Nephrectomy via ventral median celiotomy in equids.

This study examined a surgical technique called nephrectomy through a ventral median celiotomy, and its outcomes in horses, donkeys and mules. The objective of the research was to treat various kidney-related conditions in equids. The results revealed that the ventral median approach was largely effective with minimal postoperative complications.

Methods

• Six equids with a single kidney disease were selected. These ranged from 2 months to 18 years of age, and weighed between 90-434 kg.
• Ventral median celiotomy, a surgical procedure that involves making an incision along the midline of the abdomen, was used to access their left or right kidney.
• For a better surgical view, the small intestine was moved towards the diaphragm using surgical sponges, while the ascending colon was moved outside and in some cases emptied.
• After creating an incision in the peritoneum over the affected kidney, surgical dissection was used to remove the kidney from the surrounding fat. The renal artery, vein, and ureter were then identified and tied off.
• The surgery was concluded with an abdominal wash with sterile saline solution, and then the abdomen was closed up.

Results

• A repeated procedure of unilateral nephrectomy was conducted on four horses, one donkey and one mule to treat conditions like verminous nephritis, idiopathic hematuria, and ectopic ureter.
• The ventral median approach used in nephrectomy provided sufficient access to the kidney in all six cases.
• Postoperative complications like peritonitis and abdominal accumulation of lymph (chylous abdominal effusion) were noted in two horses. These complications were managed successfully using medical therapy.
• Upon follow-up after 1-8 years post-surgery, no complications relating to the nephrectomy were reported by the animal owners.

Conclusion

• The research concludes that a ventral median approach can be effectively used for nephrectomy in equids weighing up to 434 kg.
• Though there were postoperative complications in a few cases, they were manageable and did not present any long-term negative outcomes. Thus, this research assures the safety and effectiveness of this approach to kidney removal in equids.