Laparoscopic intestinal exploration and full-thickness intestinal biopsy in standing horses: a pilot study.

This research piloted a new surgical technique for taking biopsies from the intestines of horses. The process, known as standing right flank laparoscopy, was found to be a potentially safer alternative to traditional exploratory celiotomy and biopsy methods, able to reach further into the ileum (a part of the small intestine) than established procedures.

Methodology

• The researchers performed their experimental study on seven adult horses. These were divided into two groups: Group A consisted of three horses and Group B consisted of four horses.
• Prior to the procedure, food but not water was withheld from the horses for 36 hours. This was to clear the intestines and make them easier to examine and operate on.
• In Group A, the researchers tested laparoscopic access to different small intestinal segments in standing horses by comparing it to ventral median celiotomy access. Parts of the intestine that could not be reached by laparoscopy were noted upon necropsy.
• In Group B, the research team evaluated the feasibility of obtaining full-thickness biopsies of the duodenum and the cecum, two key parts of the equine digestive system. They also evaluated any associated health risks.
• The biopsy specimens were collected during standing laparoscopy using a two-step procedure and an internal suturing technique. Abdominal lavage, a cleansing procedure, was also performed.
• Post operation, the horses were closely monitored through clinical observation, cytology (examination of cells) and bacterial culture from abdominal fluid samples. A follow-up laparoscopy was also performed on day six.

Results

• The right flank laparoscopy technique provided effective observation of the small intestines and was able to manipulate more parts than the traditional ventral median celiotomy procedure; differences noted were approximately 15-20cm for the duodenum and about 40cm more for the ileum.
• In Group B, there were no reported complications, adhesions (scarring), or bacterial growth in peritoneal fluid samples. Additionally, none of the horses exhibited signs of abdominal pain.

Conclusions

• The findings suggest that standing right flank laparoscopic biopsy is a safe alternative to exploratory celiotomy and biopsy in horses. The new technique enables biopsy of larger parts of the intestine, including 50% more of the ileum than is possible with traditional ventral median celiotomy.
• Despite the positive findings in this pilot study, the researchers concluded that the suitability of this new technique in clinical settings needs to be fully evaluated.