Laparoscopic-assisted cystotomy for urolith removal in geldings.
Authors: Röcken Michael, Stehle Christiane, Mosel Gesine, Rass Julia, Litzke Lutz F
Journal: Veterinary surgery : VS
Summary
# Laparoscopic-Assisted Cystotomy for Urolith Removal in Geldings Cystic calculi in geldings present a significant clinical challenge, and whilst traditional surgical approaches exist, minimally invasive techniques offer potential advantages in terms of tissue trauma and recovery. Röcken and colleagues developed a laparoscopic-assisted procedure combining endoscopic visualisation with a small parainguinal incision, performed on four anaesthetised geldings positioned dorsally with abdominal insufflation and a 30-degree head-down tilt to optimise bladder access. All four horses tolerated urolith extraction (6–8 cm diameter) without intra- or post-operative complications, with surgical time between 35–40 minutes, minor incisional swelling resolving within 3–4 days, and transient post-operative haematuria and stranguria by day 3–4. At follow-up extending to 12 months, no recurrence of cystic calculi-related signs occurred, suggesting this hybrid technique successfully combines the reduced tissue trauma of minimally invasive surgery with the controlled visual field necessary for safe bladder incision and stone retrieval. For equine practitioners managing geldings with obstructive or symptomatic uroliths, this approach warrants consideration as it delivers reliable outcomes whilst potentially reducing post-operative morbidity compared to conventional laparocystotomy.
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Practical Takeaways
- •Laparoscopic-assisted cystotomy offers a minimally invasive alternative to full laparotomy for urolith removal in geldings, reducing surgical trauma and post-operative complications
- •Expect minor swelling and transient urinary symptoms post-operatively, which resolve within 3-4 days; this is normal and should not cause concern
- •This technique appears to have good long-term outcomes with no recurrence, making it a viable option for managing cystic calculi in practice
Key Findings
- •Laparoscopic-assisted cystotomy successfully removed uroliths (6-8 cm diameter) in 4 geldings with no intra- or post-operative complications
- •Surgical time was 35-40 minutes with minor incisional swelling for 3-4 days and transient hematuria/stranguria resolving by day 3-4
- •Long-term follow-up to 12 months showed no recurrence of clinical signs associated with cystic calculi