Use of a barbed suture for laparoscopic closure of the internal inguinal rings in a horse.

The article details a study on the usage of a barbed suture for laparoscopic closure of the internal inguinal rings in a horse. The procedure was executed on a 4-year-old Arabian horse with a right-sided inguinal hernia, showing positive results, reducing the chances of a hernia recurrence, and proving itself as an effective treatment option.

Initial Examination of the Patient

• The patient, a 4-year-old castrated Arabian horse, was evaluated for a right-sided nonstrangulating inguinal hernia that could be manually reduced.
• The medical exam revealed a right-sided hydrocele, a condition where there is an abnormal accumulation of fluid.
• Additionally, the horse had a bilateral enlargement of the inguinal rings, or openings, which was confirmed by external digital and rectal palpation.

Treatment Procedure

• Biportal laparoscopic internal inguinal ring closure was performed – a minimally invasive surgical technique utilising two surgical portals or openings.
• The unidirectional barbed suture was used, creating tension and thus a secure closure along the suture line without the need for knots at the beginning or the end.
• This suture was applied with a mechanical suturing instrument, which further enhances the security of the closure.

Post Surgery Observations

• Post-surgery, healing of the surgical sites was confirmed through physical examination and laparoscopy, a procedure to look at the abdominal organs.
• There was also a notable reduction in the size of the inguinal rings.
• The horse was exercised for a consecutive 20 months post-surgery without the recurrence of the inguinal hernia, suggesting the success of the procedure.

Conclusion & Recommendations

• The study recommends considering laparoscopic application of unidirectional barbed sutures as a treatment option for recurrent inguinal herniation in horses.
• Compared to the traditional methods, this technique only required two portals per side, in comparison to the typical usage of three to four portals.
• The barbed suture and mechanical suturing instrument provided added security to the closure; the challenges of performing suture reduction of the internal inguinal ring were dramatically reduced as dual instrument suturing and intracorporeal knot tying were no longer needed.