Incisional hernia repair in horses: a cadaveric study of endoscopic component separation.

The research article presents a study that develops and assesses an endoscopic procedure to repair incisional hernias in horses. The research indicates that while the procedure is technically feasible, it only results in a modest improvement in abdominal wall advancement.

Methodology

• The study is a descriptive research conducted on fresh horse cadavers (14 in total).
• The technique used is called endoscopic component separation. It involves making a cut in the external abdominal oblique fascia, which is the layer of muscle on the side of the horse’s abdomen, that is located beside the rectus abdominis muscle. This is a muscle that runs vertically on each side of the anterior wall of the human abdomen.
• A laparoscope is used to create a space between the external and internal abdominal oblique muscles. A laparoscope is a long, thin tube with a high-intensity light and a high-resolution camera at the front, which is inserted through an incision in the abdominal wall.
• Another incision, about 10-12 cm from the laparoscope, is made to allow for the operation of other surgical instruments.
• The separation process involved cutting the external oblique fascia from about 20 cm above the junction between the rib and cartilage to the level of the superficial inguinal ring, a tunnel in the front wall of the abdomen where blood vessels pass through in men, and ligament in women.
• A ventral median celiotomy, an opening made in the abdominal wall, of 30 cm is created and the advancement of the myofascial, a type of tissue which provides support and protection for the body’s muscle and bone, is measured at 10 and 20 cm above the navel.

Results

• The research reported that endoscopic component separation was successfully completed on all horses.
• The average increase in abdominal wall advancement measured was between 3.4 and 3.5 cm at points 10 cm and 20 cm respectively above the umbilicus or belly button.

Conclusion

• The study concluded that the endoscopic component separation technique for repairing incisional hernias in horses is technically feasible. However, the amount of abdominal wall advancement achieved through this process was modest.