Left paralumbar fossa approach combined with mesocolon fenestration for bilateral equine ovariectomy

Devick, Ian F; Hendrickson, Dean A.

doi:10.1111/vsu.13166

Cited by 6 publications

(5 citation statements)

References 29 publications

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“…Since surgeons at our facility are familiar with standing laparoscopy, all abdominal testicles were removed with this technique. Although left flank unilateral approaches for bilateral abdominal retention have recently been described [49,50], a bilateral approach was used for bilateral abdominal retentions. Despite the bilateral abdominal approach, we could observe a shorter surgical time compared to that reported for a unilateral laparoscopy in bilateral abdominal retentions, probably because of better visualization and manipulation of the retained testis over the right flank with an ipsilateral flank access.…”

Section: Discussionmentioning

confidence: 99%

A Retrospective Study of Cryptorchidectomy in Horses: Diagnosis, Treatment, Outcome and Complications in 70 Cases

Straticò

Varasano

Celani

et al. 2020

Animals

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The aim of the study was to investigate the breed predisposition and the diagnostic and surgical management of horses referred for cryptorchidism. The breed, localization of retained testis, diagnosis, type of surgical treatment and complications were analyzed. Seventy horses were included in the study; the Western Riding horse breeds were the most affected (Quarter Horse 34/70, 48.5%; Appaloosa 9/70, 12.8%). In unilateral cryptorchids (65/70, 92.8%) the most common location for a retained testis was the left abdomen (28/65, 43%), while in bilateral cryptorchids (5/70, 7.1%), bilateral abdominal retention was the most frequent (3/5, 6%). Information about testis localization was achieved through transabdominal ultrasound (30/49 cases, 61.2%), through per rectum palpation (21/49 cases, 42.9%) and through inguinal palpation (14/49 cases, 28.9%). Cryptorchidectomy was achieved with standing laparoscopy (44/70 cases, 62.8%), or with open inguinal orchiectomy in general anesthesia (26/70 cases, 37.2%). Complications during laparoscopy were spleen puncture (1/44, 2.2%), a self-limiting bleeding from the spermatic cord (10/44 cases, 22.7%), hyperthermia (3/44 cases, 6.8%), and emphysema (15/44, 34%). During inguinal open cryptorchidectomy difficulties with identifying the inguinal testis during surgery (8/26 cases, 30.8%) and a moderate and self-limiting swelling of the inguinal region after surgery (17/26, 65.4%) were observed. For orchiectomy, a standing laparoscopy was confirmed as the preferred procedure for an abdominally retained testis with almost no complications.

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Section: Discussionmentioning

confidence: 99%

A Retrospective Study of Cryptorchidectomy in Horses: Diagnosis, Treatment, Outcome and Complications in 70 Cases

Straticò

Varasano

Celani

et al. 2020

Animals

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“…Two laparoscopic portals were joined to facilitate the removal of the left and right ovaries through the left body wall. In another left flank only approach, Devick et al described fenestration of the mesocolon to reach the right ovary 33 . With this technique, a laparoscopic stapler (Multifire Endo Hernia Straight hernia stapler, 4.8‐mm staples; Metronic) was used to close the mesocolon.…”

Section: Discussionmentioning

confidence: 99%

“…3 Recently, two studies have described standing bilateral laparoscopic ovariectomy techniques performed through the left paralumbar fossa using at least four laparoscopic portals in the left body wall. 27,33 In the first study, a 45 cm articulating fan retractor (SD1672945, Sur-gicalDirect) to dorsally displace the small colon mesentery. 27 Two laparoscopic portals were joined to facilitate the removal of the left and right ovaries through the left body wall.…”

Section: Discussionmentioning

confidence: 99%

“…In another left flank only approach, Devick et al described fenestration of the mesocolon to reach the right ovary. 33 With this technique, a laparoscopic stapler (Multifire Endo Hernia Straight hernia stapler, 4.8-mm staples; Metronic) was used to close the mesocolon. Compared to our study, both techniques required the same total number of laparoscopic portals (four left paralumbar flank vs. two left and two right paralumbar flank), and the use of a fan retractor, laparoscopic stapler, and/or enjoining of two laparoscopic portals to facilitate ovary removal.…”

Section: Discussionmentioning

confidence: 99%

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Hybrid natural orifice transluminal endoscopy surgery (NOTES) to perform bilateral ovariectomy in mares

et al. 2021

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Objectives To combine laparoscopic techniques with natural orifice transluminal endoscopic surgery (hybrid NOTES) to minimize number and enlargement of paralumbar laparoscopic portals for bilateral ovariectomy in standing, sedated mares. Study design Case series. Animals Six horses. Materials and Methods Six mares with palpably normal ovaries were restrained in stocks, sedated, and had caudal epidural anesthesia performed. A 7.5 MHz ultrasound probe was used transvaginally to select placement of vaginotomy. An attempt was made to remove both ovaries with 70 cm esophageal forceps through the vaginotomy, while visualized and transected via ipsilateral paralumbar fossa laparoscopic portals. Surgical time, intraoperative, and postoperative complications were recorded. Vaginoscopy was performed at days 0, 3, 7, and 14 postoperatively. After 14 days, mares were euthanized and necropsied. Results Hybrid NOTES allowed successful bilateral ovariectomy in all six mares, with a mean surgical time of 70 ± 25 min. In two mares, one ovary was dislodged from the forceps during vaginotomy extraction. Abdominal retrieval of the ovary was successful with reapplication of forceps or a surgeon's hand via vaginotomy. At necropsy, five mares had no adhesions within the abdominal cavity or at the vaginotomy site. One mare in which hand retrieval of the ovary was necessary, developed an adhesion between the bladder and the vaginotomy. Conclusions This technique appears to offer a safe alternative for bilateral ovariectomy with minimal postoperative complications. Clinical Significance Decreased number and size of paralumbar laparoscopic incisions could decrease complications associated with exteriorization of ovaries through the flank.

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“…Ovariectomy in the mare has become an increasingly frequently performed surgical procedure as minimally invasive equipment and vessel sealing devices have become common in equine surgical facilities 1,2 . Minimally invasive techniques have been associated with fewer complications, 1 and new techniques are continually being assessed to improve surgical efficiency and decrease morbidity 3,4 …”

Section: Introductionmentioning

confidence: 99%

Outcome of bilateral equid laparoscopic ovariectomies

et al. 2021

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Objective To assess outcomes and behavior changes associated with bilateral laparoscopic ovariectomies. Study design Retrospective study. Sample population Fifty‐one equids. Methods Medical records were evaluated from equid bilateral laparoscopic ovariectomies from January 2012 to October 2018 with a potential of 6 months follow‐up. Follow‐up information obtained by telephone interviews included behavior before and after surgery. Likelihood ratio chi‐square tests and odds ratios (OR) with 95% CI were calculated where applicable, with statistical significance at p < .05. Results Bilateral ovariectomy was performed in 51 cases, with elective (no pathologic ovaries) ovariectomies performed in 41/51 cases. Occasional estrus‐like behavior was observed postoperatively in 14/51 (27%) mares, but the behavior was mild and manageable in all cases. There was no age effect on outcome in all bilateral (p = .56) or elective only (p = .36) cases. In 37/41 (90%) elective cases, improvement was observed in the reason for presentation. Some response to altrenogest administration for behavior modification was observed preoperatively in 12/18 (67%) elective cases. Response to altrenogest was not associated with (p = .31) or able to predict a beneficial response to surgery (OR = 5.5; 95% CI = 0.38–78.57; p = .21). Conclusion Response to altrenogest in elective cases may not predict behavioral outcome with ovariectomy. Occasional estrus‐like behavior in mares postoperatively was not problematic for any owners. Bilateral ovariectomy is a viable treatment option for owners seeking to alleviate undesirable behavior in mares. Clinical significance This study should aid veterinarians and horse owners in case selection for bilateral ovariectomy.

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Left paralumbar fossa approach combined with mesocolon fenestration for bilateral equine ovariectomy

Cited by 6 publications

References 29 publications

A Retrospective Study of Cryptorchidectomy in Horses: Diagnosis, Treatment, Outcome and Complications in 70 Cases

A Retrospective Study of Cryptorchidectomy in Horses: Diagnosis, Treatment, Outcome and Complications in 70 Cases

Hybrid natural orifice transluminal endoscopy surgery (NOTES) to perform bilateral ovariectomy in mares

Outcome of bilateral equid laparoscopic ovariectomies

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