Laparoscopic-assisted cystotomy for urolith removal in geldings.

The research article describes a surgical technique called laparoscopic-assisted cystotomy, used to remove bladder stones (uroliths) in male horses (geldings). The study involved four geldings and the procedure was carried out successfully without complications, with none showing recurring signs of bladder stones up to 12 months after the surgery.

Methods

• The article describes using a procedure called laparoscopic-assisted cystotomy for the removal of bladder stones. This was performed on four anesthetized geldings (male horses).
• The procedure started with the horses being placed in dorsal recumbency (on their backs). Then, using a laparoscope through the belly button (umbilicus), the horses’ abdomen were insufflated (inflated), allowing for clear viewing and manipulation of abdominal organs.
• The surgery table was tilted to a 30-degree head-down position before an instrumental portal was created near the left external inguinal ring.
• The bladder was gently grasped and elevated to the abdominal wall using laparoscopic forceps. A skin incision was made through which the apex of the bladder was brought out of the body (exteriorized).
• The bladder was incised and the bladder stone was removed. After closing the bladder incision, it was repositioned inside the abdomen.
• The skin incisions were closed in multiple layers to promote healing and prevent complications.

Results

• The procedure was carried out without any complications during or after surgery, with surgical time ranging from 35 to 40 minutes.
• Short term side effects only included minor swelling at the incision site which lasted for 3-4 days. Hematuria (blood in urine) and slight stranguria (straining to urinate) was observed up to the 4th day after surgery.
• On follow up after 12 months, none of the horses showed recurrence of symptoms associated with bladder stones.

Conclusions

• The researchers concluded that bladder stones, of 6-8 cm diameter, can be successfully and safely removed using laparoscopic-assisted cystotomy in geldings.
• This technique combines the benefits of parainguinal laparocystotomy with a laparoscopic technique, thus effectively eliminating their individual disadvantages.