Updates on techniques and equipment for equine laparoscopy in the year 2019

Equipment

The adaptation of human laparoscopic equipment for use in the horse continues. Retrieval bags, staples, suture devices, barbed suture, radio-frequency devices and mono-polar electrosurgery are commonly used in equine laparoscopy. The main detriment to all of these modalities is the cost associated with their use. As the cost increases, clients must be willing to sustain the expense associated with their use. The biggest changes in the past few years are the use of barbed suture, especially in automated suturing devices such as the EndoStitch. The barbed suture allows suturing of intra-abdominal structures without the need to tie intracorporeal knots. This is a significant benefit as intracorporeal knots can be challenging, even for the experienced laparoscopist. Mono-polar electrosurgery can be easily used in the standing animal. This technique can be valuable for adhesiolysis and hemostasis.

Techniques

Ovariectomy

In 2017, Colbath, et.al. published a report on removing both ovaries from the left side of the abdomen. The performed a bilateral ovariectomy on 12 mares from the left flank. The approach used 4 portals, one for the telescope and 3 for instruments. A fan retractor was used to hold the small colon and mesocolon dorsally to provide access to the right ovary. The ovary was splash blocked and the pedicle was infiltrated. A LigaSure device was used to amputate the right ovary. The right ovary was then held with an acute claw grasper and the left ovary removed after infiltration of the left ovarian pedicle. Both ovaries were removed from a single enlarged incision in the left flank. The technique requires two surgeons with laparoscopic experience but can be successfully performed. The time for the procedure decreased with experience. Devick reported a left sided approach where a defect was made in the mesocolon, the right ovary ligated and the hole in the mesocolon closed with staples. In study by Easley in 2018, they evaluated the intra-abdominal temperature of LigaSure tip during unilateral laparoscopic ovariectomy in 15 healthy mares. The surgical time for the unilateral ovariectomy was 30 minutes. [...]