Hand-assisted laparoscopic repair of a grade IV rectal tear in a postparturient mare

Stewart, Suzanne; Johnston, Janet; Parente, Eric J.

doi:10.2460/javma.245.7.816

Cited by 8 publications

(7 citation statements)

References 11 publications

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“…Direct suturing can also be performed through a caudal midline celiotomy under general anaesthesia 20,23,25,26 . Laparoscopic and hand assisted laparoscopic suture repair are also described 16,27 . However, access to the caudal part of the rectum, especially near or caudal to the peritoneal reflection can be challenging 16,17 .…”

Section: Discussionmentioning

confidence: 99%

“…Surgical indications relating to this area in equine surgery include rectal disorder such as rectal tears, 16,17 perirectal abscesses 15 or mass removal. However, surgical access to the caudal part of the rectum and perirectal area can be difficult 16–18 …”

Section: Introductionmentioning

confidence: 99%

“…However, surgical access to the caudal part of the rectum and perirectal area can be difficult. [16][17][18] The aims of this study were to describe the anatomy of the presacral space in horses and to define a minimal invasive approach to the presacral space in order to reach the dorsal perirectal area.…”

Section: Introductionmentioning

confidence: 99%

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Retroperitoneoscopy of the presacral space in horses: Surgical access and anatomy

Meurice,

Pujol,

De Fourmestraux

et al. 2023

Equine Veterinary Journal

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BackgroundSurgical approaches to the equine rectum and perirectal area are described in the literature. However, surgeries in this region can be challenging.ObjectiveTo describe the surgical anatomy of the presacral space and to evaluate its access using a retroperitoneoscopic approach.Study designEx vivo experiment.MethodsPreliminary dissections were performed in two cadavers to define the boundaries of the presacral space and to determine portal locations for the surgical approach. After that, nine cadavers were used for experimental presacral retroperitoneoscopic procedure in a standing position. Following retroperitoneoscopy, cadavers were dissected to confirm the anatomical structures observed during the endoscopic procedures, to control the location of each portal and to record iatrogenic trauma.ResultsThe presacral space was bordered by the vertebral column from the ventral aspect of lumbosacral promontorium to the first coccygeal vertebra dorsally and by the presacral fascia and peritoneum ventrally. Lateral limits were composed of the sacrosciatic ligament and transversalis fascia. Cranial and caudal borders were composed of the peritoneum and coccygeal and levator ani muscles respectively. Retroperitoneoscopic portals were placed between the external anal sphincter and semimembranosus muscles and between the base of the tail and the external anal sphincter muscle through the anococcygeal fascia to enter the space by its caudal border. The retroperitoneal space was reached in all cases and the dorsal and lateral aspects of the rectum were visualised after creation of a working space.Main limitationsUse of cadaver specimens do not permit to evaluate the tolerance in living animals and the surgical complications such as rectal damage, haemorrhage and infection.ConclusionThis study provides an anatomical description and surgical access of the presacral space with a minimal invasive approach. Retroperitoneoscopy allows access to the rectum and the dorsal aspect of the pelvis.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Retroperitoneoscopy of the presacral space in horses: Surgical access and anatomy

Meurice,

Pujol,

De Fourmestraux

et al. 2023

Equine Veterinary Journal

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“…Pelvic flexure enterotomy is performed for evacuation of ingesta, sand, enteroliths and foreign bodies from the pelvic flexure or right dorsal colon (Stewart et al 2014). Emptying a majority of the contents of the large colon through a pelvic flexure enterotomy rather than injection of fluids to soften and disperse the impaction may prevent the development of post-operative ileus (Roussel et al 2001;Cohen et al 2004).…”

Section: Feed Impactionmentioning

confidence: 99%

Diagnosis, management and prognosis of large colon impactions

Hanson

Schumacher

2019

Equine Veterinary Education

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The majority of large colon feed impactions occur in the left ventral colon at the pelvic flexure. Sand and enterolith impactions most commonly occur in the left ventral colon at the pelvic flexure or in the right dorsal colon; however, sand can accumulate anywhere along the gastrointestinal tract. Enteral fluid therapy can, in most cases, supplement or even replace i.v. administration of fluids and it appears effective and safe to soften large colon contents and resolve simple large colon impactions. Surgical intervention is indicated when a concurrent displacement is suspected, as lengthy medical treatment of large colon impaction secondary to large colon displacements would not be indicated and may increase the risk of colonic rupture. Other indications for surgical intervention include uncontrollable pain, when cardiovascular parameters deteriorate, or when there is evidence of intestinal devitalisation. The prognosis for horses undergoing large colon enterotomy is dependent on the extent and type of impaction, but is generally excellent. Diagnosis Feed impaction Horses with a large colon feed impaction (Fig 2) typically have signs of mild to moderate abdominal pain, decreased

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“…On peut citer la suture de la vessie lors de sa rupture chez le poulain (Edwards et al 1995) ou l'adulte (Walesby et al 2002, et la réparation de la déchirure du rectum (Stewart et al 2014).…”

Section: Laparoscopies Réparatricesunclassified

La laparoscopie chez le cheval

Perrin¹

2016

bavf

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Après des balbutiements dans les années 1970, la laparoscopie équine a vraiment pris son essor grâce au travail de Wilson dans les années 1980. Depuis elle s'est développée et certaines interventions sont maintenant pratiquées de manière courante par les chirurgiens équins. Les actes chirurgicaux réalisés par laparoscopie chez le cheval sont de plusieurs types : (1) les laparoscopies exploratrices qui permettent de faire un bilan lésionnel intra abdominal et de réaliser des biopsies ; (2) les laparoscopies permettant l'ablation d'un organe, ovaire, testicule cryptorchide ou rein ; (3) celles ayant pour objectif de prévenir des affections intra abdominales, par exemple la herniorraphie de l'anneau vaginal pour éviter la hernie inguinale étranglée chez l'étalon ; (4) les laparoscopies réparatrices comme la suture de la déchirure vésicale chez le poulain ; et (5) les laparoscopies visant à traiter la douleur, par exemple l'infiltration des ligaments ovariens chez la jument. Cet article décrit les particularités de la laparoscopie chez le cheval. Mots-clés : laparoscopie, cheval, progrès. Résumé

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Hand-assisted laparoscopic repair of a grade IV rectal tear in a postparturient mare

Abstract: Successful repair with an excellent outcome was achieved in this mare. Hand-assisted laparoscopic repair should be considered as a possible treatment option in horses with grade IV rectal tears.

Cited by 8 publications

References 11 publications

Retroperitoneoscopy of the presacral space in horses: Surgical access and anatomy

Retroperitoneoscopy of the presacral space in horses: Surgical access and anatomy

Diagnosis, management and prognosis of large colon impactions

La laparoscopie chez le cheval

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