Use of a hand-assisted laparoscopic technique for removal of a uterine leiomyoma in a standing mare.

This research studied a surgical technique for removing a uterine tumor in a horse. The 20-year-old mare had fertility issues and a leiomyoma was discovered in her right uterine horn. Surgeons performed a hand-assisted laparoscopic technique which allowed them to visualize the abdominal structures and ensure accurate placement of ligatures.

Background

• The study is about a 20-year-old Thoroughbred mare who had been infertile for 2 years. Despite having regular estrous cycles and having been bred 7 times by different stallions, the mare remained infertile.
• A homogenous hyperechoic intramural mass was detected in the tip of the mare’s right uterine horn through ultrasonography and hysteroscopy.
• This mass or tumor was diagnosed as a leiomyoma, which is a type of benign tumor that originates from the smooth muscle layer of the uterus. In some cases, these tumors can cause fertility problems in mares.

Technique Used

• The researchers dealt with the mare’s leiomyoma through a medical procedure known as “hand-assisted laparoscopic technique.”
• This technique is minimally invasive and is performed by making a small incision in the abdomen to insert a laparoscope – a long, thin tube with a high-intensity light and a high-resolution camera at the front. The image is displayed on a screen, providing a live, magnified view of the internal organs without the need for a large incision.
• The surgeon then uses hand-assisted laparoscopic instruments to remove the tumor while watching the procedure on the screen.

Results and Recommendations

• The hand-assisted laparoscopic technique proved successful in this case, as the surgeons were able to clearly see and study the organs in the abdomen. This also allowed for accurate placement of ligatures (ties or sutures used for binding) without placing tension on the broad ligament (an important structure supporting the uterus).
• The technique aids in minimizing the risks and costs commonly associated with general anesthesia.
• This illustrates the effectiveness of using a hand-assisted laparoscopic technique for removing a leiomyoma in mares, specifically those struggling with infertility. It is suggested that a unilateral ovariectomy and partial hysterectomy be considered for mares with leiomyoma in a uterine horn, especially when fertility has become a concern.