Laparoscopic cryptorchidectomy using a resorbable self‐locking loop device in dorsally recumbent horses

Abstract

ObjectiveTo report the use and feasibility of a self‐locking resorbable loop device for cryptorchidectomy.Study designClinical prospective study.PopulationTwenty horses.MethodsHorses suspected to have an abdominal testicle/s after admission work‐up were enrolled. Horses were anesthetized in dorsal recumbency and a standard laparoscopic technique was performed. The looped device was inserted into the abdomen, glided around the testis/cord and tightened. Then, the spermatic cord was transected prior testis removal. Surgical procedure details and remarks, perioperative complications and total surgical time were recorded. Short‐ (>3 weeks) and long‐term (>6 months) follow‐ups were obtained by telephone questionnaire.ResultsMedian total surgical time was 67 min (range: 43–189 min) and significantly shortened after the first four horses. The loop device was easily glided around 13/20 abdominal testes and required more time and technical skills around larger testes (≥3 years). Excellent intraoperative hemostasis was achieved in 17 horses. Three horses demonstrated mild intraoperative bleeding that required retightening, device replacement or adding a second device, respectively. Three horses developed mild postoperative hemoabdomen identified ultrasonographically and were successfully managed medically. Follow‐up revealed no significant complications related to the procedure. One horse was euthanized for colic 4 months after surgery and one died of hemolytic shock 17 months postoperatively.ConclusionThis device represents another method to perform equine cryptorchidectomy that requires minimal training and laparoscopic expertise but demands knowledge of the device and application to prevent complications.Clinical significanceLaparoscopic cryptorchidectomy using this device is an alternative technique for horses <3 years.

A Single-Port, Multiple-Access, Custom-Made Device Used in Laparoscopically Assisted Cryptorchidectomy in Standing Horses—A Preliminary Study

“…The new device evaluated in live animals proved to be efficient for cryptorchidectomy of testicles retained in the inguinal region in cases not complicated by adhesions [6,9]. Laparoscopy with a new device allowed a broad intra-abdominal inspection and tissue manipulation in the inguinal region of standing horses, a place where cryptorchid testicles are commonly retained, allowing easy identification of the gonadal and an immediate diagnosis of these testicles [1,7].…”

“…In recent decades, there have been many advances related to laparoscopic cryptorchidectomy in horses, the main benefits of which are the absence of general anesthesia and better visualization of the cryptorchid [1,6,7]. Standing horse laparoscopy is the best option to remove ectopic testicles, but complications can occur when the devices are not used during access to the abdominal cavity [8,9].…”

“…Related advances to laparoscopic surgery depend on improvements and related innovations to the technique and equipment [1,9,10]. The most recent studies demonstrate single access through an umbilical port for the removal of cryptorchid testicles and the use of devices such as wound retractors and resorbable self-locking loops [7,11,12].…”