FREE SHIPPING over $40
OVER 10000 FIVE-STAR REVIEWS
5% OFF ALL SUBSCRIPTIONS
100% HAPPINESS GUARANTEE
Analyze Diet
0
Veterinary surgery : VS2024; 54(1); 189-198; doi: 10.1111/vsu.14117

Ex vivo biomechanical evaluation of tissue construct strength in an equine colopexy model.

Abstract: To compare strength of left paramedian colopexies using various techniques in equine ex vivo models. Methods: Experimental study. Methods: Equine cadavers euthanized for nongastrointestinal pathology (36 specimens derived from 9 horses). Methods: Colopexies were performed after euthanasia. Suture pattern (horizontal mattress vs. cruciate) and incorporation of dorsal sheath of the rectus abdominis (partial-thickness) versus incorporation of dorsal and ventral sheath of the rectus abdominis (full-thickness) were evaluated. Single cycle load to failure, work to peak load, stiffness, and mode of failure of colopexy tissue constructs were assessed. Results: Mean load to failure of all constructs ranged from 102.26 to 166.38 N. Partial-thickness bites demonstrated a mean load to failure and standard deviation (SD) of 111.91 (35.88) N and 102.26 (30.06) N (p < .05) which was significantly lower than the mean and SD of full-thickness bites (166.3 [72.42] N and 163.21 [51.40 N]), respectively. All full-thickness bites regardless of suture pattern and over half of partial-thickness bites failed at the colonic wall. There was no significant difference in load to failure compared to mode of failure. Conclusions: A stronger colopexy was achieved with a full-thickness bite regardless of the suture pattern. The most common mode of failure was the colon wall. Conclusions: Incorporating ventral and dorsal fascia of the rectus abdominus provided a stronger colopexy structure, which may necessitate a second incision or subcutaneous palpation of the needle when performing a colopexy. The lateral band of the colon failed in most constructs (77%) regardless of technique, which could weaken the colonic wall and risk colonic rupture.
© 2024 The Author(s). Veterinary Surgery published by Wiley Periodicals LLC on behalf of American College of Veterinary Surgeons.
Get Full Text
Publication Date: 2024-07-08 PubMed ID: 38975740PubMed Central: PMC11734877DOI: 10.1111/vsu.14117Google Scholar: Lookup
The Equine Research Bank provides access to a large database of publicly available scientific literature. Inclusion in the Research Bank does not imply endorsement of study methods or findings by Mad Barn.
LinkedInCopy
  • Journal Article

Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

Overview

  • This study evaluated the strength of different surgical techniques for attaching the colon to the abdominal wall (colopexy) in horse cadaver models.
  • The goal was to identify which technique provides the strongest attachment to help inform surgical practices and avoid complications such as colon rupture.

Study Purpose and Background

  • The researchers wanted to compare the biomechanical strength of left paramedian colopexies performed using various suture patterns and techniques in horses.
  • Colopexy is a surgical procedure where the colon is attached to the abdominal wall to prevent displacement or torsion, important in equine abdominal surgeries.
  • Understanding which suture technique offers the best strength can reduce the risk of post-surgical complications like colonic rupture.

Materials and Methods

  • Subjects: 9 horses euthanized for reasons unrelated to gastrointestinal disease provided 36 abdominal specimens.
  • Procedure: Various colopexy techniques were performed on these equine cadaver specimens post-euthanasia.
  • Surgical Techniques:
    • Suture Patterns Tested: horizontal mattress vs. cruciate patterns.
    • Incorporation of abdominal wall layers:
      • Partial-thickness: only the dorsal sheath of the rectus abdominis muscle incorporated.
      • Full-thickness: both dorsal and ventral sheaths of the rectus abdominis muscle incorporated.
  • Biomechanical Testing:
    • Single cycle load to failure (maximum force before the construct fails).
    • Work to peak load (energy absorbed up to failure).
    • Stiffness (resistance to deformation before failure).
    • Mode of failure (where or how the construct failed, e.g., colon wall or suture tissue).

Results

  • Load to Failure:
    • All constructs showed load to failure ranging from approximately 102 to 166 Newtons.
    • Partial-thickness bites had significantly lower mean load to failure (around 102-112 N) compared to full-thickness bites (around 163-166 N), indicating they were weaker.
  • Mode of Failure:
    • More than half of partial-thickness constructs and all full-thickness constructs failed at the colonic wall rather than the suture or fascial tissues.
    • MOST commonly, failure occurred through the lateral band of the colon (77% of constructs), indicating this is a weaker point in the colonic wall.
  • Suture Pattern:
    • No significant difference found between horizontal mattress and cruciate suture patterns in terms of load to failure.

Conclusions and Clinical Implications

  • Full-thickness colopexy bites (incorporating both ventral and dorsal fascial layers) provide stronger tissue constructs than partial-thickness bites (incorporating only dorsal fascia), regardless of suture pattern used.
  • Stronger colopexy may require more comprehensive surgical technique, potentially necessitating:
    • A second surgical incision, or
    • Careful subcutaneous palpation during needle placement to properly engage both fascial layers.
  • The predominant failure site being the lateral band of the colon suggests that this area is vulnerable and may predispose to colonic rupture post-colopexy.
  • Choosing techniques that optimize colonic wall integrity and fascial incorporation may reduce postoperative complications in equine colopexy surgeries.

Cite This Article

APA
Gaitan HM, Mudge MC, Litsky AS, Arruda AG, Gardner AK. (2024). Ex vivo biomechanical evaluation of tissue construct strength in an equine colopexy model. Vet Surg, 54(1), 189-198. https://doi.org/10.1111/vsu.14117

Publication

Veterinary surgery : VS
ISSN: 1532-950X
NlmUniqueID: 8113214
Country: United States
Language: English
Volume: 54
Issue: 1
Pages: 189-198

Researcher Affiliations

Gaitan, Hannah M
  • Department of Veterinary Clinical Sciences College of Veterinary Medicine, The Ohio State University, Columbus, Ohio, USA.
Mudge, Margaret C
  • Department of Veterinary Clinical Sciences College of Veterinary Medicine, The Ohio State University, Columbus, Ohio, USA.
Litsky, Alan S
  • Departments of Orthopedics and Engineering, College of Medicine, The Ohio State University, Columbus, USA.
Arruda, Andreia G
  • Department of Veterinary Preventive Medicine College of Veterinary Medicine, The Ohio State University, Columbus, USA.
Gardner, Alison K
  • Department of Veterinary Clinical Sciences College of Veterinary Medicine, The Ohio State University, Columbus, Ohio, USA.

MeSH Terms

  • Animals
  • Horses / surgery
  • Cadaver
  • Biomechanical Phenomena
  • Suture Techniques / veterinary
  • Colon / surgery

Conflict of Interest Statement

The authors declare no conflicts of interest related to this report.

References

This article includes 35 references
  1. Broyles AH, Hopper SA, Woodie JB, Ruggles AJ. Clinical outcomes after colopexy through left ventral paramedian incision in 156 thoroughbred broodmares with large colon disorders (1999‐2015). Vet Surg 2018;47(4):490‐498.
    doi: 10.1111/vsu.12791pubmed: 29626348google scholar: lookup
  2. Hance SR. Colopexy. Vet Clin North Am Equine Pract 1997;13(2):351‐358.
    pubmed: 9290188
  3. Southwood LL, Auer JA, Stick JA, Kummerle JM. Large Colon. 5th ed. WB; 2019:591‐620.
  4. Hance SR, Embertson RM. Colopexy in broodmares. 44 cases (1986‐1990). J Am Vet Med Assoc 1992;201(5):782‐787.
    pubmed: 1399786
  5. Hall MD, Rodgerson DH. Colopexy dehiscence preceding an episode of large colon volvulus, followed by repeat colopexy, in three thoroughbred broodmares. Equine Vet Educ 2002;32(8):e136‐e140.
  6. Ellis CM, Lynch TM, Slone DE, Hughes FE, Clark CK. Survival and complications after large colon resection and end‐to‐end anastomosis for strangulating large colon volvulus in seventy‐three horses. Vet Surg 2008;37:786‐790.
    pubmed: 19121175
  7. Whyard JM, Brounts SH. Complications and survival in horses with surgically confirmed right dorsal displacement of the large colon. Can Vet J 2019;60(4):381‐385.
    pmc: PMC6417614pubmed: 30992593
  8. Smith LJ, Mair TS. 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?. Equine Vet J 2010;42(1):44‐46.
    pubmed: 20121912
  9. Suthers JM, Pinchbeck GL, Proudman CJ, Archer DC. Survival of horses following strangulating large colon volvulus. Equine Vet J 2013;45(2):219‐223.
    pubmed: 22994687
  10. Barclay WP, Foerner JJ, Phillips TN. Volvulus of the large colon in the horse. J Am Vet Med Assoc 1980;177(7):629‐630.
    pubmed: 7440357
  11. Rose J, Rose EM, Peterson PR. Clinical experience with subtotal large colon resection in the horse. Proceedings of the American Association of Equine Practitioners American Association of Equine Practitioners; 1988:29.
  12. Rose PL, Bradley WM. Resection and anastomosis for treatment of strangulating volvulus of the large colon of horses. J Am Vet Med Assoc 1992;201(3):454‐457.
    pubmed: 1506251
  13. Hardy J. Large colon enterotomy, resection, and anastamosis. In: White NA, Moore JN, Mair TS, eds. The Equine Acute Abdomen. Tenton New Media; 2008:597‐603.
  14. Trostle SS, White NA, Donaldson L, Freeman LJ, Hendrickson DA. Laparoscopic colopexy in horses. Vet Surg 1998;27(1):56‐63.
    pubmed: 9449178
  15. Markel MD, Ford TS, Meagher DM. Colopexy of the left large colon to the right large colon in the horse. Vet Surg 1986;15:407‐413.
  16. Hunt RJ, Spirito MA. Ventral midline colopexy as a prevention of large colon volvulus. Proceedings of the American Association of Equine Practitioners, 41st Annual Convention of the American Association of Equine Practitioners Proceedings American Association of Equine Practitioners; 1995:202.
  17. Sevensma KE, Leavitt L, Pihl KD. Anatomy, Abdomen and Pelvis, Rectus Sheath. StatPearls [Internet] StatPearls Publishing; 2023.
    pubmed: 30725838
  18. Epstein KL, Fehr J. 16 Colic Surgery. Practical Guide to Equine Colic. Wiley‐Blackwell; 2013:173.
  19. Mudge MC, Gardner AK. Left ventral colopexy: an alternative technique to avoid a second abdominal incision. Equine Vet Educ 2017;29:23.
  20. Markel MD, Richardson DW, Meagher DM. Colopexy of the large colon: experimental and clinical results. Proceedings of the American Association of Equine Practitioners, 35th Annual Convention of the American Association of Equine Practitioners American Association of Equine Practitioners; 1989:45.
  21. Sergeant ESG. Epitools Epidemiological Calculators. Ausvet; 2018.
  22. Levine SH, Caywood DD. Biomechanical evaluation of gastropexy techniques in the dog. Vet Surg 1983;12(3):166‐169.
  23. Verkade ME, Suthers J, Wiemer P, Martens A, De Clercq E, Burford J. Ultrasonographic evaluation of the width, thickness, and length of the normal linea alba in standing and dorsal recumbent horses. Vet Surg 2021;50:158‐169.
    pubmed: 33043994
  24. Bertran J, Ham KM, Gibson JF, Litsky A, Kieves NR. Penile urethral resection and anastomosis augmentation with regional tissue tension relieving technique: a cadaveric mechanical study and clinical outcome in two dogs. Vet Surg 2021;50(4):888‐897.
    pubmed: 33760239
  25. Imhoff DJ, Cohen A, Monnet E. Biomechanical analysis of laparoscopic incisional gastropexy with intracorporeal suturing using knotless Polyglyconate. Vet Surg 2015;44(Suppl 1):39‐43.
    pubmed: 24617501
  26. Webb RJ, Monnet E. Influence of length of incision and number of suture lines on the biomechanical properties of incisional gastropexy. Vet Surg 2019;48(6):933‐937.
    pubmed: 31187882
  27. Markel M. Fracture biomechanics. In: Nixon AJ, Auer JA, Watkins JP, eds. Equine Fracture Repair. Wiley‐Blackwell; 2019:12‐23.
  28. Trostle SS, Wilson DG, Stone WC, Markel MD. A study of the biomechanical properties of the adult equine linea alba: relationship of tissue bite size and suture material to breaking strength. Vet Surg 1994;23(6):435‐441.
    pubmed: 7871706
  29. Chism PN, Latimer FG, Patton CS, Rohrbach BW, Blackford JT. Tissue strength and wound morphology of the equine linea alba after ventral median celiotomy. Vet Surg 2000;29(2):145‐151.
    pubmed: 10730707
  30. Fierheller EE, Wilson DG. An in vitro biomechanical comparison of the breaking strength and stiffness of polydioxanone (sizes 2, 7) and polyglactin 910 (sizes 3, 6) in the equine linea alba. Vet Surg 2005;34(1):18‐23.
    pubmed: 15720592
  31. Markel MD, Dreyfuss DJ, Meagher DM. Colopexy of the equine large colon: comparison of two techniques. J Am Vet Med Assoc 1988;192(3):354‐357.
    pubmed: 3356571
  32. Hann MJ, Mair TS, Gardner A. Acute abdominal dehiscence following laparotomy: a multicentre, international retrospective study. Equine Vet J 2022;54(4):719‐725.
    pubmed: 34418125
  33. Arbaugh M, Case JB, Monnet E. Biomechanical comparison of glycomer 631 and glycomer 631 knotless for use in canine incisional gastropexy. Vet Surg 2013;42(2):205‐209.
    pubmed: 23094713
  34. Babkine M, Desrochers A, Bouré L, Hélie P. Ventral laparoscopic abomasopexy on adult cows. Can Vet J 2006;47(4):343‐348.
    pmc: PMC1405825pubmed: 16642872
  35. Seeger T, Kümper H, Failing K, Doll K. Comparison of laparoscopic‐guided abomasopexy versus omentopexy via right flank laparotomy for the treatment of left abomasal displacement in dairy cows. Am J Vet Res 2006;67(3):472‐478.
    pubmed: 16506910

Citations

This article has been cited 0 times.
Subscribe to our newsletter
Join 99,970 horse owners like you who receive our email updates on horse health and nutrition.