Laparoscopic mesh incisional hernioplasty in five horses.

The study demonstrates a successfully implemented laparoscopic technique for repairing incisional hernia in horses using a prosthetic mesh. The procedure avoided major complications and provided satisfactory cosmetic results.

Research Methodology

• The study involved a case series of five horses.
• All these horses had ventral median abdominal incisional hernia, a condition that occurs when an area of the abdominal wall becomes weak, enabling the inner abdominal content to push through and form a bulge.
• The researchers conducted laparoscopic surgery, a minimally invasive surgical method through which an instrument known as a laparoscope is inserted into the abdomen via small incisions.
• The laparoscopic procedure involved a telescope and two instrument portals established bilaterally, lateral to, and distant from the hernia margins.
• The technique required exposure of the internal rectus sheath, which was achieved by removing retroperitoneal fat with endoscopic scissors and monopolar cautery. This approach involved careful operation to avoid damaging the surrounding tissues and organs.
• After the exposure, a prosthetic mesh was introduced into the abdomen, which was then secured intraperitoneally using transfascial sutures, with or without supplemental endoscopic hernia fixation devices.

Results of the Study

• The technique resulted in successful placement of the prostheses without any major intraoperative or postoperative complications associated with traditional hernia surgeries. This suggests that the laparoscopic technique results in a lesser degree of trauma, fewer postoperative complications, and quicker recovery.
• All repairs were intact in all horses for a follow-up range of 6 to 23 months. There was no evidence of adhesion formation, a common postoperative complication where scar-like tissues cause organs and tissues that are normally separate to stick together. This indicates the long-term effectiveness of the procedure.
• Cosmetic results were found to compare favorably with results typically achieved using conventional, open hernioplasty techniques. This is an important consideration as the appearance of the incision site matters in the equine industry, particularly for show and race horses.

Conclusions

• The researchers concluded that incisional hernia repair in horses can be successfully achieved with a laparoscopic intraperitoneal mesh onlay technique.
• Consequently, the study suggests that laparoscopic mesh hernioplasty presents promising prospects as a safe and effective method for the repair of incisional hernias in horses.