Thoracoscopic diaphragmatic hernia repair in a warmblood mare.
Authors: Röcken Michael, Mosel Gesine, Barske Katharine, Witte Tanja S
Journal: Veterinary surgery : VS
Summary
# Thoracoscopic diaphragmatic hernia repair in a standing horse: expanding minimally invasive options A previously unreported case demonstrates that standing thoracoscopy offers a viable alternative to general anaesthesia for repairing central diaphragmatic hernias in horses, a condition typically managed through conventional open surgery. An 18-year-old Warmblood mare presented with small intestinal strangulation through a diaphragmatic defect; following initial laparoscopic repair attempts in standing sedation (which failed due to splenic obstruction), successful repair was achieved via left-sided thoracoscopy using an intrathoracic suture technique. The mare remained complication-free for at least 4 years post-operatively, returning to full athletic work and subsequently breeding. By eliminating the anaesthetic and recumbency-related risks inherent to conventional diaphragmatic repair, thoracoscopic herniorrhaphy under standing sedation represents a meaningful advancement in equine surgical trauma reduction and recovery optimisation—particularly relevant for older or high-risk individuals. Whilst this is a single-case report, the technical success and long-term outcome suggest that thoracoscopic techniques should be considered in referral centres equipped for minimally invasive surgery, especially when standing laparoscopy proves anatomically limited by visceral displacement.
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Practical Takeaways
- •Thoracoscopic repair offers a minimally invasive alternative to conventional surgery for diaphragmatic hernias, reducing anesthesia risk and recovery time
- •Standing sedated procedures may provide superior outcomes for appropriate diaphragmatic cases, particularly when laparoscopic approach fails due to anatomical obstruction
- •Horses can return to full athletic and reproductive function after thoracoscopic diaphragmatic repair with appropriate surgical technique
Key Findings
- •Thoracoscopic diaphragmatic hernia repair was successfully performed in a standing sedated horse using an intrathoracic suture technique
- •The mare had no long-term complications over a 4-year follow-up period and returned to previous athletic activity
- •Standing sedated thoracoscopy avoided risks associated with general anesthesia and reduced surgical trauma compared to conventional approaches