Standing laparoscopic peritoneal flap hernioplasty technique for preventing recurrence of acquired strangulating inguinal herniation in stallions.

The research article discusses a newly developed surgical intervention referred to as standing laparoscopic peritoneal flap hernioplasty (PFH), aimed at preventing the recurrence of strangulating inguinal hernia (SIH) in stallions. The study found that using this technique to close the entire vaginal ring showed no SIH recurrence, and it did not affect stallions’ fertility.

Description of the Method

• The research used a total of 30 stallions aged between 3 to 15 years. Intervention was applied to stallions that had previously had SIH without castration.
• The researchers performed bilateral standing laparoscopic PFH, which involved the creation of a large, inverted U-shaped peritoneal flap that was dissected from the abdominal wall before being reflected over the vaginal ring. This was then secured to the abdominal wall using laparoscopic staples.
• The surgical procedure was conducted through three portals; two in the paralumbar fossa and a third one situated between the 17th and 18th ribs on the ipsilateral side.

Diversity in Method Application

• In the application of the surgery, diversity was observed where in the first 11 cases, only the cranial and mid third of the vaginal ring was covered by the flap.
• In the remaining 19 stallions, complete closure of the vaginal ring was achieved, including the entire caudal aspect of the ring.

Results of the Study

• Findings from this procedure were significant. It was observed that SIH recurrence happened in 4 out of 11 stallions where incomplete ring coverage was done. However, no SIH recurrence was reported where the entire vaginal ring was covered.
• No major complications were reported post-surgery, and the outcome was rated excellent from a cosmetic viewpoint.
• All the stallions used in the study were successfully employed for breeding post intervention, indicating that the method does not affect stallions’ fertility.

Study Conclusion

• The study concludes the standing laparoscopic closure of the vaginal ring using a PFH is a promising and effective method for preventing SIH recurrence amongst stallions. Key to its efficiency, however, is ensuring that the entire vaginal ring, including the caudal aspect, is completely covered by the flap.