FREE SHIPPING over $40
OVER 10000 FIVE-STAR REVIEWS
5% OFF ALL SUBSCRIPTIONS
100% HAPPINESS GUARANTEE
Analyze Diet
0
Equine veterinary journal2021; 54(2); 359-367; doi: 10.1111/evj.13454

Laparoscopic closure of the vaginal rings in the standing horse using a tacked intraperitoneal slitted mesh (TISM) technique.

Abstract: Indirect inguinal herniation (IIH) is a potentially life-threatening condition in stallions. The ideal preventive measure for breeding stallions ensures a minimally invasive closure of the vaginal ring that avoids recurrence of IIH while preserving both testicles. Objective: To describe a minimally invasive laparoscopic tacked intra-peritoneal slitted mesh (TISM) technique in the standing horse to close the vaginal rings and to evaluate its efficacy in preventing recurrence of IIH in stallions. Methods: Retrospective case series. Methods: Medical records of 17 stallions with a history of IIH were reviewed retrospectively. The surgical procedure was performed on the standing horse through a flank approach using four laparoscopic portals. The vaginal ring was covered with a commercial mesh. The mesh was partially cut to create a slitted mesh with two flaps: the dorsal flap was passed under the spermatic cord and ductus deferens and the ventral flap above. The mesh was secured in place with laparoscopic tacks. Long-term follow-up was obtained by a structured telephone interview of the owners. Results: A total of 32 laparoscopic vaginal rings closures were successfully performed in 17 horses. No major intra- or postoperative complications occurred. None of the horse suffered from re-occurrence. Nine of the 13 active breeding stallions were breeding again with similar semen quality as before treatment, 4/13 will resume their breeding activity during the next breeding season. None of the horses were castrated and none of the owners reported abnormal size or shape of the testicles. In three stallions, post-operative pain and activity limitations were noted that gradually resolved after 6 months. Conclusions: The lack of large numbers to compare the results of different mesh and tack combinations, the lack of follow-up veterinary examinations and the limited number of laparoscopic rechecks. Conclusions: The TISM technique is an effective minimally invasive technique to surgically reduce the size of the vaginal ring and thereby prevent recurrence of IIH.
© 2021 EVJ Ltd.
Get Full Text
Publication Date: 2021-05-26 PubMed ID: 33864714DOI: 10.1111/evj.13454Google Scholar: Lookup
The Equine Research Bank provides access to a large database of publicly available scientific literature. Inclusion in the Research Bank does not imply endorsement of study methods or findings by Mad Barn.
LinkedInCopy
  • Journal Article

Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

This research introduces a new minimally invasive surgical technique for preventing recurrence of indirect inguinal herniation (IIH) in breeding stallions. The method, called the Tacked Intra-peritoneal Slitted Mesh (TISM) technique, was found to be effective, with successful laparoscopic closures and no reported recurrence among all participating horses.

Background and Objectives

Indirect inguinal herniation is a potentially life-threatening condition in male horses. The best preventive measures should be minimally invasive, avoid the recurrence of IIH, and ensure that both testicles are preserved. The TISM procedure is positioned as a solution to this, and this article sought to describe it and evaluate its effectiveness.

Methods

  • The researchers conducted a retrospective review of the medical records of 17 stallions who had suffered from IIH.
  • The surgery involved a laparoscopic approach—performed while the horse was standing—through a flank, using four portals. A commercial mesh was used to cover the vaginal rings.
  • The mesh was crafted to have a slitted structure with two flaps—one to pass under the spermatic cord and the ductus deferens, the other to sit above. The mesh was then secured with laparoscopic tacks.
  • Long-term data was gathered via a structured telephone interview with the horse owners.

Results

  • There were 32 successful laparoscopic closures of vaginal rings among the 17 participating horses, with no significant complications during and after surgery.
  • No recurrence was recorded in any of the horses. Of the 13 stallions that were still involved in breeding, 9 were able to continue breeding with preserved semen quality. The other 4 were expected to return to breeding during the upcoming season.
  • Owners did not observe any irregularities in the size or shape of testicles of the horses, and no castrations were necessary.
  • Post-operative pain and activity constraints were experienced in three instances but had resolved by 6 months post surgery.

Limitations and Conclusions

The primary limitations of the study include the small sample size, the absence of follow-up veterinary exams, and limited post-surgery laparoscopic checks. Despite these, the TISM technique was found to be an effective surgical method for reducing the size of the vaginal ring, which in turn may prevent a recurrence of indirect inguinal herniation.

Cite This Article

APA
Wilderjans H, Meulyzer M. (2021). Laparoscopic closure of the vaginal rings in the standing horse using a tacked intraperitoneal slitted mesh (TISM) technique. Equine Vet J, 54(2), 359-367. https://doi.org/10.1111/evj.13454

Publication

Equine veterinary journal
ISSN: 2042-3306
NlmUniqueID: 0173320
Country: United States
Language: English
Volume: 54
Issue: 2
Pages: 359-367

Researcher Affiliations

Wilderjans, Hans
  • Dierenkliniek De Bosdreef, Moerbeke-Waas, Belgium.
Meulyzer, Michael
  • Dierenkliniek De Morette, Asse, Belgium.

MeSH Terms

  • Animals
  • Contraceptive Devices, Female
  • Female
  • Herniorrhaphy / veterinary
  • Horses
  • Laparoscopy / veterinary
  • Male
  • Retrospective Studies
  • Semen Analysis / veterinary
  • Surgical Mesh / veterinary

References

This article includes 28 references
  1. François I, Lepage O, Boswell J, Schofield W, Olmos JP, Grulke S. Acquired inguinal herniation in horses: a retrospective multicenter study of 48 cases. Vet Surg 2014;43:E167.
  2. Wilderjans H, Meulyzer M, Simon O. Standing laparoscopic peritoneal flap hernioplasty technique for preventing recurrence of acquired strangulating inguinal herniation in stallions. Vet Surg 2012;41:292-9.
  3. Freeman DE. Jejunum and ileum. In: Auer JA, Stick JA, Kümmerle JM, Prange T (Eds), Equine surgery 5th edition. St. Louis, MO: Elsevier Saunders; 2018. pp. 550-2.
  4. Tóth F, Schumacher J. Abdominal hernias. In: Auer JA, Stick JA, Kümmerle JM, Prange T (Eds). Equine surgery 5th edition. St. Louis, MO: Elsevier Saunders; 2018. pp. 656-8.
  5. Wilderjans H, Simon O, Boussauw B. Strangulating Hernia in 63 Horses - Results of A Manual Closed Non-Surgical REDUCTION Followed by a Delayed Laparoscopic Closure of The Vaginal Ring. Proceedings of the 16th ECVS Annual Meeting Dublin, Ireland. 2007; pp 92-7.
  6. Baranková K, de Bont M, Simon O, Meulyzer M, Boussauw B, Vandenberghe F. Nonsurgical manual reduction of indirect inguinal hernias in 89 adult stallions. Equine Vet Educ 2021. Epub ahead of print.
    doi: 10.1111/eve.13494google scholar: lookup
  7. McCormick JD, Valdez R, Rakestraw PC. Effects of surgical technique for unilateral orchiectomy on subsequent testicular function in miniature horse stallions. Equine Vet J Suppl 2012;43:100-4.
  8. Vaughan JT. Surgery of the testes. In: Walker DF, Vaughan JT (Eds), Bovine and equine urogenital surgery. Philadelphia, PA: Lea & Febiger. 1980; pp. 145-69.
  9. Gignozzi L. Surgical treatment of scrotal hernia in foals and yearlings without orchectomy. Tijdschr Diergeneeskunde 1973;98:1025-6.
  10. Fisher AT Jr, Vachon AM, Klein SR. Laparoscopic inguinal herniorrhaphy in two stallions. J Am Vet Med Assoc 1995;207:1599-601.
  11. Marien T. Standing laparoscopic herniorrhaphy in stallions using cylindrical polypropylene mesh prosthesis. Equine Vet J 2001;33:91-6.
  12. Rossignol F, Perrin R, Boening KJ. Laparoscopic hernioplasty in recumbent horses using transposition of a peritoneal flap. Vet Surg 2007;36:557-62.
  13. Caron JP, Brakenhoff J. Intracorporeal suture closure of the internal inguinal and vaginal rings in foals and horses. Vet Surg 2008;37:126-31.
  14. Rossignol F, Mespoulhes-Rivière C, Vitte A, Lechartier A, Boening KJ. Standing laparoscopic inguinal hernioplasty using cyanoacrylate for preventing recurrence of acquired strangulated inguinal herniation in 10 stallions. Vet Surg 2014;43:6-11.
  15. Ragle CA, Yiannikouris S, Tibary AA, Fransson BA. Use of a barbed suture for laparoscopic closure of the internal inguinal rings in a horse. J Am Vet Med Assoc 2013;242:249-53.
  16. Luijendijk RW, Hop WC, van den Tol MP, de Lange DCD, Braaksma MMJ, IJzermans JNM. A comparison of suture repair with mesh repair for incisional hernia. N Engl J Med 2000;343:392-8.
  17. Burger JW, Luijendijk RW, Hop WC, Halm JA, Verdaasdonk EGG, Jeekel J. Long-term follow-up of a randomized controlled trial of suture versus mesh repair of incisional hernia. Ann Surg 2004;240:578-83.
  18. Gray SH, Hawn MT, Itani KM. Surgical progress in inguinal and ventral incisional hernia repair. Surg Clin Norh Am 2008;88(1):17-26.
  19. LeBlanc KA. Incisional hernia repair: laparoscopic techniques. World J Surg 2005;29:1073-9.
  20. Smietanski M, Bigda J, Iwan K, Kołodziejczyk M, Krajewski J, Śmietańska IA. Assessment of usefulness exhibited by different tacks in laparoscopic ventral hernia repair. Surg Endosc 2007;21:925-8.
  21. Hollinsky C, Gobl S. Bursting strength evaluation after different types of mesh fixation in laparoscopic herniorrhaphy. Surg Endosc 1999;13:958-61.
  22. Reynvoet E, Berrevoet F, De Somer F, Vercauteren G, Vanoverbeke I, Chiers K. Tensile strength testing for resorbable mesh fixation systems in laparoscopic ventral hernia repair. Surg Endosc 2012;26(9):2513-20.
  23. Hollinsky C, Kolbe T, Walter I, Joachim A, Sandberg S, Koch T. Tensile strength and adhesion formation of mesh fixation systems used in laparoscopic incisional hernia repair. Surgical Endosc 2010;24(6):1318-24.
  24. Reynvoet E, Berrevoet F. Pros and cons of tacking in laparoscopic hernia repair. Surg Technol Int 2014;25:136-40.
  25. Colavita PD, Tsirline VB, Belyansky I, Walters AL, Lincourt AE, Sing RF. Prospective, long-term comparison of quality of life in laparoscopic versus open ventral hernia repair. Ann Surg 2012;256:714-23.
  26. Wassenaar E, Schoenmaeckers E, Raymakers J, van der Palen J, Rakic S. Mesh-fixation method and pain and quality of life after laparoscopic ventral or incisional hernia repair: a randomized trial of three fixation techniques. Surg Endosc 2010;24:1296-302.
  27. Eriksen JR, Poornoroozy P, Jorgensen LN, Jacobsen B, Friis-Andersen HU, Rosenberg J. Pain, quality of life and recovery after laparoscopic ventral hernia repair. Hernia 2009;13:13-21.
  28. Reynvoet E, Deschepper E, Rogiers X, Troisi R, Berrevoet F. Laparoscopic ventral hernia repair: is there an optimal mesh fixation technique? A systematic review. Arch Surg 2014;399:55-63.

Citations

This article has been cited 5 times.
  1. Vázquez FJ, Romero A, Fuente S, Barrachina L, Vitoria A. Laparoscopically Assisted Percutaneous Inguinal Ring Closure for Resolution of Inguinal/Scrotal Hernias in Rams: Cadaveric Study and Three Cases Report. Animals (Basel) 2023 Feb 24;13(5).
    doi: 10.3390/ani13050836pubmed: 36899693google scholar: lookup
  2. Straticò P, Guerri G, Palozzo A, Varasano V, Petrizzi L. Current Use of Equine Laparoscopy in Urogenital Disorders: A Scoping Review of the Literature from 2000 to 2021. Vet Sci 2022 Jan 22;9(2).
    doi: 10.3390/vetsci9020041pubmed: 35202295google scholar: lookup
  3. Saitua A, Sanchez de Medina A, Bulnes F, Buzon A, Miraz R, Argüelles D, Diez de Castro E. Urogenital surgery in foals. Front Vet Sci 2025;12:1520491.
    doi: 10.3389/fvets.2025.1520491pubmed: 40586037google scholar: lookup
  4. Vitoria A, Barrachina L, Romero A, Fuente S, de Blas I, Gil L, Vázquez FJ. Laparoscopic Inguinal Hernioplasty with a Polyether Ether Ketone Anchoring Device in Intact Male Horses Does Not Compromise Testicular Perfusion, Sperm Production or Motility Characteristics. Animals (Basel) 2025 Jan 31;15(3).
    doi: 10.3390/ani15030402pubmed: 39943172google scholar: lookup
  5. Vázquez FJ, Argüelles D, Muñoz JA, Genton M, Méndez Angulo JL, Climent F, Roquet I, Iglesias M, Velloso Álvarez A, Vitoria A, Bulnes F, Saitua A, Romero A, Ezquerra J, Prades M, López-Sanromán FJ, Rossignol F. Use of Knotless Barbed Sutures in Laparoscopic Inguinal Hernioplasty in Horses: 40 Cases. Animals (Basel) 2024 Jun 19;14(12).
    doi: 10.3390/ani14121826pubmed: 38929445google scholar: lookup
Subscribe to our newsletter
Join 99,727 horse owners like you who receive our email updates on horse health and nutrition.