J-incision to approach the cranial abdomen in the adult horse.

The research article is about the successful usage of a modified surgical procedure–the J-incision—to reach the cranial abdominal structures in horses, particularly those with gastric impactions and diaphragmatic hernias.

Study Methods and Participants

• The study utilizes a short case series methodology involving four adult horses.
• Three of these horses had gastric impactions and were thus subjected to gastrotomies, which involve the surgical incision into the stomach to remove foreign materials.
• The remaining horse had a diaphragmatic hernia and underwent a herniorrhaphy (the surgical repair of a hernia) with mesh augmentation, a technique utilized to provide extra support to the weakened area.

Procedure

• In the surgical process, a ventral midline celiotomy, a traditional incision along the midline of the horse’s abdomen, was modified.
• The modification involved a cranially extended J-incision through the body wall, along the paracostal arch, a curved line towards the backside of the rib cage.

Results

• The only noticeable surgical complications were infections at the site of the midline incisions in all the horses. However, these complications were controlled.
• Long-term outcomes were favorable in three out of the four horses. The fourth horse was euthanized for reasons presumably unrelated to the surgical complications.

Conclusions

• The adoption of the J-incision reportedly improved access to the stomach and the diaphragm in all the studied horses.
• The paracostal component of the incision healed successfully in all cases, without any signs of infection or dehiscence (a surgical complication where the wound ruptures along a surgical suture).
• The researchers therefore suggest the usage of the J-incision during gastrotomies and the repair of dorsally located diaphragmatic hernias, which are located towards the spine.