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Home / Equine Research Bank / Vet Rec / Full-laparoscopic nephrosplenic space closure with barbed kn...
The Veterinary record2025; doi: 10.1002/vetr.6013

Full-laparoscopic nephrosplenic space closure with barbed knotless sutures in horses with left dorsal colon displacement without previous colon repositioning.

Abstract: Nephrosplenic space entrapment (NSE) has reported recurrence rates of 8%‒23%, and closure of the nephrosplenic space (NSS) has been shown to lower the incidence. Described techniques for nephrosplenic space closure (NSC) with concurrent left dorsal displacement (LDD) of the colon at the time of surgery consist of reducing the displaced colon prior to closure. Methods: A retrospective study was performed to evaluate the medical records of horse undergoing NSC between 2017 and 2024. A total of 18 horses with LDD at time of NSC and 21 without displacement at time of NSC were evaluated. Short- and long-term outcomes were compared. Results: Surgical time was similar for both groups. No significant association was found between LDD at time of surgery and the presence of signs of colic after the surgery. A statistically significant decrease in number of colic episodes after surgery was seen in both groups, and none of the horses were represented with an NSE again. Conclusions: Retrospective study design and the associated potential for bias. Conclusions: Full-laparoscopic closure of the NSS with a left dorsally displaced colon, and without prior repositioning of the colon, in subacute or chronic cases, is technically feasible, and safe and does not increase the total surgical time.
© 2025 British Veterinary Association.
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Publication Date: 2025-12-04 PubMed ID: 41342421DOI: 10.1002/vetr.6013Google Scholar: Lookup
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Summary

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Overview

  • This study evaluated a laparoscopic surgical technique to close the nephrosplenic space (NSS) in horses experiencing nephrosplenic space entrapment (NSE) without repositioning the left dorsal colon (LDD) before surgery.
  • The research compared outcomes between horses with and without LDD at the time of nephrosplenic space closure (NSC), assessing surgical time, postoperative colic, and recurrence rates.

Background

  • Nephrosplenic space entrapment (NSE): A condition in horses where part of the large colon becomes trapped in the nephrosplenic space, causing colic and potential recurrence with rates between 8% and 23%.
  • Nephrosplenic space closure (NSC): A surgical procedure designed to close this space to prevent recurrence of entrapment.
  • Left dorsal displacement (LDD) of colon: A concurrent condition where the left dorsal colon is displaced, which traditionally has been repositioned prior to NSC.
  • Existing NSC techniques require repositioning the colon before closure to avoid complications.

Objective

  • To evaluate the safety, feasibility, and outcomes of performing full-laparoscopic NSC using barbed knotless sutures in horses that have LDD at the time of surgery, without first repositioning the colon.
  • Compare these results with horses undergoing NSC without LDD at the time of surgery.

Methodology

  • Study type: Retrospective analysis of medical records from 2017 to 2024.
  • Sample size: 39 horses total — 18 with LDD present at time of NSC and 21 without LDD.
  • Technique: Full-laparoscopic closure of the nephrosplenic space using barbed knotless sutures.
  • Data compared: Surgical duration, postoperative colic signs, number of colic episodes after surgery, and recurrence of NSE.

Results

  • Surgical duration: No significant difference between horses with LDD and those without; the presence of displaced colon did not extend surgery time.
  • Postoperative colic: No statistical association found between LDD and postoperative colic episodes, indicating that leaving the colon displaced did not increase risk.
  • Colic episodes after surgery: Both groups experienced a statistically significant reduction in the number of colic episodes after the NSC procedure.
  • Recurrence: None of the horses in either group had a recurrence of nephrosplenic entrapment following the procedure.

Conclusions

  • Performing full-laparoscopic closure of the nephrosplenic space without prior repositioning of the left dorsal colon is technically feasible and safe, especially in subacute or chronic cases.
  • This approach does not increase surgical time or postoperative complications.
  • The technique successfully reduces colic episodes and prevents recurrence of NSE in treated horses.
  • Retrospective design may introduce some bias, and further prospective clinical studies could strengthen evidence.

Significance

  • This study challenges previous surgical norms that required repositioning of the displaced colon prior to NSC, potentially simplifying the surgical procedure.
  • Using barbed knotless sutures may enhance surgical efficiency and facilitate minimally invasive laparoscopic techniques.
  • Improved surgical technique may decrease the risk of NSE recurrence and postoperative complications while reducing surgical time.

Cite This Article

APA
Willems T, Dias ABM, Dedecker L, Matamalas SS, De Lange L, de Beauregard T. (2025). Full-laparoscopic nephrosplenic space closure with barbed knotless sutures in horses with left dorsal colon displacement without previous colon repositioning. Vet Rec. https://doi.org/10.1002/vetr.6013

Publication

The Veterinary record
ISSN: 2042-7670
NlmUniqueID: 0031164
Country: England
Language: English

Researcher Affiliations

Willems, Tuur
  • Clinique Equine de Meslay, Meslay du Maine, France.
Dias, Ana Beatriz Mourato
  • Department of Large Animal Medicine, University of Georgia, Athens, Georgia, USA.
Dedecker, Lana
  • Department of Clinical Sciences, Auburn University College of Veterinary Medicine, Auburn, Alabama, USA.
Matamalas, Sebastia Sureda
  • Clinique Equine de Meslay, Meslay du Maine, France.
De Lange, Lisa
  • Clinique Equine de Meslay, Meslay du Maine, France.
de Beauregard, Tamara
  • Clinique Equine de Meslay, Meslay du Maine, France.

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