Indications, surgical technique, and long-term experience with laparoscopic closure of the nephrosplenic space in standing horses.

The research is a retrospective study discussing a laparoscopic surgical technique for the treatment of recurrent left colonic displacement in horses, also documenting its long-term outcomes and success rate.

Research Methodology

• The study was conducted retrospectively, reviewing cases of forty-four horses with recurrent left dorsal displacement of the left colon (LDDLC).
• The horses underwent laparoscopic surgery, a minimally invasive surgical technique where small incisions are made to insert a camera and the surgical instruments.
• The procedure was performed with the horse standing. The laparoscopic portals were located in the horse’s left flank region.
• The medication etilefrin was administered intravenously to the horses to cause contraction of the spleen. Post contraction, the dorsal splenic margin was sutured to the nephrosplenic ligament to close the nephrosplenic space – a potential space found between the spleen and the left kidney.
• The horses were re-examined within or equal to 3 years for a history of recurrence. Medical records of a total of 4,852 horses treated for colic over 16 years were also studied to establish the occurrence rate of LDDLC and recurrence after treatment.

Research Results

• Results showed that the contraction of the spleen facilitated the placement of sutures and the closure of the nephrosplenic space was accomplished without complications.
• None of the horses showed recurrence of LDDLC, although five had subsequent episodes of colic and four had displacement of the ascending colon between the spleen and the body wall.
• Upon review of extensive medical records, the occurrence of LDDLC was found to be at 6%, with a 21% recurrence rate in horses showing signs of colic.

Research Conclusion

• The study concluded that the laparoscopic closure of the nephrosplenic space, facilitated by etilefrin-induced splenic contraction, can be efficiently performed in standing horses.
• Given the low recurrence rate of LDDLC and the minimal complications, the study suggests that laparoscopic obliteration of the nephrosplenic space should be considered in horses that are predisposed to recurrent LDDLC.