Equine Clinic De Morette Asse, Vlaams-Brabant, Belgium
Laparoscopic Closure of the Vaginal Rings in the Standing Horse Using a Tacked Intraperitoneal Slitted Mesh (TISM) Technique. Wilderjans H1, Meulyzer M2. 1Equine Clinic De Bosdreef, Moerbeke-Waas, Belgium; 2Equine Clinic De Morette, Asse, Belgium.
Indirect inguinal herniation (IIH) is a potentially life-threatening condition in stallions. The objectives of this study are to describe a laparoscopic tacked intraperitoneal slitted mesh (TISM) technique to close the vaginal rings and to evaluate its efficacy in preventing recurrence of IIH in stallions. Medical records of 17 stallions with a history of IIH were reviewed retrospectively. Laparoscopy was performed on the standing horse. The vaginal ring was covered with a mesh that was partially cut to create two flaps: the dorsal flap was passed under the spermatic cord and ductus deferens and the ventral flap above. The mesh was secured in place with laparoscopic tacks. Long-term follow-up was obtained by telephone interview of the owners. A total of 32 laparoscopic vaginal rings closures were successfully performed in 17 horses. No major intra- or postoperative complications occurred. None of the horse suffered from reoccurrence. Nine of the 13 active breeding stallions were breeding again with similar semen quality as before treatment, and 4/13 will resume their breeding activity during the next breeding season. In three stallions, postoperative pain and activity limitations were noted that gradually resolved after six months. The main limitations of this study are the lack of large numbers to compare the results of different mesh and tack combinations, the lack of follow-up veterinary examinations, and the limited number of laparoscopic rechecks. The TISM technique is an effective technique to surgically reduce the size of the vaginal ring and thereby prevent recurrence of IIH.