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Home / Equine Research Bank / Equine Vet J / Laparoscopic closure of the vaginal rings in the standing ho...
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.
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Publication Date: 2021-05-26 PubMed ID: 33864714DOI: 10.1111/evj.13454Google Scholar: Lookup
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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

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This article includes 28 references
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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).
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