ISSN 2398-2977      

Abdomen: laparotomy

pequis

Introduction

  • To assess, either palpably or visually, all of the abdominal organs.
  • Laparotomy in the horse is most frequently performed for gastrointestinal problems.
  • Successful abdominal surgery requires a thorough knowledge of the abdominal anatomy and a technique to thoroughly explore it.
  • The best abdominal approach for exposure and exploration and the most commonly used is a ventral midline celiotomy Abdomen: surgical approaches. The abdomen can also be explored via paramedian, inguinal/parainguinal and flank approaches.
  • The paramedian approach can be used for colic operations Abdomen: pain - adult and is favored by some surgeons if wound healing is compromised. This incision seems to heal well and is less prone to hernia formation than the ventral midline. It can also be used in relaparotomy where there may be inflammation, infection or adhesions in the midline.
  • Flank approaches are usually used in the standing patient and only give limited access to the abdomen. Uterine torsion in the mare Uterus: torsion can be corrected in some cases via this approach.
  • Inguinal or parainguinal approaches are mainly used in surgery of the cryptorchid horse Testis: cryptorchidism or inguinal/scrotal hernias Inguinal ring: hernia in the stallion.

Uses

Advantages

  • Easily performed via a ventral midline celiotomy.
  • Whole of gastrointestinal (GI) tract is palpable, and 75% can be exteriorized.
  • If followed in a logical manner, all of the abdominal organs can be assessed either palpably or visually.
  • There is minimal hemorrhage from the linea alba incision, it is easily extended, and provides strong fibrous tissue for closure of the incision.

Disadvantages

  • General anesthesia Anesthesia: general - overview and dorsal recumbency required.
  • Not all of the GI tract can be exteriorized or visible.
  • If a more caudal incision is required in the male animal, then the prepuce and penis limit access and may be required to be reflected laterally to improve access.

Requirements

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Preparation

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Procedure

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Aftercare

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Outcomes

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Prognosis

  • Depends upon primary reason for surgery.

Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Anderson S L et al (2015) Occurrence of incisional complications after closure of equine celiotomies with USP 7 polydioxanone. Vet Surg 44 (4), 521-526 PubMed.
  • Munoz E et al (2008) Retrospective analysis of exploratory laparotomies in 192 Andalusian horses and 276 horses of other breeds. Vet Rec 162 (10), 303-306 PubMed.
  • Smith L J et al (2007) Incisional complications following exploratory celiotomy: does an abdominal bandage reduce the risk? Equine Vet J 39 (3), 277-283 PubMed.
  • Wilson D A, Baker G J & Boero M J (1995) Complications of celiotomy incisions in horses. Vet Surg 24 (6), 506-514 PubMed.
  • Phillips T J & Walmsley J P (1993) Retrospective analysis of the result of 151 exploratory laparotomies in horses with gastrointestinal disease. Equine Vet J 25 (5), 427-431 PubMed.

Other sources of information

  • Stick J A & Prange T (2018) Alimentary System in Equine Surgery. 5th edn. Eds: Auer J A & Stick J A. Elsevier Saunders, USA.
  • Blikslager A T, White, N A Moore J N & Mair T S (2017) The Equine Acute Abdomen. 3rd edn. John Wiley & Sons, USA.

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