Laparoscopic cryptorchidectomy using electrosurgical instrumentation in standing horses

OBJECTIVE: To describe a technique for laparoscopic cryptorchidectomy in standing horses using electrosurgical instrumentation. STUDY DESIGN: Retrospective clinical study. ANIMALS OR SAMPLE POPULATION: Ten horses, 1 to 7 years of age, with unilaterally or bilaterally retained testes. METHODS: Food was withheld for a minimum of 12 to 24 hours. Horses were sedated using xylazine hydrochloride (0.5 to 1 mg/kg) and butorphanol tartrate (0.02 mg/kg) or detomidine hydrochloride (0.02 to 0.03 mg/kg) and restrained in standing stocks. Three portal sites in the paralumbar fossae were locally desensitized using 2% mepivacaine. After trocar and laparoscope insertion, the ipsilateral testicle, mesorchium, and ductus deferens were identified. The cranial mesorchium was coagulated with either monopolar (one horse) or bipolar (nine horses) electrosurgical forceps, and then the mesorchium, ductus deferens, and ligament of the tail of the epididymis were transected from cranial to caudal using laparoscopic scissors. Once the testis was freed, the transected mesorchium was inspected for hemorrhage and the testis was removed by connecting the two instrument portals (eight horses). In two horses, the testis was placed within a laparoscopic retrieval bag and then removed without enlarging the portal incision. If the testes were retained bilaterally, the retained contralateral testis was removed similarly through the opposite paralumbar fossa. If the contralateral testis was descended, it was removed by a standard, standing castration technique. RESULTS: Vessels of the mesorchium were adequately coagulated using bipolar and monopolar electrosurgical forceps. No immediate or short-term complications occurred in 10 horses at 3 to 11 months after surgery. CONCLUSION: Standing laparoscopic cryptorchidectomy can be performed easily and safely using electrosurgical instrumentation as the sole means of providing hemostasis of the equine mesorchium. CLINICAL RELEVANCE: Standing laparoscopic cryptorchidectomy using electrosurgical instrumentation provides a safe, reliable, and efficient alternative to achieve hemostasis of the equine mesorchium.