Comparison of Mesh and Barbed Suture for Laparoscopic Nephrosplenic Space Ablation in Horses.
Authors: Gialletti Rodolfo, Nannarone Sara, Gandini Marco, Cerullo Anna, Bertoletti Alice, Scilimati Nicola, Giusto Gessica
Journal: Animals : an open access journal from MDPI
Summary
Nephrosplenic space ablation via laparoscopy effectively prevents left dorsal displacement of the large colon, but debate persists regarding optimal technique—this Italian multicentre study compared mesh implants against barbed suture in 28 horses (9 mesh, 19 barbed suture) treated for nephrosplenic entrapment between 2017–2019, examining surgical time, complication rates, long-term outcomes and costs. Barbed suture ablation proved significantly faster and more economical than mesh implantation, with lower overall complication rates: whilst one barbed suture case failed at 5-month follow-up laparoscopy, the mesh group experienced three horses with recurrent colic, including one death of unknown aetiology and one requiring revision surgery due to mesh failure at 3–6 months post-operatively. For equine practitioners managing colonic displacement cases, these findings suggest barbed suture represents a more practical and cost-effective laparoscopic approach, though the single suture failure warrants cautious interpretation and emphasises the importance of meticulous surgical technique regardless of material choice. The relatively small cohort size and retrospective design mean results should be considered preliminary, and larger prospective studies would strengthen confidence in selecting barbed suture as a first-line technique for NSS ablation in clinical practice.
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Practical Takeaways
- •For laparoscopic nephrosplenic space ablation, barbed suture offers faster surgery times and lower costs than mesh implants while maintaining comparable or better outcomes
- •Monitor horses post-NSS ablation closely regardless of technique, as recurrent colic can occur from implant failure; barbed suture shows slightly lower failure rates in this cohort
- •Consider barbed suture as first-line technique for NSS ablation in your colic prevention protocol due to improved efficiency and cost without increased complications
Key Findings
- •Barbed suture technique had significantly lower surgery time and costs compared to mesh implant
- •Barbed suture group (n=19) had 1 recurrent colic case (5.3%) with suture failure at 5-month follow-up
- •Mesh implant group (n=9) had 3 recurrent colic cases (33.3%), including 1 death and 1 requiring revision surgery
- •Barbed suture demonstrated superior cost-effectiveness and lower complication rate than mesh for NSS ablation