Laparoscopic nephrosplenic space ablation with barbed suture in eight horses

Abstract

CASE DESCRIPTION 8 horses (5 geldings and 3 mares) were evaluated for laparoscopic closure of the nephrosplenic space following a history of recurrent left dorsal displacement of the large colon. CLINICAL FINDINGS All horses underwent a physical examination and routine clinicopathologic testing. Transrectal palpation and transabdominal ultrasonography were performed to exclude the presence of organs in the left paralumbar region. TREATMENT AND OUTCOME A left flank laparoscopic approach with the horses standing was used. A continuous suture was placed in a craniocaudal direction between the renal and splenic capsules with unidirectional barbed suture material. This allowed obliteration of the nephrosplenic space without the need for knots to secure the leading and terminal ends of the suture line. In all horses, transrectal palpation was performed 2 months after surgery; at this time, closure of the caudal part of the nephrosplenic space was evident. In 2 horses, follow-up laparoscopy was performed, and complete closure of the nephrosplenic space was confirmed. Telephone follow-up revealed that none of the horses had any signs of recurrent left dorsal displacement of the large colon. CLINICAL RELEVANCE Results suggested that laparoscopic nephrosplenic space closure with unidirectional barbed suture material could be considered as an option for prevention of left dorsal displacement of the large colon in horses. In the horses of this report, barbed suture material allowed secure ablation of the nephrosplenic space and eliminated the need for intracorporeal knot tying.

Ex vivo comparison of barbed sutures for pelvic flexure enterotomy in horses

“…Single-layer closure with barbed sutures was chosen because this is a common application of the material. 10,14,16,17,21,22 The V-Loc suture had a mean reduction percentage in lumen diameter of 11%, which is in agreement with previous studies. 2,6,7 In previous work, a luminal percentage reduction after EPF of between 4.7% and 16% has been shown, depending on the location and technique of measurement.…”

“…Some construction time may be saved by the use of a double‐layer closure with line reversal, but this has been shown to be no different from a standard double‐layer closure and is not routinely used in the authors’ hospital. Single‐layer closure with barbed sutures was chosen because this is a common application of the material …”

Hand‐assisted laparoscopic reattachment of a mesoduodenojejunal defect in a broodmare

“…For the purposes of mesentery reattachment, it was considered that suturing would be necessary given the need to engage the intestinal serosa for complete apposition. The use of barbed, knotless suture has been previously described for laparoscopic procedures in the horse, including closure of the internal inguinal rings (Ragle et al 2013), ablation of the nephrosplenic space (Albanese et al 2016;Gandini et al 2017) and imbrication of the mesometrium (Corsalini et al 2016). The suture lends itself for those inexperienced with the skill of laparoscopic suturing as the preformed anchor loop at the end of the suture avoids the need for an initial intracorporeal knot.…”

Concurrent repair of a displaced rib fracture and splenic capsular tearing using laparoscopic technique in a standing horse with acute haemoperitoneum

“…In view of the preoperative clinical parameters, subjective quantity of haemoperitoneum and laparoscopic observation of continued haemorrhage from the splenic tear, a decision was taken to initiate a repair. The use of barbed, knotless suture has been previously described for laparoscopic procedures in the horse, including closure of the internal inguinal rings (Ragle et al 2013), ablation of the nephrosplenic space (Albanese et al 2016;Gandini et al 2017) and imbrication of the mesometrium (Corsalini et al 2016). The suture lends itself for those inexperienced with the skill of laparoscopic suturing as the preformed anchor loop at the end of the suture avoids the need for an initial intracorporeal knot.…”