Development of a new laparoscopic Foramen Epiploicum Mesh Closure (FEMC) technique in 6 horses.

This research introduces a new laparoscopic technique called Foramen Epiploicum Mesh Closure (FEMC) for preventing a life-threatening colic condition in horses known as Epiploic Foramen Entrapment (EFE). The procedure involves inserting a mesh through the Epiploic Foramen (EF), a space in the horse’s abdomen. Six horses underwent the procedure successfully, with results suggesting that it is a safe and reliable method for mitigating the risk of EFE.

Objective and Research Methodology

• The study was designed to describe the new technique and measure its outcome and effects in real-life procedures.
• The researchers performed the FEMC technique on six horses. The procedure involved the insertion of a diabolo-shaped mesh into the Epiploic Foramen, a pathway in the horse’s abdomen that can sometimes cause life-threatening EFE when obstructed.
• All procedures were performed under laparoscopic visualization on sedated horses, standing upright.
• The researchers tracked clinical and laboratory parameters post-operation, and performed a repeat laparoscopy four weeks after the procedure.
• Three of the horses were euthanized at different intervals (1, 2, and 3 months) after the procedure to be inspected for necropsy and histopathology. The remaining three horses were observed clinically for six months.

Results of the Study

• All six procedures were performed successfully within an average surgery time of 22 minutes.
• One horse required treatment for large colon impaction in the immediate post-operative period.
• Four weeks after the procedures, upon repeat laparoscopy, all six EFs were found to be closed, and no undesired adhesions were identified.
• This was further confirmed through gross and histopathological examination of the three horses that were euthanized.
• The remaining three horses showed no adverse clinical signs in the six-month post-operative observation period.

Conclusions

• The researchers concluded that the FEMC technique is a quick, simple, and reliable procedure for preventing EFE in horses.
• This method of closing the EF using a diabolo-shaped mesh could help significantly in curbing the risk of the life-threatening condition EFE in at-risk horses.