Standing laparoscopic herniorrhaphy in stallions using cylindrical polypropylene mesh prosthesis.

The research study involves performing laparoscopic herniorrhaphy on nine stallions while standing, using a cylindrical polypropylene mesh prosthesis. The herniorrhaphy was successfully accomplished by using an innovative, minimally invasive technique, which resulted in a closed inguinal canal within two weeks, while preserving the testis.

Methodology

• In this study, standing laparoscopic herniorrhaphy was carried out on nine stallions. Laparoscopic herniorrhaphy is a surgical procedure to repair hernias using a laparoscope, a long, slender device equipped with a light and camera that enables surgeons to observe the internal structure without creating a large incision.
• For effective pain management during the operation, the stallions were sedated using Detomidine, an alpha-2 adrenergic agonist used for sedation and analgesia in large animals like horses. Local flank infiltration was also performed with Mepivacaine, an amide local anesthetic, to numb the surgical site.

Procedure

• Three portal sites were created at the paralumbar fossa, an area on the lower back of the horse, to perform the herniorrhaphy using triangulation. Triangulation in surgical context refers to the approach of using multiple points of access for the surgical instruments to enable better precision and visibility.
• A cylindrical polypropylene mesh was inserted and fixated in the inguinal canal, a passage in the anterior abdominal wall which in males conveys spermatic cord and in females, the round ligament of the uterus. The mesh works as a flexible scaffold that supports the affected area promoting healing and preventing further herniation.

Results

• Following the surgery, adhesion formation occurred which led to the obliteration of the inguinal canal within two weeks. The term obliteration in this context refers to the closure or blockage of a space or passage in the body as a result of the healing process.
• This innovative, minimally invasive technique made it possible to perform a testis sparing herniorrhaphy while the horse was standing. This not only maintained the reproductive abilities of the stallions, but also potentially decreased the recovery time and surgical complications often associated with traditional open surgery.