Hand‐assisted laparoscopic nephrectomy in a standing horse for the management of renal cell carcinoma

An 18‐year‐old Quarter Horse gelding was examined for haematuria of 6 weeks' duration. Rectal examination identified an enlarged left kidney and ultrasonographic examination of the kidney identified grossly abnormal renal architecture. Hand‐assisted laparoscopic nephrectomy was performed following laparoscopic exploration of the abdomen for metastatic disease. A laparoscopic stapling device was successfully used to transect and ligate the renal vasculature and ureter. Histopathological examination of the kidney identified renal cell carcinoma. A 7 month survival was documented following surgery. Unilateral nephrectomy should be considered a therapeutic or palliative procedure for horses with renal cell carcinoma.     

Infertility in a mare with a chronic uterine tear,diagnosis and successful standing hand‐assisted laparoscopic repair

Uterine rupture is a well recognised and potentially fatal complication in the peripartum broodmare. This case report describes a 16 month history of infertility as the sole clinical sign in a Thoroughbred mare, subsequently diagnosed with a full thickness uterine tear. The clinical course, standing laparoscopically assisted repair and outcome are discussed.     

Successful laparoscopic surgery for a uterine leiomyoma in a mare

Leiomyomas are the most common of uterine tumours in mares but large tumours are rare. A case with a 15 cm uterine leiomyoma diagnosed by rectal palpation and ultrasound examinations with apparent adverse effects on fertility is reported. Management of the case was by hand assisted laparoscopic tumour removal and unilateral ovariectomy. Complications included post operative pain, tachycardia and wound infection. The mare was confirmed to be in foal after her first cover post surgery.     

Laparoscopic‐assisted splenectomy in a horse with splenomegaly

This reports describes the surgical management of a horse evaluated for recurrent colic. These frequent colic episodes were attributed by exclusion to an abnormally enlarged spleen (idiopathic splenomegaly). Splenectomy was elected and performed with a laparoscopic assisted technique. The advantages observed by using this surgical approach were a clear view of the visceral aspect of the spleen and consequently an accurate dissection of the hilus of the spleen and associated vasculature. Ultimately the laparoscopic technique allowed the surgeons to reduce the size of the laparotomy incision required to remove the spleen and the overall invasiveness of the procedure. The horse recovered well from the procedure and ultimately returned to the previous level of competitiveness.     

Standing hand‐assisted laparoscopic removal of large granulosa cell tumours in horses using a specimen retrieval bag and morcellator

This report describes a method for removal of large granulosa cell tumours through small paralumbar incisions using laparoscopic dissection of the mesovarium and subsequent removal of the ovary in a sterile retrieval bag via morcellation. Morcellation allows division of the granulosa cell tumour and subsequent reduction of incision size required for removal. The use of a specimen retrieval bag prevented contamination of the abdomen and incision with tumour cells during activation of the morcellator.     

A two-step ovariohysterectomy with unilateral left flank laparoscopic assistance in a Quarter Horse mare

This case report describes the technique and outcome of a two-step laparoscopic-assisted ovariohysterectomy in a Quarter Horse mare performed through the left paralumbar fossa for the treatment of chronic pyometra. Ovariohysterectomy is a procedure uncommonly performed in the horse. It is surgically demanding, invasive and can be associated with significant complications when a ventral midline approach is performed. Laparoscopic-assisted techniques reduce the invasiveness and some of the complications associated with ovariohysterectomy through ventral midline alone. The described modification further reduces the invasiveness of laparoscopic-assisted ovariohysterectomy and has the potential to reduce the overall surgical time of the procedure. Further work is needed to determine if the technique could be extrapolated to large-sized mares.     

Single‐port laparoscopic incisional hernia repair in a horse

A 16‐year‐old Italian Saddle Horse gelding was referred for treatment of an incisional hernia that developed 7 months after a ventral midline laparotomy for treatment of acute abdominal pain. Physical examination revealed a hernia approximately 20 cm long and 15 cm wide on the ventral aspect of the abdomen. Ultrasonography revealed the dimensions of the hernia ring to be approximately 15 cm in length and 10 cm in width. A single‐port laparoscopic incisional hernia repair using an operating 0° laparoscope was performed with an appropriately sized (24 × 18 cm) piece of mesh fixed in place with simple interrupted transabdominal sutures. At 4 weeks post operatively, follow‐up physical examination and ultrasonography confirmed healing of the surgical site with no evidence of hernia recurrence. The same evaluation was done 6 months post operatively, and the horse returned to its previous level of activity 8 months post operatively. In horses, laparoscopic application of mesh should be considered among the treatment options for incisional hernia. In the present case, this technique was performed with a single port using an operative laparoscope, in contrast to the multiportal techniques reported previously. The case presented here demonstrates that single‐port laparoscopic herniorrhaphy is feasible, and allows proper placement of an expanded polytetrafluoroethylene intraperitoneal mesh in horses     

Laparoscopically‐assisted ovariohysterectomy in three mares with pyometra

Open surgical ovariohysterectomy in the mare provides limited visualisation and a long surgical incision. Laparoscopically‐assisted ovariohysterectomy has been performed by the authors in 3 mares with pyometra. This approach does seem to offset some of these disadvantages.     

Penetrating injury at the thoracic inlet in a Paint‐Arab mare

A 12‐year‐old Paint‐Arab mare was admitted for evaluation of a penetrating chest laceration at the thoracic inlet. The left brachiocephalic muscle was transected and the recurrent laryngeal nerve was traumatised. Subsequent to the injury, the horse developed Horner's syndrome on the left side of the neck and face, Grade IV left laryngeal hemiplegia, dysphagia, cough and subcutaneous emphysema. The defect was closed in multiple layers. Antimicrobial and antiinflammatory therapy was instituted along with local wound care. The mare remained bright and responsive and the wound healed normally. The mare showed no signs of respiratory distress. Dysphagia and ptosis persisted at 30 days post trauma.     

Laparoscopic‐assisted tube cystotomy for urethral rupture in a foal

A 10‐day‐old Tennessee Walking Horse colt was hospitalised due to a pelvic urethral tear. After 2 unsuccessful attempts to repair the tear by primary closure, the colt underwent perineal urethroplasty and laparoscopic‐assisted tube cystotomy which permitted complete urine diversion and allowed the urethral tear to heal completely.     

Permanent colostomy after small colon prolapse in a parturient mare

Small colon prolapse is a possible complication during parturition and diarrhoea. A case diagnosed in a mare during birth labour was reduced by the attending veterinarian at the farm, and referred to the authors for evaluation. After thorough physical examination, blood and peritoneal fluid tests, a ruptured mesocolon was suspected and the mare explored under general anaesthesia by a median celiotomy approach. During the procedure the affected mesocolon‐rectum was confirmed and a resection of the intestine elected. After prolapsing the segment of damaged viscera a permanent end colostomy was performed. Fourteen months later and after an uneventful recovery, the mare was in a very good physical condition and waiting to be covered for the next breeding season.     

Surgical correction of entrapment of the large colon and caecum through a mesoduodenal rent with standing laparoscopic repair in a mare

A 12-year-old Tennessee Walking Horse mare displaying signs of severe colic for 48 h was found during an exploratory celiotomy to have entrapment of a cranially displaced large colon and the caecum through a rent in the mesoduodenum. The entrapment was relieved, and 24 h later, the mesoduodenal rent was closed laparoscopically, with the mare standing. The owner reported 6 months later that the mare had displayed no signs of colic since being discharged from the hospital 11 days after surgery.     

Laparoscopic‐assisted diagnosis of anomalous unilateral abdominal cryptorchidism

This report describes an unusual case of unilateral abdominal cryptorchidism in a Shetland pony. On the cryptorchid side, no testicular structures were present in the inguinal area but testicular/epididymal remnants at the distal end of a pedunculated structure could be discerned in the abdomen at laparoscopic examination. Furthermore, the deferent duct was disconnected from the epididymal remnants and the deferent duct was visible at the caudal aspect of the bladder, traversing over the lateral ligament of the bladder into the vaginal ring where it ended blindly in the vaginal process. After laparoscopic removal of the testicular/epididymal remnants and castration of the contralateral normally descended testicle, the hCG stimulation test was negative and the pony no longer exhibited masculine behaviour.     

Laparoscopic repair of a ruptured bladder in an adult mare

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.     

Cerebellar abiotrophy in a 6‐year‐old Arabian mare

Cerebellar abiotrophy (CA) is an uncommon neurological disease that most commonly affects Arabian horses. Affected horses are typically identified within the first 6 months of life. Intention tremor, wide based stance and ataxia are common clinical signs observed in affected individuals. No treatment is available for resolution of clinical signs. Definitive diagnosis is based on histopathological examination of cerebellar tissue, which is characterised by loss of Purkinje cell layer. This report describes a case of cerebellar abiotrophy that had a delayed diagnosis until 6 years of age.     

Surgical repair of a mandibular degloving injury in a 5‐month‐old colt

A 5‐month‐old colt sustained a mandibular degloving injury and penetrating cheek wound after catching his cheek on a metal hook. Avulsion of the lower left lip and cheek exposed parts of the underlying labial surface, interalveolar margin and body of the mandible. The injury prevented the colt from closing his mouth completely and food accumulated between the degloved mandible and avulsed soft tissues. Surgical repair included 7 stented, transmandibular mattress sutures placed over the length of the interalveolar margin, closing the dead space and repositioning the avulsed soft tissues. The horse recovered without complications and functional as well as cosmetic outcome were excellent.     

Gastric and small intestinal ileus as a cause of acute colic in the post parturient mare

REASONS FOR PERFORMING STUDY: Ileus (functional obstruction of aboral gastrointestinal transit) is an uncommon cause of gastrointestinal dysfunction and colic in the horse. A number of specific conditions have been previously reported in association with ileus. This report describes the recognition of primary gastric and small intestinal ileus of undetermined cause in a series of post parturient mares. OBJECTIVES: To describe the clinical features, treatment and outcome of a series of episodes of primary gastric and small intestinal ileus. METHODS: A retrospective study was performed of colic episodes seen in an equine practice in Newmarket, UK over a 6 year period (2002-2007). RESULTS: Seventeen episodes of gastric and small intestinal ileus were identified, which occurred in 15 horses. All episodes occurred in post parturient mares. No previously reported cause of ileus was identified in any of the episodes. Fifteen of the 17 episodes received medical treatment (medical support and nasogastric decompression) and, in addition, surgical decompression was performed in 9 episodes. Two mares were subjected to euthanasia before treatment due to the presence of gastric rupture and the remaining 13 mares survived with a follow-up period of at least 10 months. Two mares suffered a further episode of gastric and small intestinal ileus, one 4 days and the other 2 years after the initial episode. CONCLUSIONS: Gastric and small intestinal ileus of, as yet, unknown aetiology appears to be a potential cause of acute colic in the post parturient mare. The outcome following treatment by decompression is good.     

Removal of cystic calculi using a transinguinal laparoscopic‐assisted technique in two stallions

A 12‐year‐old donkey and a 6‐year‐old Connemara pony, both sexually intact males, were admitted for surgical removal of urinary calculi. Both underwent a laparoscopic‐assisted cystotomy technique to exteriorise the bladder and remove uroliths via the inguinal canal after hemi‐castration. Both surgeries were successful and no complications occurred. This modified technique, which is minimally invasive, may be a safe and efficient way to remove bladder stones from adult stallions.