Thoracoscopic‐Assisted Diaphragmatic Hernia Repair Using a Thoracic Rib Resection

Abstract

Thoracic rib resection can provide access to diaphragmatic hernias in adult horses. Thoracoscopy or a flank incision, or both, may aid in determining which rib is best resected.

Diaphragmatic hernias in horses

“…Lack of palpable abdominal viscera during rectal examination may occur in cases where a large proportion of the abdominal viscera are herniated into the thoracic cavity (Malone et al . ). Borborygmi may be audible during thoracic auscultation (Hart and Brown ).…”

“…Malone et al . () used thoracoscopy as guidance for a thoracotomy approach via rib resection. Repair of small diaphragmatic defects has been described via laparoscopy with or without hand‐assistance (Hart and Brown ; Klohnen ) although abdominal organs may obscure the defect in some cases (Röcken et al .…”

Surgical Repair of a Diaphragmatic Tear in a Thoroughbred Broodmare

“…There are reports of conservative management; however, patients were eventually euthanized for severe episodes of colic rather than respiratory signs [9,10]. Forms of surgical approach that have been described for diaphragmatic hernia repair include a cranioventral midline incision, lateral thoracotomy through rib resection, flank approach, and thoracoscopy [9,11].…”

“…The cranioventral midline approach can provide adequate visualization of the diaphragm in foals; however, in adults, access to defects located dorsally is limited [9,11]. Tilting the surgery table in reverse Trendelenburg position or lateral away from the lesion may aid in improving access [4].…”

Clinical course, heart rate and pulmonal functions during thoracoscopy in the standing horse – part 1: clinical, heart rate and blood gases

“…Die ersten thorakoskopischen Untersuchungen wurden beim Pferd Mitte der 80er Jahre des letzten Jahrhunderts erfolgreich durchgeführt (Mackey und Wheat 1985, Mansmann und Bernard-Strother 1985. Danach folgten Berichte über den Einsatz der Thorakoskopie zur Diagnostik verschiedener thorakaler Erkrankungen (Ford et al 1987, Rossier et al 1990, Mueller et al 1992, Pollock und Russell 2006 sowie zum therapeutischen Einsatz (Vachon und Fischer 1998, Malone et al 2001). …”