTLA procedure was completed in 9.8 +/- 1.8 mins (mean +/- sd). Sedation was provided by a combination of intravenous morphine with xylazine or detomidine. Overall analgesia, provided by the combination of PTLA and sedation, was rated as excellent in 2 horses and good in 6 horses. In the remaining 2 horses, overall analgesia was rated as fair beca...
Effect of surgical removal of endometrial cups on concentrations of chorionic gonadotrophin and subsequent fertility in the mare. Seven pregnant mares underwent general anaesthesia, laparotomy, hysterotomy and removal of a 50-day conceptus. Eversion of the uterine horn through the hysterotomy site allowed direct visualisation and electrosurgical removal of endometrial cup tissue from 5 randomly selected mares (Nos 1-5), while cup tissue in 2 mares (Nos 6 and 7) was left intact. Two pregnant mares served as unoperated controls (Nos 8 and 9). Efforts to re-establish pregnancy were initiated 20 days after surgery. Serum samples collected before surgery and during the post-operative period were analysed for concentration of ...
The effect of exploratory laparotomy on the serum and peritoneal haptoglobin concentrations of the pony. Serum haptoglobin concentration was used as an indicator of the acute phase response in ponies undergoing exploratory laparotomy. Preoperative, 1 h intraoperative, 3 h, 6 h, 12 h and 24 h postoperative blood samples and 48 h postoperative peritoneal fluid samples were obtained for haptoglobin analysis. A spectrophotometric assay based on cyanmethemoglobin binding capacity (CyanBC) was used to determine haptoglobin concentrations. The preoperative reference range for serum haptoglobin concentrations in these ponies was 25-60 mg CyanBC/dL. Intraoperative and 3 h postoperative blood samples had d...
Obstructive enterolith in an 11-month-old miniature horse. An obstructive enterolith was diagnosed in an 11-month-old 68-kg miniature horse with a 24-hour history of mild, intermittent colic. Abdominal radiography revealed gas distention of the cecum and the right and left ascending colon, and a radiodense elliptical structure in the area of the left kidney. During exploratory laparotomy, the right dorsal colon was noticed to contain ecchymotic hemorrhage and generalized discoloration in the portion proximal to the location of the enterolith. While exteriorizing the ascending colon, it ruptured caudal to the diaphragmatic flexure in the right dorsal c...
[2 cases of ‘hardware’ foreign objects in ponies]. An obstruction of the small intestine was suspected in two ponies with colic. At surgery and at necropsy, the cause of the colic appeared to be an inflammation process caused by perforation of the jejunum by a piece of wire. One pony recovered after laparotomy and enterectomy, but had to be put down eight weeks later because of severe laminitis. The other pony was euthanized immediately after clinical evaluation.
Uterine torsion and uterine tear in a mare. A 15-year-old Standard-bred mare was examined because of signs of abdominal discomfort in late gestation. Palpation per rectum revealed tight broad ligaments above and below the uterus, with the right broad ligament running across the top of the uterine body down toward the left, ventral side of the abdomen. A diagnosis of counterclockwise uterine torsion was made and surgical correction was approached via a left, flank laparotomy with the horse standing. The uterus was repositioned and a uterine tear encompassing 180 degrees of the uterine surface was found in the lateral, uterine body just c...