Elevating the uterus (uteropexy) of five mares by laparoscopically imbricating the mesometrium.
Authors: Brink P, Schumacher J, Schumacher J
Journal: Equine veterinary journal
Summary
# Editorial Summary: Laparoscopic Uterine Elevation in Subfertile Mares Mares with chronic subfertility often present with a ventrally-positioned, pendulous uterus—a conformation that impairs normal uterine drainage and debris clearance, perpetuating infection and reducing conception rates. Brink and colleagues developed a standing laparoscopic technique to address this problem by imbricating (plicating) the mesometrium bilaterally, effectively shortening the supporting ligaments and elevating the uterine body and horns back to a horizontal position. In five pluriparous mares that had been barren for an average of 3.8 years, the procedure successfully restored normal uterine positioning in all cases, with three mares (60%) conceiving naturally within the same breeding season without additional intervention. The authors propose that restoring anatomical alignment improves gravitational drainage of inflammatory fluid and cellular debris, addressing a fundamental pathophysiology of delayed uterine clearance that underpins many cases of subfertility. For practitioners managing persistently barren mares with poor uterine conformation and history of delayed clearance, this technique offers a minimally invasive surgical option that warrants consideration alongside conventional medical management, though larger cohort studies would strengthen evidence for its broader clinical application.
Read the full abstract on PubMed
Practical Takeaways
- •Consider laparoscopic uteropexy for mares with pendulous, ventrally-positioned uteri and delayed uterine clearance, particularly those barren for extended periods
- •The procedure can be performed standing and shows promising fertility outcomes (60% pregnancy rate in this small series) without requiring concurrent medical treatment
- •Correcting uterine position may restore normal drainage of uterine debris, addressing a potential mechanical barrier to conception in subfertile mares
Key Findings
- •Laparoscopic mesometrial imbrication successfully elevated the uterus to a horizontal position in all 5 mares
- •Three of five mares (60%) became pregnant within one year post-procedure without additional treatment
- •The technique was performed standing using a simple continuous suture pattern through the dorsal uterine body and mesometrium
- •Elevation of ventrally-angled uterus may improve uterine fluid clearance and restore fertility in chronically barren mares