Laparoscopic cryptorchidectomy using electrosurgical instrumentation in standing horses.

This research paper details a technique for performing laparoscopic cryptorchidectomy, a surgery to remove undescended testes, in standing horses with the use of electrosurgical instrumentation.

Methodology

• The study examined ten horses aged between 1 and 7 years old, all of which had one or both of their testes undescended.
• With the horses on fasting for a minimum period of 12 to 24 hours, they were sedated using xylazine hydrochloride, butorphanol tartrate, or detomidine hydrochloride and restrained in a standing position.
• Three portal sites in the paralumbar fossae, an area on the horse’s back, were then anesthetized using mepivacaine.
• A trocar (a surgical instrument) and a laparoscope (a thin tube with a camera on the end) were inserted into the horses to identify the undescended testicle, mesorchium (part of the spermatic cord), and the ductus deferens (the tube carrying sperm).
• The cranial mesorchium was coagulated, or clotted, using either monopolar (one horse) or bipolar (nine horses) electrosurgical forceps to stop blood flow. The mesorchium, ductus deferens, and ligament of the epididymis’ tail were then cut from the top to the bottom using laparoscopic scissors.
• After freeing the testis, the cut mesorchium was checked for bleeding. If no bleeding was detected, the testis was then removed by joining the two instrument portals (eight horses).
• In cases where two testes were retained, the same procedure was carried out through the opposite paralumbar fossa. If the other testis was already descended, it was removed with a standard, standing castration method.
• Lastly, in two of the cases, the removed testis was placed within a laparoscopic retrieval bag and then taken out without enlarging the incision.

Results

• The vessels of the mesorchium were successfully coagulated using both bipolar and monopolar electrosurgical forceps.
• There was an absence of immediate or short-term complications in the 10 horses that were monitored for a 3 to 11 month period after the surgery.

Conclusion

• The research concludes that laparoscopic cryptorchidectomy can be safely and easily performed in standing position in horses using electrosurgical instrumentation.
• This technique offers a reliable option for addressing cryptorchidism in horses by achieving hemostasis of the equine mesorchium, which is the control of bleeding during surgery.