Laparoscopic repair of a ruptured bladder in an adult mare

Abstract

A bladder rupture suffered by an adult mare during parturition was repaired, using a laparoscopic approach with the mare in dorsal recumbency. During the laparoscopic approach, the bladder was empty, inverted and had a rent on the dorsal apical surface. The bladder was located far caudally within the pelvis. By grasping the left lateral ligament and exerting gentle traction, it proved possible to manoeuvre the bladder more cranially where the rupture could be sutured. The benefits of the laparoscopic approach are reduction in incision size, visualisation of the tear, reachability of the empty bladder and the tear, and reduced reconvalescence time.

Transurethral endoscopic‐guided intraluminal closure of multiple urinary bladder tears in a standing mare

“…The conventional laparoscopic approach provides improved surgical access to the bladder compared to laparotomy, but still necessitates placing traction on the intrapelvic bladder to manoeuvre it into a more cranial abdominal position for intracorporeal suturing (Rijkenhuizen et al . ). Furthermore, laparoscopic surgery is associated with uncommon but serious complications including inadvertent puncture of the bowel or spleen, and laceration of the circumflex iliac artery during cannula placement (Hendrickson ).…”

“…Atrioventricular conduction disturbances have been reported to occur in foals and mature horses anaesthetised for urinary bladder rupture repair (Rijkenhuizen et al . ; Haga et al . ).…”

“…In addition, horses suffering bladder rupture and uroperitoneum are generally acknowledged to have an increased risk of complications during general anaesthesia (Rijkenhuizen et al . ). Standing surgical approaches have been developed to avoid the risks of general anaesthesia and attempt to provide better surgical access to the bladder (Rodgerson et al .…”

“…More recently, laparoscopic techniques have been developed for the repair of bladder tears in standing and recumbent horses (Rijkenhuizen et al . ; Tuohy et al . ; Hendrickson and Lee ).…”

Ex vivo comparison of single‐layer and double‐layer laparoscopic closure of equine bladders with 2 types of barbed sutures

“…The reason for rupture of the control bladders at the ventral aspect instead of at the dorsal apex, as most commonly occurs clinically, is unknown but may be related to weakening of the wall at that location when the ventral attachment to the body wall is cut during sample collection at necropsy. Comparison of laparoscopic closure to open closure by hand was considered beyond the scope of this study because double‐layer laparoscopic closure of the bladder with conventional suture has been reported in several clinical studies . Furthermore, laparoscopic closure with barbed suture has been found to provide similar results as conventional laparoscopic suture with intracorporeal knots in ex vivo models of porcine and adult equine bladders .…”