Ex vivo comparison of the giant and transfixing knot in equine open and closed castration

Abstract

The giant and transfixing knot techniques have comparable haemostatic capability and parietal tunic tensile strength, but the giant knot requires less suture material. In open castration, using the emasculator alone may produce adequate haemostasis. In closed castration, using the giant knot in combination with the emasculator increases the bursting pressure and possibly reduces the incidence of haemorrhage. In closed castration, application of a ligature may reduce the risk of evisceration.

Do different characteristics of two emasculators make a difference in equine castration?

“…In the open castration technique, the Reimer emasculator obtained significantly higher leaking pressure than the Serra emasculator, but both instruments produced leaking pressure values higher than physiological values. By contrast, in the closed castration technique, as shown previously [6,10], the Serra emasculator produced leaking pressures quite close to physiological conditions; this may be related to the occurrence of post-operative haemorrhage when this type of instrument is used in the closed technique [6].…”

“…The testicle was hung from the spermatic cord or vascular bundle in front of graph paper and the diameters of the spermatic cord (closed technique) or vascular bundle (open technique), testicular artery at the proximal aspect of the cord (i.e. approximately 9 cm from the epididymis [6]) and major and minor axes of each testis were measured from digital photographs using Image J. c In the closed castration group, the testis, encapsulated by the parietal tunic, was stripped off the remaining part of the tunica dartos and spermatic fascia.…”

Evaluation of three ligatures in simulated equine open castration

“…Vaginal tunic and cremaster muscle were removed before storing the specimens in a 0.9% saline solution for a maximum of 4 hours. We defined the vascular bundle as the testicular artery and vein, nerves, lymphatics, connective tissue, and ductus deferens for the purpose of this study …”

“…This photograph was analyzed in Image J (National Institutes of Health, Bethesda, Maryland), and the diameter of the vascular bundle was measured. The same procedure was used to measure the major and minor axes of the testicle and the diameter of the testicular artery at the proximal aspect of the cord (ie, approximately 9 cm from the epididymis) . Measurements were taken to ensure uniformity of the sample and also to uncover any possible effects related to the size of the testis, vascular bundle, and artery on the hemostatic ability of the ligatures …”

“…Castration is a common surgical procedure in horses, yet its complications constitute one common cause of malpractice claims against equine veterinarians . Although there are variations in surgical techniques (open, closed, half‐closed) and approaches (scrotal, inguinal, laparoscopic), a ligature can be used with or without an emasculator to control bleeding from the vascular bundle before transection . Despite the possible use of the emasculator and the introduction of newer electrosealing devices, ligatures are still considered the gold standard method to achieve hemostasis in surgery .…”