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1.
Laparoscopic repair of a small intestinal mesenteric rent in a broodmare   总被引：1，自引：0，他引：1  
OBJECTIVES : To describe standing laparoscopic repair of mesoduodenal rent inaccessible by ventral median celiotomy. STUDY DESIGN : Clinical case report. SAMPLE POPULATION : A 6-year-old Thoroughbred broodmare with a right displacement of the dorsal colon and small intestinal incarceration in a mesoduodenal rent. METHODS : Two days after correction of a right dorsal displacement of the ascending colon, small intestinal incarceration, and partial closure of mesoduodenal rent, standing left and right flank laparoscopy was used to explore the abdomen to identify the mesoduodenal defect. The mesenteric rent was repaired from right flank portals by approximation with hemostatic clips. RESULTS : Approximation of the mesoduodenal rent was achieved with laparoscopic clips. No further complications or signs of abdominal pain occurred over the following year. CONCLUSIONS : Mesenteric rents in the mesoduodenum can be repaired by laparoscopic techniques in the standing horse. CLINICAL RELEVANCE : Use of laparoscopic techniques in the standing horse should be considered for mesoduodenal rents that are not accessible form a ventral median celiotomy.  相似文献   

2.
OBJECTIVE: To assess a technique for laparoscopic collection of serial full-thickness small intestinal biopsy specimens in horses. ANIMALS:13 healthy adult horses. PROCEDURES: In the ex vivo portion of the study, sections of duodenum and jejunum obtained from 6 horses immediately after euthanasia were divided into 3 segments. Each segment was randomly assigned to the control group, the double-layer hand-sewn closure group, or the endoscopic linear stapler (ELS) group. Bursting strength and bursting wall tension were measured and compared among groups; luminal diameter reduction at the biopsy site was compared between the biopsy groups. In the in vivo portion of the study, serial full-thickness small intestinal biopsy specimens were laparoscopically collected with an ELS from the descending duodenum and distal portion of the jejunum at monthly intervals in 7 sedated, standing horses. Biopsy specimens were evaluated for suitability for histologic examination. RESULTS: Mean bursting strength and bursting wall tension were significantly lower in the ELS group than in the hand-sewn and control groups in both the duodenal and jejunal segments. Use of the hand-sewn closure technique at the biopsy site reduced luminal diameter significantly more than use of the stapling technique. In the in vivo part of the study, all 52 biopsy specimens collected during 26 laparoscopic procedures were suitable for histologic examination and no clinically important perioperative complications developed. CONCLUSIONS AND CLINICAL RELEVANCE: Laparoscopic collection of serial full-thickness small intestinal biopsy specimens with a 45-mm ELS may be an effective and safe technique for use in healthy adult experimental horses.  相似文献   

3.
Laparoscopic Cryptorchid Castration in Standing Horses   总被引：1，自引：0，他引：1  
Objective — This article describes a new technique for laparoscopic cryptorchid castration in standing horses. Study Design — Prospective study. Animals or Sample Population — Eight horses aged 11 months to 3 years and weighing between 300 and 643 kg. Methods — Food was withheld for 24 to 36 hours, and then horses were sedated with detomidine HC1 (0.02 to 0.03 mg/kg) and butorphanol tartrate (0.02 mg/kg). The paralumbar fossa region was desensitized with 2% mepivacaine in an inverted “L” pattern and caudal epidural anesthesia was administered with either xylazine (0.18 mg/kg diluted to 10 to 15 mL with 0.9% sodium chloride) or a combination of 2% mepivacaine and xylazine (0.18 mg/kg). Initial laparoscopic exploration was performed from the left flank; in three horses, right flank laparoscopy was needed to complete the procedure. The spermatic cord was ligated within the abdomen with one or two sutures of 0 polydioxanone suture, and the testis or testes removed through a flank incision. Results — In five horses with no palpably descended testes, standing laparoscopy was the only procedure performed, whereas in two horses, the abdominal testis was removed laparoscopically, and the descended testis was removed under short acting anesthesia. In one horse, with nonpalpable testes, it was determined by laparoscopic observation that the testes were in the inguinal canal, and castration was performed under general anesthesia. No surgical or postoperative complications were noted. The right side of the abdomen, and especially the right vaginal ring, could be easily observed from the left side by passing the laparoscope through a small perforation in the mesocolon of the descending colon or by elevating the descending colon with an instrument or by use of an arm in the rectum. Conclusions — The standing laparoscopic approach combined with or without short-acting anesthesia to remove the descended testis is easily performed. Clinical Relevance — This approach will provide surgeons with another option to castrate cryptorchid stallions.  相似文献   

4.
This report describes the surgical anatomy and successful removal of the internal gonads in a 6-year-old male pseudohermaphrodite Friesian horse by standing laparoscopy. Gonads could not be identified by physical or ultrasonographic examination and bilateral standing flank laparoscopy revealed the presence of intra-abdominal gonads suspended from the dorsal aspect of the abdominal cavity by 10–15 cm long vascular pedicles. No evidence of female internal genitalia such as a uterus was found and bilateral gonadectomy was performed laparoscopically. Histological analysis of the excised gonads confirmed the diagnosis of male pseudohermaphroditism. Minor cosmetic surgery of the external genitalia to correct urinary misdirection was successfully performed 3 months after laparoscopic castration. Standing flank laparoscopic examination was excellent for identification and surgical removal of internal genitalia. Standing flank laparoscopy should be considered for inspection and removal of internal genitalia in intersex horses.  相似文献   

5.
Cryptorchidectomy is the most commonly performed laparoscopic procedure in horses. However, its use for the extraction of an abdominal testis has disadvantages such as loss of a resected testis from grasp and fragmentation of the specimen because of the excessive tension required for extraction through a thick body wall. The ring wound retractor laparoscopic port system was recently used in human and small animal surgery to perform laparoscopic-assisted procedures and retrieve large specimens from the abdomen. In the present case, the wound retractor was placed as the ventral port in the right flank through a minilaparotomy. Thereafter, the cap with the gas inlet and instrument port was connected. The other two ports were placed dorsally using 10-mm stainless steel cannulas. Grasping forcep was introduced through the ventral port, and the laparoscope and vessel-sealing devices were introduced through the dorsal ports. After the testis was resected, it was retrieved from the abdomen through the retractor without the grasping forceps jaw being released. This is the first case report describing the use of the wound retractor laparoscopic port system for standing cryptorchidectomy in a horse. This system can be a feasible and safe option for flank laparoscopy in horses, and it facilitates specimen retrieval from the abdominal cavity, but further studies should confirm this preliminary report.  相似文献   

6.
OBJECTIVE: To report the postoperative outcome in horses undergoing jejunoileal anastomosis performed with a 2-layer simple continuous technique. DESIGN: Retrospective study. ANIMALS: 7 horses. PROCEDURE: Information regarding signalment, clinical signs, findings at surgery, and postoperative complications was obtained from medical records of horses that underwent exploratory ventral midline celiotomy, small intestinal resection, and jejunoileal anastomosis to correct various small intestinal strangulating lesions. Follow-up information was obtained via telephone conversations with owners or trainers. RESULTS: Six males and 1 female of various breeds aged 10 months to 27 years and weighing 312 to 785 kg (686.4 to 1,727 lb) were included. The most common complications were mild to moderate tachycardia and mild to moderate signs of abdominal pain. Two horses developed incisional infections and soft, fluctuant swelling at the incision site following resolution of the infection. Follow-up time ranged from 7 to 17 months after surgery. Owners reported no further colic episodes and no diet change necessary following surgery. All horses had returned to their intended level of use. CONCLUSIONS AND CLINICAL RELEVANCE: Advantages to the jejunoileal technique include maintaining the normal ileocecal valve and a postoperative recovery period similar to that described following other small intestinal anastomoses. Jejunoileal anastomosis is a viable alternative to ileal bypass. This technique appears to result in a postoperative complication rate similar to that reported following jejunojejunostomy procedures.  相似文献   

7.
Diagnostic laparotomy and laparoscopy are surgical techniques commonly used for the investigation of chronic abdominal disease and weight loss. They can both be usefully carried out in the standing sedated horse, allowing a thorough examination of the dorsal abdominal cavity and biopsies to be harvested. Small intestinal disease is an important cause of weight loss and recurrent colic. Inflammatory or neoplastic bowel disease may not always be apparent grossly and histopathological assessment of full thickness biopsies may be required to provide a definitive diagnosis. Details of cases of 15 horses that underwent small intestinal biopsy or enterectomy while sedated and standing are presented. Three incisional infections occurred causing delayed wound healing. Three horses were subjected to euthanasia before hospital discharge: two had persistent gastric reflux and one had colitis. A further six were subjected to euthanasia in the first 4 months due to their underlying inflammatory bowel condition. One horse was subjected to euthanasia for severe laminitis that was presumed to be caused by treatment with a corticosteroid 4 years later, and one died of acute colic 2.3 years after successful resection and anastomosis. Five horses were alive at the time of review, median 2.7, range 1.2–4.3 years. Overall therefore, 3 (20%) horses died during hospitalisation and 5 (33%) were still alive at the end of the study. Results from this series suggest that minimising the number of intestinal biopsies may reduce morbidity, but the underlying pathological process appears to be the most important prognostic factor for survival. Resection and anastomosis in the standing sedated horse proved feasible.  相似文献   

8.
REASONS FOR PERFORMING STUDY: Abdominal insufflation is performed routinely during laparoscopy in horses to improve visualisation and facilitate instrument and visceral manipulations during surgery. It has been shown that high-pressure pneumoperitoneum with carbon dioxide (CO2) has deleterious cardiopulmonary effects in dorsally recumbent, mechanically ventilated, halothane-anaesthetised horses. There is no information on the effects of CO2 pneumoperitoneum on cardiopulmonary function and haematology, plasma chemistry and peritoneal fluid (PF) variables in standing sedated horses during laparoscopic surgery. OBJECTIVES: To determine the effects of high pressure CO2 pneumoperitoneum in standing sedated horses on cardiopulmonary function, blood gas, haematology, plasma chemistry and PF variables. METHODS: Six healthy, mature horses were sedated with an i.v. bolus of detomidine (0.02 mg/kg bwt) and butorphanol (0.02 mg/kg bwt) and instrumented to determine the changes in cardiopulmonary function, haematology, serum chemistry and PF values during and after pneumoperitoneum with CO2 to 15 mmHg pressure for standing laparoscopy. Each horse was assigned at random to either a standing left flank exploratory laparoscopy (LFL) with CO2 pneumoperitoneum or sham procedure (SLFL) without insufflation, and instrumented for measurement of cardiopulmonary variables. Each horse underwent a second procedure in crossover fashion one month later so that all 6 horses had both an LFL and SLFL performed. Cardiopulmonary variables and blood gas analyses were obtained 5 mins after sedation and every 15 mins during 60 mins baseline (BL), insufflation (15 mmHg) and desufflation. Haematology, serum chemistry analysis and PF analysis were performed at BL, insufflation and desufflation, and 24 h after the conclusion of each procedure. RESULTS: Significant decreases in heart rate, cardiac output and cardiac index and significant increases in mean right atrial pressure, systemic vascular resistance and pulmonary vascular resistance were recorded immediately after and during sedation in both groups of horses. Pneumoperitoneum with CO2 at 15 mmHg had no significant effect on cardiopulmonary function during surgery. There were no significant differences in blood gas, haematology or plasma chemistry values within or between groups at any time interval during the study. There was a significant increase in the PF total nucleated cell count 24 h following LFL compared to baseline values for LFL or SLFL at 24 h. There were no differences in PF protein concentrations within or between groups at any time interval. CONCLUSIONS: Pneumoperitoneum with CO2 during standing laparoscopy in healthy horses does not cause adverse alterations in cardiopulmonary, haematology or plasma chemistry variables, but does induce a mild inflammatory response within the peritoneal cavity. POTENTIAL RELEVANCE: High pressure (15 mmHg) pneumoperitoneum in standing sedated mature horses for laparoscopic surgery can be performed safely without any short-term or cumulative adverse effects on haemodynamic or cardiopulmonary function.  相似文献   

9.
Objective: To evaluate the occurrence of, and variables associated with, incisional complications after right ventral paramedian celiotomy in horses. Study Design: Case series. Animals: Horses (n=159). Methods: Occurrence of incisional complications after right ventral paramedian celiotomy was determined in 159 horses (161 celiotomies) that survived at least 30 days after surgery at a private equine hospital (2003–2007). Follow‐up information for 121 horses was obtained ≥90 days after surgery. Univariate analysis and multivariate logistic regression was performed to evaluate variables associated with incisional complications after celiotomy. Results: Of 161 celiotomies, ≥1 incisional complications occurred in 27 (16.8%) during hospitalization and/or after discharge, including: drainage (15.5%), skin dehiscence (3.7%), noticeable cutaneous scarring (1.9%), and herniation (0.6%). Variables significantly associated with incisional complications after multivariate analysis included: Quarter horse‐type breed (odds ratio [OR]: 3.9, 95% confidence interval [95% CI]: 1.3–11.7); use of an abdominal bandage (OR: 9.5, 95% CI: 2.9–30.8); and >4 postoperative febrile (>38.3°C) days (OR: 12.9, 95% CI: 2.8–58.2). Conclusions: Overall occurrence of incisional complications after right paramedian ventral celiotomy compared favorably to those reported for ventral median celiotomies. Several variables were associated with, but not necessarily predictive for, the occurrence of incision complications.  相似文献   

10.
This study aimed to describe and evaluate a laparoscopic technique to promote nephrosplenic space ablation in horses using a homologous pericardium implant, preserved in 98% glycerin and fixed using laparoscopic polydioxanone staples. In this experimental study, six Arabian horses without previous related abdominal diseases were used. The surgical procedures were performed in the standing position under sedation with alpha-2 agonists and opioids, associated with local infiltration of the local anesthetic in the portal sites. The horses were restrained in a stock, and the left flanks were clipped and aseptically prepared. Three portals were created on the left flank, and the homologous pericardium implant, measuring 10 × 5 cm, was introduced into the abdominal cavity covering the nephrosplenic space, positioned between the dorsal border of the spleen and perirenal fascia, fixed with polydioxanone staples using a laparoscopic stapler. Physical examination and blood and peritoneal fluid sample collection were performed on days 0, 1, 3, 7, 14, 30, and 60 of the postoperative period, and an exploratory laparoscopy was performed on day 60 to assess the effectiveness of the technique and eventual complications. There were no difficulties or significant complications during the surgical procedure, and the total average time to perform was 49.83 minutes (±10.19). In the postoperative period, there was a significant increase (P < .05) in the plasma fibrinogen concentration on days 7 and 14 compared with the preoperative moment. The total nucleated cell count in the peritoneal fluid increased (P < .05) on days 1, 3, 7, 14, and 30. After 60 days of the surgical procedure, the physical examination and laboratory data were within the normal range. Exploratory laparoscopy performed on day 60 revealed complete occlusion of the nephrosplenic space, and it was not possible to differentiate the pericardium implant from the scar tissue, not even in the histological evaluation performed on the collected samples. In two horses, omentum adhesion was observed in the region where the implant was fixed, and in two others, a synechia was observed between the implant area and mesocolon without association with clinical complications. The animals were followed up for 36 months at surgery, and no colic signs were observed along this period. It was concluded that the technique of ablation of the nephrosplenic space, using homologous pericardium preserved in 98% glycerin, fixed by polydioxanone staples by laparoscopy, was simple to perform, effective, and free of clinical complications during the period of evaluation, and its use may be indicated as a surgical option in clinical cases of horses with recurrent nephrosplenic entrapment.  相似文献   

11.
A 14-y-old pony mare was referred after 30-d duration of intermittent pyrexia, anorexia, weight loss, and change in manure consistency. Physical examination revealed a palpable but reducible ventral abdominal mass. Transabdominal ultrasonography revealed multiple distended, hypomotile, and thickened small intestinal loops in close approximation with numerous, well-defined, hyperechoic masses. There was a large amount of echogenic peritoneal fluid; abdominocentesis revealed a neutrophilic and macrophagic inflammatory exudate, and a mixed bacterial population was cultured. Given the poor prognosis, the mare was euthanized. The autopsy findings included a large abdominal abscess, serosanguineous peritoneal fluid with fibrin strands, and ~50 outpouches communicating with the lumen and extending from the anti-mesenteric aspect of the duodenum, jejunum, and ileum. These structures were classified as pseudodiverticula based on the histologic absence of the tunica muscularis layer of the intestinal wall. Pseudodiverticula should be included as a differential etiology in horses when clinical signs consistent with colic, diarrhea, or weight loss are recognized and, when on examination, one or more organized masses are palpated or visualized on transabdominal ultrasound, as well as visualization of small intestinal loops with thickened walls.  相似文献   

12.
Peritonitis was induced in 12 horses by median celiotomy and 1 hour of small intestinal ischemia. Six horses had primary closure of the incision, whereas six horses had a plastic mesh sutured to the ventral abdominal wall leaving the abdomen open for ventral drainage. The mesh was removed after 5 days and the abdominal wall was closed by apposition of the linea alba and subcutaneous tissues and approximation of the skin edges. Peritoneal fluid was collected and analyzed for nucleated cell count and total protein concentration on days 0 and 5. Serum biochemical profiles, serum electrolyte concentrations, and complete blood counts were performed on days 0, 1, 2, 5, 6, 10, and 14. Body weight, rectal temperature, and physical examination findings were recorded daily for 30 days, then horses were euthanatized and the abdominal cavity was examined for the presence of adhesions. Histological examination was performed to assess the inflammatory response of the healing body wall; inflammation scores were significantly lower in horses that had primary closure of the incision. The mesh was well tolerated by all horses and allowed egress of peritoneal fluid for 5 days. Adhesions were present in four control horses and in two horses that had open peritoneal drainage. All horses that had open drainage developed incisional infections after mesh removal. Abdominal wall herniation did not occur in any of the horses. The mild peritonitis induced in this study was insufficient to establish the efficacy of open peritoneal drainage for an established peritonitis in horses; however, the results of this study indicate that open peritoneal drainage is feasible in horses.  相似文献   

13.
The objective of this study was to determine the characteristics based on ultrasonographic examination of the stomach, duodenum, jejunum, cecum, and peritoneal fluid in normal adult ponies. Abdominal ultrasonographic examination was performed in nine unsedated standing ponies. The duodenum was examined at three sites and the jejunum in 12 regions. Wall thickness, contractility, distention, and luminal contents were recorded. Stomach wall thickness and location, cecal wall thickness, and peritoneal fluid location and character were recorded. Statistical analysis was performed. Wall thicknesses (in cm) were 0.431 +/- 0.069 for the stomach, 0.188 +/- 0.033 for the duodenum (at all sites), 0.195 +/- 0.031 for the jejunum (at all regions), and 0.179 +/- 0.031 for the cecum. Duodenal contractions per minute were 3.78 +/- 1.10. The stomach spanned 5.14 +/- 0.9 intercostal spaces, with the 8th intercostal space being the most cranial and the 15th intercostal space being the most caudal space through which the stomach was identified. It was possible to identify the jejunum in all ponies dorsal to the left dorsal colon and from the ventral abdominal wall. Peritoneal fluid was identified in six ponies. Peritoneal fluid was usually seen transiently and most commonly in the ventral aspect of the abdominal cavity or around the duodenum. Overall, the ponie's abdominal ultrasonographic examinations revealed wall thicknesses that were less than the published normal ranges for horses. It appears that ponies may have increased duodenal contractility than horses and that the conformation of ponies may change the locations for imaging the stomach.  相似文献   

14.
OBJECTIVE: To report our experience and complications associated with different cannula insertion techniques for laparoscopy in standing horses. STUDY DESIGN: Retrospective study. SAMPLE POPULATION: Forty horses that had laparoscopy for diagnostic or surgical purposes. METHODS: After a physical examination, including rectal palpation, standing laparoscopy was performed in 40 sedated horses. Local anesthetic was injected at each site of cannula insertion in the left flank. Horses were divided into 5 groups: Pneumoperitoneum was induced before cannula insertion using a Verres needle (group 1, n = 3) or a 12-g catheter (group 2, n = 14); the cannula was inserted before inducing a pneumoperitoneum (group 3, n = 9); the cannula was inserted under visual control, using an operating laparoscope (group 4, n = 2) or a Visiport Optical Trocar (group 5, n = 12). Horses were observed for 7 days. RESULTS: Problems with insufflation or cannula insertion occurred in 12 horses: 6 had peritoneal detachment, 4 had a splenic puncture, and 2 had descending colon puncture. Eleven of these complications occurred in groups 1 to 3 and only 1 in groups 4 and 5. CONCLUSIONS: The Visiport optical device allows controlled insertion of the initial trocar, and thus avoided potential problems associated with "blind" cannula insertion techniques and was used effectively in horses that had feed withheld for 12 hours. This technique enables direct insertion of a cannula directly into the right flank. CLINICAL RELEVANCE: Complications associated with initial cannula insertion in the paralumbar fossa, for laparoscopy, in standing horses can be minimized with the use of an optical cannula.  相似文献   

15.
Objective — The purpose of this study was to determine the feasibility of using laparoscopy to remove cryptorchid testes from standing horses.
Study Design — Prospective clinical study.
Animals or Sample Population — Eleven client-owned horses ranging in age from 4 months to 2 years.
Methods — Abdominal insufflation was initiated and maintained using a 20 F insufflation tube, attached via a stopcock, to the low pressure regulator on a standard carbon dioxide pressure tank. After trocar and laparoscope placement in the ipsilateral flank the testes were identified. Local anesthesia of the structures to be manipulated was administered through the instrument channel on the operative laparoscope, using a catheter with a needle attached. Testes were grasped with large laparoscopic forceps and exteriorized through the abdominal wall. Ligation and transection of the mesorchium was extracorporeal. The descended testes were removed using a standard standing technique.
Results — Complications were minor, including mild colic in one horse. The mean surgical time for standing laparoscopic cryptorchidectomy and castration of these colts was 58.9 ±24.3 minutes.
Conclusions and Clinical Relevance — Standing laparoscopic cryptorchidectomy, using the instrumentation described, is a safe and practical technique in young horses.  相似文献   

16.
OBJECTIVE: To evaluate outcome after laparoscopic closure of the nephrosplenic space in horses that had previous nephrosplenic entrapment of ascending colon (left dorsal displacement of the left colon; LDDLC). STUDY DESIGN: Retrospective study. SAMPLE POPULATION: Horses that had previous LDDLC. METHODS: Medical records of horses that had LDDLC and subsequent laparoscopic nephrosplenic space closure between 2002 and 2004 were retrieved. Follow-up information was obtained by telephone interview of owners. Preoperative versus postoperative comparisons were: incidence of LDDLC, incidence of colic signs, and incidence of ventral celiotomy. Data were analyzed using a chi2-square test with significance set at P<.05. RESULTS: Ten horses met the inclusion criteria. Mean follow-up was 22 months. No horses had recurrence of LDDLC; however, 3 horses had colic signs subsequently that required surgical intervention. Over the follow-up period there was a significant decrease in the total incidence of colic and ventral celiotomy. Technique modifications included use of different cannula site locations, use of polyglyconate suture material for nephrosplenic space closure, and development of a custom cannula. CONCLUSIONS: Laparoscopic nephrosplenic space closure prevented recurrence of LDDLC, and significantly lowered the overall incidence of colic and ventral celiotomy. The custom-designed cannula provided good access to the operative site and no complications were encountered with use of polyglyconate suture material for nephrosplenic space closure. CLINICAL RELEVANCE: Closure of the nephrosplenic space will prevent LDDLC; however, other surgical lesions can occur.  相似文献   

17.
Ventral Abdominal Approach for Laparoscopic Cryptorchidectomy in Horses   总被引：1，自引：0，他引：1  
Objective —To report a ventral abdominal approach and a ligating loop technique for laparoscopic cryptorchidectomy in horses.
Study Design —Prospective.
Sample Population—Six horses, aged 1 to 5 years, with retained testes.
Methods —One laparoscopic portal and three to four instrument portals were used for ventral abdominal laparoscopic cryptorchidectomy. Laparoscopic instruments were used to maneuver and secure the testis through a ligating loop (modified Roeder knot) that was secured from outside the abdominal cavity. Only minimal enlargement of one instrument portal was used to remove the testicle.
Results —Three horses were bilateral cryptorchids, and three were unilateral (left side, two; right side, one) cryptorchids. Operative time, defined as the time from laparoscope insertion to removal, ranged from 20 to 25 minutes for unilateral cryptorchids and from 40 to 50 minutes for bilateral cryptorchids.
Conclusions —The reported technique allowed decreased tension on the tissues during ligation and removal of the testis from the peritoneal cavity. Improved observation of the abdominal cavity, ligation security, shortened patient confinement time, and minimally invasive technique are all considered to be benefits of laparoscopic cryptorchidectomy.
Clinical Relevance —Direct observation of retained testes and intraabdominal castration are distinct advantages of the use of laparoscopy in horses that have had previous unsuccessful surgical attempts, horses with unknown histories that have retained testicular tissue, or bilateral abdominal cryptorchids.  相似文献   

18.
Safe, effective surgery can be performed in the standing, conscious horse using a combination of mechanical and chemical restraint. Clear indications for performing standing abdominal surgery exist, but many procedures are best performed under general anesthesia. The preferred approach involves a modified grid incision of the left paralumbar fossa. Flank celiotomy allows the surgeon to thoroughly explore the abdominal cavity, but few structures can be exteriorized, and visibility of abdominal contents is poor. Indications for standing abdominal surgery include diagnosis of abdominal masses, drainage and biopsy techniques, correction of left dorsal displacement of the large colon, and evaluation of rectal injuries, and performing loop colostomy techniques, laparoscopy, removal of retained testicles, correction of uterine torsions, surgical embryo transfer, ovariectomy in normal mares, and some experimental procedures. Standing surgical techniques are most useful and appropriate for surgical exploration, to correct uterine torsions, and to perform loop colostomy and surgical embryo transfer techniques. Perioperative antimicrobial and antiinflammatory therapy is recommended. Mild discomfort and ventral incisional swelling after surgery are expected.  相似文献   

19.
A technique for hand-assisted laparoscopic removal of cystic calculi in male horses is described. Three cystic calculi ranging from 5 to 10 cm in diameter were removed successfully using bilateral para-inguinal laparoscopic portals assisted by a human hand within the abdomen, effectively sealing the midline incision. Long-term follow-up information obtained from referring veterinarians and owners indicated that the patients returned to their previous activity level and had no recurrence of clinical signs in the following 6 to 12 months.Key clinical message:Hand-assisted recumbent laparoscopy is a satisfactory surgical technique for removal of cystic calculi in horses which cannot be operated on standing or whose body condition would make the parainguinal approach difficult.  相似文献   

20.
Incarceration of the small intestine through a rent in the gastrosplenic ligament was diagnosed in five horses. Three affected horses were mature males and two were mature females. Persistent moderate to severe abdominal pain, elevated heart rate, congested mucous membranes, serosanguineous peritoneal fluid, and distended small intestine on rectal examination were consistent findings.
Exploratory celiotomy or gross necropsy examination showed the incarcerated intestine to be distal jejunum or ileum. In all horses, the intestine had herniated cranially through the rent in the gastrosplenic ligament. The incarcerated intestine was situated lateral to the stomach and craniolateral to the spleen. Three horses underwent exploratory celiotomy, and the incarcerated small intestine was reduced by gentle traction and then resected. Two of these horses were alive more than 2 years postoperatively without recurrence of signs of abdominal pain, and one was euthanized because of dehiscence of the abdominal incision. Two horses were euthanized without surgical intervention, and necropsy examination revealed a recent rent in the gastrosplenic ligament. This condition should be considered in the differential diagnosis of causes of small intestinal strangulation and obstruction in the horse.  相似文献   

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