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1.
A 14-year-old quarter horse mare had a 2-year history of infertility and the presence of a mass in the right uterine horn. Prior to surgery, the mass was determined to be invasive by using ultrasonography and hysteroscopy. A partial ovariohysterectomy was performed. The mass was diagnosed histologically as a uterine leiomyoma.  相似文献   

2.
A 20-year-old Arabian mare presented to Washington State University Veterinary Teaching Hospital for evaluation of haemorrhagic vaginal discharge of 3 months' duration. The referring veterinarian had identified a mass within the uterine wall via transrectal ultrasonographic examination. On presentation, the mare had an unremarkable physical examination with the exception of a mild haemorrhagic vaginal discharge. Rectal palpation was performed and an approximately 9 cm diameter mass with a granular texture was identified associated within the uterine body and left uterine horn. Endoscopic examination of the reproductive tract revealed a linear defect in the ventral uterine wall near the cervix with direct communication into the abdomen. Standing laparoscopic-assisted vaginal ovariohysterectomy (OHE) was performed, which involved laparoscopic facilitated dissection and haemostasis of uterine and ovarian structures, and inversion of the uterus through the cervix. Removal of the uterus was performed vaginally. No post operative complications were noted. Standing laparoscopic-assisted vaginal OHE is an alternative to traditional OHE techniques. This technique allowed for excellent direct visual observation during dissection and ligation and did not require general anaesthesia.  相似文献   

3.
We performed a standing hand-assisted laparoscopic ovariectomy in a draft mare that presented with high serum anti-Müllerian hormone (AMH) level and had an enlarged single cystic ovary. Histopathological examination revealed no tumor cell proliferation in the ovary, but the presence of a large ovarian cyst was confirmed. In the diagnosis of abnormal ovaries in mares, a comprehensive assessment should be performed, including the monitoring of ovarian morphology and biomarkers over time, to determine the disease prognosis and treatment plan. The case of this mare with a nonneoplastic abnormal ovary and increased serum AMH level was rare. We suggest that standing hand-assisted laparoscopic ovariectomy is useful for the removal of large ovaries in draft mares.  相似文献   

4.
A 13‐year‐old pluriparous Dutch Warmblood mare presented to Utrecht University's Department of Equine Sciences 4 weeks after suspected abortion at 3.5 months gestation, to investigate the nature of a uterine mass and persistent vulval discharge. Transrectal ultrasonographic examination revealed copious flocculent fluid and fetal remnants within the uterus and a 5–6 cm heterogenous mass in the uterine wall at the tip of the right horn. Expulsion of fetal parts and resolution of the coexisting endometritis were effected by a combination of repeated PGF2a analogue injections to induce oestrus, application of PGE2 gel to aid cervical relaxation, and daily uterine lavage and antibiotic instillation. The presence of the mass in the uterine wall was confirmed by hysteroscopy and the suspected tumour subsequently removed by partial laparoscopic ovariohysterectomy under standing sedation and local anaesthesia. The histological appearance of the tumour was consistent with a leiomyoma or moderately malignant leiomyosarcoma. Although a follow‐up examination 6 months post surgery revealed uncomplicated healing of the uterus, the owner decided to retire the mare from breeding. Uterine neoplasia is an extremely unusual cause of fetal death in the mare but, in the present case, laparoscopic partial ovariohysterectomy proved a promising, minimally invasive technique for salvaging sufficient uterus to make subsequent breeding a realistic proposition.  相似文献   

5.
Two American Paint Horses, a 3-year-old nulliparous mare and a 7-year-old primiparous mare, presented for recent infertility and a pre-breeding examination, respectively. Examination of the internal reproductive tract of both mares using transrectal palpation and ultrasonography revealed the presence of the cervix, uterine body, left uterine horn and bilateral ovaries. The right uterine horn could neither be palpated nor imaged. The clinical diagnosis of uterus unicornis in one mare was confirmed at necropsy, which revealed combined aplasia of the right uterine horn and oviduct.  相似文献   

6.
The purpose of this study was to provide a detailed laparoscopic anatomy of the caudal abdominal region of mare in a standing position and to evaluate and modify a technique for standing laparoscopic ovariectomy using combination between hand-tied ligating loop and electrocoagulation techniques, as the ligating loops, electrocoagulation, and modified electroligation laparoscopic ovariectomy were applied using nine adult mares. Laparoscopy was practical and effective for direct visual examination of internal abdominal organs in the mare. Ventral dislocation of abdominal viscera after pneumoperitoneum was established with the mare in standing position, which provided an excellent inspection of the dorsal and ventral structures in the peritoneal cavity on the right and left sides. Standing laparoscopic ovariectomy using an electroligation modified method was considered a safe and effective method for hemostasis of the mesovarium, technically easy, time saving, and economical. The mean surgical time for bilateral ovariectomy was 40 ± 7.63, 60 ± 5.25, and 85 ± 6.43 minutes for electroligation-modified technique, ligating loops technique, and electrocoagulation technique, respectively.  相似文献   

7.
A 9-year-old American Saddlebred mare was referred because of abdominal distention and signs of abdominal pain. Copious peritoneal fluid obtained by abdominocentesis appeared to be frank blood. Rectal and ultrasonographic evaluation of the abdomen revealed a large mass at the distal tip of the right uterine horn. The mare was euthanatized and necropsied and the mass was determined to be a granulosa-thecal cell neoplasm. The most common clinical sign of granulosa-thecal cell neoplasm is infertility or abnormal sexual behavior. Hemoperitoneum is infrequently associated with neoplasms in horses.  相似文献   

8.
Objective: To describe a standing laparoscopic ovariectomy technique with intraabdominal ovarian dissection inside a specimen retrieval bag for removal of large pathologic ovaries through small incisions. Study Design: Case series. Animals: Mares (n=43) aged 2–21 years and weighing 380–680 kg. Methods: Unilateral laparoscopic ovariectomy was performed on 43 standing sedated mares. Ovaries were approached via 3 portal sites, 2 in the paralumbar fossa and a 3rd between the 17th and 18th ribs on the ipsilateral side. Ovaries were dissected free using either a LiNA Tripol‐bipolar laparoscopic forceps or a Ligasure™ Vessel Sealing Device and removed by enlarging the proximal portal site ventrally using a grid technique. Use of a plastic specimen retrieval bag and cannula suction device facilitated intraabdominal dissection of very large ovaries into 2 or more pieces, before removal through small incisions. Results: Regardless of size, all ovaries were removed successfully through small incisions (range, 5–10 cm), with no major complications and an excellent cosmetic result. All sport horses returned to previous levels of work or higher, with 93% of breeding mares successfully bred in the 1st season after surgery. Conclusions: Large pathologic ovaries can be easily and safely removed by standing laparoscopic ovariectomy on the mare. Clinical Relevance: Standing laparoscopic ovariectomy combined with a small flank incision is a safe and highly effective technique for removal of large pathologic ovaries in the mare, negating the requirement for general anesthesia or large incisions.  相似文献   

9.
An 8-year-old grey Arabian mare was presented for reproductive evaluation with a history of failing to become pregnant during two previous breeding seasons. An enlargement was identified on the right uterine horn on rectal examination which was confirmed as a fluid-filled nonechogenic mass on ultrasonography. Subsequent examination procedures and laparotomy revealed an old hematoma in the wall of the uterine horn.  相似文献   

10.
An ectopic fetus was discovered in an 18-month-old uniparous queen that was admitted for an elective ovariectomy. Six months prior she had delivered three healthy kittens. During the preoperative examination, a mass similar in size to a full-term fetus was detected in the abdominal cavity. Ultrasound examination revealed the mass to be an ectopic fetus in the mid-abdominal region. A mummified fetus was removed by laparotomy. No rupture of the uterine wall was visible, but a small necrotic area was present on the left uterine horn, adjacent to the very proximal portion of the uterine horn. The fetus, which was fully developed and covered by a thin membrane, was carefully dissected. Histological examination did not enable us to definitively prove the extra-uterine development of the fetus; however, the ectopic development of the conceptus secondarily expelled into the peritoneal cavity could be assumed.  相似文献   

11.
Three mares underwent diagnostic laparoscopy because of suspicion of post-partum uterine ruptures. All three horses showed clinical signs of a uterine rupture between 1 and 3 days after parturition and underwent diagnostic laparoscopy. In all cases a full thickness uterine rupture could be detected and was sutured laparoscopically. Availability of suture material and surgeon experience were responsible for the surgical methods chosen for repair. In the first case, a hand-assisted laparoscopic approach was chosen for suturing the ruptured uterus, whereas in the other cases the approach was entirely laparoscopic. In the second case, extracorporeal knots were used for the repair and in the last case described a barbed loop suture was available for closure of the uterus. Two of three mares were alive for at least 12 months after surgery without any abdominal problems. One of these mares delivered a healthy foal 2 years after surgery. The remaining mare died 3 months after surgery but no necropsy was done. Laparoscopy should be considered for post-partum mares with signs of peritonitis to access the uterus and repair a rupture if it is accessible. A laparoscopic approach using intracorporeal knots or barbed sutures for the repair of the uterine rupture as well as a hand-assisted laparoscopic approach are feasible. The use of the barbed suture for intracorporeal closure makes the minimal invasive laparoscopic technique easier to perform.  相似文献   

12.
The objective of this retrospective study was to describe the use of bilateral laparoscopic ovariectomy without hysterectomy for chronic pyometra in horses. Four client-owned horses were included, each having chronic pyometra that was unresponsive to treatment. Bilateral laparoscopic ovariectomy was performed on the horses under standing sedation. A final uterine lavage was performed either 24 hours before or after surgery, with no further treatment of the uterus. No complications were encountered during surgery or post-operatively, and each horse had resolution of the pyometra without recurrence of clinical signs over at least 3 years. All owners were satisfied with the procedure. Following histopathology, one horse was found to be a true hermaphrodite, with one vestigial testis and one ovotestis. Ovariectomy alone was an effective treatment for four horses with chronic pyometra, without complications. Ovarian steroids and abnormal uterine or cervical conformation are important influences in the pathogenesis of pyometra, and removal of the hormone source via ovariectomy should be considered to avoid a more invasive surgery and the potential complications associated with ovariohysterectomy in horses.  相似文献   

13.
Leiomyomas are the most common of uterine tumours in mares but large tumours are rare. A case with a 15 cm uterine leiomyoma diagnosed by rectal palpation and ultrasound examinations with apparent adverse effects on fertility is reported. Management of the case was by hand assisted laparoscopic tumour removal and unilateral ovariectomy. Complications included post operative pain, tachycardia and wound infection. The mare was confirmed to be in foal after her first cover post surgery.  相似文献   

14.
OBJECTIVE: To develop a minimally invasive, hand-assisted laparoscopic ovariohysterectomy (HALS-OHE) technique in the mare and to evaluate safety and any associated complications. STUDY DESIGN: Experimental study. ANIMALS: Eight, 11-24-year-old mares with anatomically normal urogenital tracts. METHODS: The surgical technique was developed in 2 non-survival mares and subsequently evaluated in 6 survival procedures. Food was withheld for 48 hours, then mares were anesthetized and positioned in dorsal recumbency for laparoscopic surgery. A hand access device (Omniport) was placed followed by 4 laparoscopic portals. Transection of the ovarian pedicles and broad ligaments was achieved using a combination of a laparoscopic stapling instrument (Endo GIA II), an ultrasonically activated instrument (Harmonic Scalpel), and endoscopic clips (Endo Clip II ML). The genital tract was exteriorized through the laparotomy, and the uterus transected and sutured in a conventional pattern. Horses were evaluated through postoperative day 14 when a necropsy was performed. RESULTS: Four mares recuperated well after surgery, 1 mare was euthanatized because of bilateral femur fracture during anesthetic recovery, and another developed severe pleuropneumonia. At necropsy all but 1 abdominal incision was healing routinely. One mare had abscessed along the celiotomy incision and developed visceral adhesions. Uncomplicated healing of transected mesovarial, mesometrial, and uterine remnants was observed. CONCLUSIONS: Ovariohysterectomy in horses can be accomplished using HALS technique. CLINICAL RELEVANCE: HALS-OHE technique represents a minimally invasive and technically feasible alternative for conventional OHE. Careful patient selection and preparation may reduce the complications observed. The HALS technique may be useful in other laparoscopic surgical procedures.  相似文献   

15.
A pregnant mare with a history of prolonged gestation (～515 days) and suspected diagnosis of fetal mummification was examined. Rectal palpation revealed that the left broad ligament of the uterus was dorsal and medial to the right uterine ligament and it was not possible to observe the cervix during vaginal examination. Transabdominal ultrasound revealed fluid in the uterus, fetal membranes and the uterine walls defined and thickened. Free fluid was not seen in the peritoneal cavity. Laboratory tests (blood cell count and clinical chemistry) were normal. Based on clinical history, physical examination and ultrasound findings, a chronic uterine torsion with fetal death was diagnosed and the mare was subjected to exploratory celiotomy. The uterus was strongly adhered to the peritoneum of the ventral abdominal wall and there were multiple adhesions to the colon. Hysterotomy was performed to remove the fetus and to permit repositioning of the uterus. When the fetus was removed, a large devitalised grey tissue area of the right ventral uterine horn was observed. Multiple adhesions prevented a rescue hysterectomy and euthanasia of the patient was performed. During the necropsy, a 180° cranial cervix clockwise uterine torsion was observed. This rare case of uterine torsion appears to be the most chronic case reported in the equine literature.  相似文献   

16.
Laparoscopic Adhesiolysis in a Horse   总被引：1，自引：0，他引：1  
Objective —The purpose of this report was to describe the use of laparoscopy as a method of treatment for abdominal adhesions in the horse.
Clinical Report —Unilateral ovariectomy for removal of a granulosa cell tumor was performed through a diagonal paramedian approach in a 14-year-old Arabian mare. Progressive incisional swelling and hemorrhage culminated in acute incisional dehiscence with herniation of ileum on the sixth postoperative day. Septic peritonitis that responded to parenteral antibiotic therapy was identified 7 days after hernia repair. Seven days later, the mare had signs of abdominal pain, and adhesions of small intestine to the paramedian incision were identified on rectal palpation. Transrectally assisted laparoscopic adhesiolysis was performed. No further complications occurred.
Clinical Relevance —Laparoscopic adhesiolysis may provide better observation of adhesions and reduced postoperative morbidity compared with laparotomy.  相似文献   

17.
In this report, a jejunal entrapment through a presumptive chronic mesenteric defect extending over approximately 20 cm of the duodenojejunal region was found as a cause of acute onset colic in a multiparous broodmare. Mesenteric reattachment during the initial exploratory laparotomy was deemed unsafe given the majority of the avulsion could only be palpated deep within the abdomen. Following recovery and an uneventful parturition 12 days later, the mare returned 18 days post-foaling for attempted, standing laparoscopic reattachment of the mesentery. The procedure was converted to a hand-assisted technique and reattachment completed using a mechanical suturing device and knotless, unidirectional barbed suture. The mare was discharged 3 days post-operatively, bred 28 days following discharge and a singleton pregnancy confirmed 15 days post-ovulation and 46 days following laparoscopy. There were no signs of abdominal discomfort noted in the first 8 months following surgery. In summary, a standing, right-sided hand-assisted laparoscopic approach provided effective visibility to the mesoduodenojejunal region.  相似文献   

18.
A 12‐year‐old Thoroughbred broodmare was presented for laparoscopic removal of an abnormal ovary. Rectal examination and ultrasound revealed firm attachment of the enlarged right ovary to the ventral pelvis and right abdominal wall, and gas accumulation within the right ovary. Laparoscopic examination revealed extensive adhesion formation between the abnormal ovary, ispilateral uterine horn, ventral pelvis and the right abdominal wall. A flank laparotomy was then performed to improve visualisation of the area. Due to contamination of the abdomen during attempts to detach adhesions, the complexity of the structures involved and the poor prognosis for further reproduction, the decision was made to subject the mare to euthanasia. Post‐mortem evaluation revealed a large encapsulated abscess of the right ovary, with a small, linear wire foreign body within the centre of the abscess.  相似文献   

19.
In this report, we describe the diagnostic findings and outcome of a uterine B cell lymphoma in a mare. A well circumscribed uterine mass with significant peripheral vascularisation was identified by transrectal ultrasonography during the reproductive examination of an 8‐year‐old Thoroughbred mare. Subsequent hysteroscopy revealed that the uterine mass was located intramurally and contained a protruding polyp‐like structure. A diagnosis of uterine B cell lymphoma was established by histopathological examination of a hysteroscopically‐obtained tissue sample. Additional diagnostics demonstrated that the uterus was a site of metastasis. Due to her deteriorating condition, extensiveness of the tumour and poor prognosis, the owner decided that the mare should be subjected to euthanasia.  相似文献   

20.
This paper describes a case of uterine fibrosarcoma in an 18-year-old Warmblood mare. The mare had exhibited bloody fluid accumulation inside the uterus and vaginal haemorrhagic discharge since the previous foaling. The mare was euthanized, and on pathological examination, in addition to the uterine neoplasia, multiple metastases were found in the lungs, liver and spleen. The histological and immunohistochemical examination determined that the tumour was a fibrosarcoma. To our knowledge, this is the first paper to describe a uterine fibrosarcoma in a mare.  相似文献   

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