Objective: To report a standing hand-assisted laparoscopic technique for closure of the nephrosplenic space (NS), and short-term outcome in horses. Study Design: Case series. Animals: Horses (n = 12) aged 5-14 years. Methods: Medical records (2007-2010) of horses treated for left dorsal displacement of the large colon (LDDLC) using a hand-assisted laparoscopic correction technique with closure of the NS in the same surgical procedure were reviewed. A modified grid laparotomy in the left paralumbar fossa was used with manual correction of LDDLC, after which the NS was closed with a laparoscopic technique. Follow up was obtained by telephone interview of owners or referring veterinarians. Results: Resolution of LDDLC and closure of the NS was successful, with only minor postoperative complications, in all horses. On short-term follow-up (>10 months; mean, 23.8 months), 2 horses had displacement of the large colon between the spleen and the body wall. Conclusion: Standing hand-assisted laparoscopic correction of LDDLC and closure of the NS in a single surgical procedure is feasible. Appropriate case selection is mandatory when performing this combined technique.Left dorsal displacement of the large colon (LDDLC) and entrapment in the nephrosplenic space (NS) occurs in horses and is typically associated with colic of mild to moderated intensity. 1 Both geldings and NS depth have been reported as predisposing factors for LDDLC. [2][3][4][5] Phenylephrine administration in combination with rolling under general anesthesia has been reported for successful correction of LDDLC in up to 80% of cases. 2, 6, 7 Surgical correction is indicated when there is moderate to severe pain that is nonresponsive to medical therapy and/or when clinical signs of intestinal compromise are present. Correction of LDDLC by standing flank laparotomy has been recommended in horses that are poor candidates for general anesthesia because of advanced pregnancy, physical size (draft horses), or because of economic constraints. 8 If no other abnormalities are present and large colon (LC) viability is not compromised, the prognosis for horses with LDDLC is considered good.We describe a surgical procedure of standing handassisted laparoscopic technique with closure of the nephrosplenic space in the same surgical procedure in horses with LDDLC and report on outcome.

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Summary A 9‐month‐old Thoroughbred filly was presented for colic of a few hours’ duration. Examination revealed tachycardia at 64 beats/min, and a colon displaced to the right with wall oedema on ultrasound. After an hour of intravenous fluid therapy, the filly became restless and exploratory laparotomy was performed. Impaction and incarceration of the large colon up to the caeco‐colic fold through the epiploic foramen (EF) were diagnosed. After evacuating the colonic contents through a pelvic flexure enterotomy, the EF entrapment (EFE) was reduced. The large colon appeared congested with a fragile serosa, serosal tear at its antimesenteric aspect, and amotile for the remainder of the surgery. Colon motility resumed as evidenced by ultrasonographic examination on the second day post‐surgery, and despite pasty diarrhoea, the filly made a complete and uneventful recovery and was alive at 6 months’ follow‐up. Epiploic foramen entrapment of the large colon is very rare but should be included as a differential diagnosis of colon displacements, even in young horses, requiring prompt surgical resolution.

Based on our study, UGTACP of the ICA and ECA caudal part is a feasible alternative to fluoroscopy. An advantage of this technique is the accuracy with which you can catheterize both ICA and ECA and the ability to identify unusual branching at the origin of the ICA. Regarding the rostral part of the ICA, angiographic catheter guidance in this region is probably more precise using fluoroscopy as it is performed blindly. In a clinical situation, combination of US and fluoroscopy guidance can result in reduction of radiation exposure time.