Repair of a Massive Abdominal Hernia in a Horse Using Polypropylene Mesh

Laparoscopic Mesh Incisional Hernioplasty in Five Horses

“…4,5,12 Postoperative problems have occurred with some regularity using open approaches to incisional hernia repair in humans and horses. The potential for avoiding some of these complications resulted in increasing popularity of minimally invasive techniques for incisional hernia repair in humans and a report of successful treatment of an acute traumatic hernia in a foal using laparoscopic placement of a polypropylene mesh, secured with endoscopic staples, 13 prompted us to investigate the feasibility of conducting minimally invasive mesh incisional hernioplasty in horses.…”

“…The prosthesis was then rolled tightly and introduced into the abdomen through one 12 mm cannula while viewed with the telescope situated in a cannula on the opposite side of the abdomen. The mesh was oriented within the abdomen and the suture ends retrieved using a suture passer (Gore Suture Passer Instrument, WL Gore and Associates, Flagstaff, AZ [horses [1][2][3][4]; Berci Fascial Closure Instrument, Karl Storz GmbH & Co., Tuttlingen, Germany [horse 5]) introduced into the abdominal cavity through a stab incision (to the external rectus sheath), corresponding to the desired location of the cranial, caudal, and laterally placed mesh sutures (Fig 2). Once the appropriate position of the mesh was assured, each of the 4 sutures was tied with the knots resting on the external rectus sheath, thus provisionally securing the mesh to the internal rectus sheath.…”

“…Except for horse 1, additional provisional fixation of the mesh was accomplished using endoscopic hernia fixation devices (EndoANCHORt, Ethicon Endo-Surgery Inc., Cincinnati, OH [horse 2] or Salute II Disposable Fixation Device, Davol Inc., Cranston, RI [horses [3][4][5]) placed at 2-3 cm intervals around the entire outer circumference of the mesh. Finally, fixation was further supplemented with transfascial sutures of 2-nylon placed via 5-7 mm stab incisions (through skin and subcutaneous tissue to the external rectus sheath) at 3-4 cm intervals around the outer circumference of the mesh.…”

“…[1][2][3] Open hernioplasty techniques with mesh prostheses 4,5 are associated with complications similar to those encountered after incisional and ventral hernioplasty in humans including seroma, wound or mesh infection, fistula, and recurrence. 6 In humans, laparoscopic hernioplasty is currently the preferred technique 7,8 with cited advantages of reduced hospitalization, less soft tissue complications, and lower recurrence rates.…”

Laparoscopic repair of a traumatic ventral abdominal hernia using a mesh

“…Ventral herniation in horses is most frequently seen in the form of incisional hernias after colic surgery (Gibson et al 1989;van der Velden and Klein 1994) and in pregnant mares (Kawcak and Stashak 1995), but may also occur after trauma (Hilbert et al 1978;Hanson and Todhunter 1986). In the latter category, there may be a perforation of the skin, but after blunt trauma this is most often not the case.…”