Use of Polyamide (Nylon) Cable Ties for Vascular Ligation of Healthy Equine Jejunal Mesentery.
Abstract: Jejunal vascular ligation is an essential step in performing jejunojejunostomy. Hand sewn ligation is typically used and can increase operative time with long sections of bowel to be removed. Nylon cable ties (NCT) have been used for vascular ligation in horses but are yet to be investigated for application on the mesenteric vasculature of the gastrointestinal tract. Our objective was to evaluate the efficacy and short-term safety of NCT jejunal mesenteric vessel ligation in healthy horses. Eight healthy adult horses underwent midline celiotomy. A segment of jejunal mesentery was identified (≥4 arcades). Briefly, three fenestrations (proximal, middle, distal) were made 5-10 mm apart adjacent to the first and last vascular arcade to be ligated. Two sterilized NCT were passed to encircle the mesentery through the proximal and middle fenestrations, separated by intact mesentery. NCT were closed tightly and the vascular pedicle transected with Mayo scissors through the distal fenestration. Jejunojejunostomy was then performed and the mesentery sutured closed. The number of vascular arcades and time to ligate using NCT were recorded. At 2 weeks, horses underwent repeat celiotomy to assess the healing of the NCT ligation site and an equal number of vascular arcades were hand sewn double ligated using 2-0 Polyglactin 910 as a timed comparison. NCT mesenteric ligation was significantly faster than hand sewn methods ( < 0.01). Effective hemostasis was achieved in all cases. There was no evidence of local infection or adhesions at 14 days post-operatively. Further investigation in the long-term effects in horses as well as horses with strangulating jejunal lesions are needed for clinical application.
Copyright © 2021 Hurcombe, Roessner, Klein, Engiles and Hopster.
Publication Date: 2021-08-12 PubMed ID: 34458347PubMed Central: PMC8387623DOI: 10.3389/fvets.2021.639424Google Scholar: Lookup
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Summary
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This research paper explores the use of nylon cable ties (NCT) as an efficient method for ligation during jejunojejunostomy performed on healthy horses. The study indicates that the use of NCT is significantly quicker compared to traditional hand sewn methods and does not cause local infection or adhesions after 14 days of the operation.
Objective and Methodology
- The researchers aimed to assess the effectiveness and short-term safety of using nylon cable ties (NCT) for ligation of jejunal mesenteric vessels in healthy horses. The efficiency of the method was examined by comparing the time taken for the ligation process between NCT and the conventional hand-sewn-double-ligation method.
- The study was conducted on eight healthy adult horses who underwent midline celiotomy, a specific veterinary surgery procedure, and a section of jejunal mesentery was identified for the study (≥4 arcades).
- The researchers used a specific technique whereby three fenestrations (openings) were created on the area of interest and two sterilized NCT encircled the mesentery through these fenestrations, leaving intact mesentery between them.
- After closing the NCT tightly, the vascular pedicle was cut through the distal fenestration. Following the ligation, jejunojejunostomy was performed and the sutured mesentery was closed.
Observations and Findings
- The findings of the study showed that the use of NCT for ligation was significantly faster than the traditional hand-sewn method.
- The researchers also noted that the use of NCT resulted in effective hemostasis (stopping of blood flow) in all cases, making it a potentially reliable method for vascular ligation during veterinary surgery.
- Post-operative assessment two weeks later showed no signs of local infection or adhesions, further supporting the safety of the method. However, the legitimacy of the assessment could be questioned, given the short timeline involved.
Conclusion and Future Work
- The researchers concluded that the use of NCT could be effective and safe for vascular ligation in horses, with observed advantages over traditional hand-sewn methods in terms of speediness and reduction of operative time. This could make NCT good candidates for usage during veterinary surgeries.
- However, the paper highlights the need for further investigation to understand the long-term effects of using NCT for ligation, while also investigating its appropriateness for use in horses with certain medical conditions like strangulating jejunal lesions.
Cite This Article
APA
Hurcombe SD, Roessner HA, Klein CE, Engiles JB, Hopster K.
(2021).
Use of Polyamide (Nylon) Cable Ties for Vascular Ligation of Healthy Equine Jejunal Mesentery.
Front Vet Sci, 8, 639424.
https://doi.org/10.3389/fvets.2021.639424 Publication
Researcher Affiliations
- Department of Clinical Sciences, School of Veterinary Medicine, New Bolton Center, University of Pennsylvania, Kennett Square, PA, United States.
- Department of Clinical Sciences, School of Veterinary Medicine, New Bolton Center, University of Pennsylvania, Kennett Square, PA, United States.
- Department of Clinical Sciences, School of Veterinary Medicine, New Bolton Center, University of Pennsylvania, Kennett Square, PA, United States.
- Department of Clinical Sciences, School of Veterinary Medicine, New Bolton Center, University of Pennsylvania, Kennett Square, PA, United States.
- Department of Pathobiology, School of Veterinary Medicine, New Bolton Center, University of Pennsylvania, Kennett Square, PA, United States.
- Department of Clinical Sciences, School of Veterinary Medicine, New Bolton Center, University of Pennsylvania, Kennett Square, PA, United States.
Conflict of Interest Statement
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
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