Mesh closure of epiploic foramen by ventral laparotomy in 17 horses with entrapment.

The research article describes a surgical technique – the peroperative mesh closure of the Epiploic Foramen (EF), used in treating horses suffering from EF entrapment, which causes severe strangulating small intestinal obstruction. The article details the procedure, its application on 17 horses, and its long-term results indicating its effectiveness in reducing the risk of recurrence.

Objective and Methodology

• The research aims to propose a solution for an ongoing problem with horses suffering from Epiploic Foramen Entrapment (EFE), characterized by the entrapment of the small intestine, leading to a severe obstruction.
• The technique proposed is a peroperative mesh closure of the EF. This is a surgical procedure involving the creation of an occlusion of the entrapment site using a mesh.
• The study spanned over 5.5 years, during which 36 horses diagnosed with EFE were examined. Among these, 17 horses underwent the mesh closure surgery.

Surgical Procedure

• The surgeons performed various procedures in conjunction with the mesh closure for different cases, based on the individual requirement. These included resection anastomosis and enterotomy in 4 cases each.
• Resection anastomosis is a surgical procedure where a segment of the intestine is removed, and the remaining ends are joined together.
• Enterotomy is a surgical incision into the intestine, generally performed to remove obstructions.

Results and Long-Term Effects

• Out of the 17 horses that underwent the mesh procedure, 15 survived and were discharged.
• Long-term follow-ups ranging from one to three years found that all these 15 horses showed no recurrence of EFE or any related signs of colic, thus indicating the effectiveness of the procedure.
• In two cases, laparoscopic evaluation of the EF was carried out, showing the successful integration of the mesh. Laparoscopy is a minimally invasive surgical procedure used for examination and treatment, which uses a laparoscope to view the internal structures.
• One horse was euthanized due to unrelated reasons 3.5 years post operation, and postmortem examinations showed that the mesh was firmly adhered and the EF was successfully obliterated.

Conclusion

• This study concludes that the mesh closure technique of the EF during coeliotomy (surgical incision into the abdominal cavity) did not cause any short-term complications. This fact held even for horses that underwent resection or enterotomy in addition to the mesh procedure.
• The study suggests that this procedure can effectively reduce the risk of recurrence of EFE in horses.