Left- and right-sided laparoscopic-assisted nephrectomy in standing horses with unilateral renal disease.
Authors: Röcken Michael, Mosel Gesine, Stehle Christiane, Rass Julia, Litzke Lutz F
Journal: Veterinary surgery : VS
Summary
# Editorial Summary: Standing Laparoscopic-Assisted Nephrectomy in Horses Unilateral renal disease in horses traditionally requires general anaesthesia and invasive surgery, both carrying significant perioperative risks. Röcken and colleagues developed and refined a laparoscopic-assisted technique performed under standing sedation with local infiltration anaesthesia, using two ipsilateral portals and a small laparotomy to access and remove diseased kidneys. Three horses underwent successful procedures (two left-sided for hydronephrosis, one right-sided for nephrolithiasis) with adequate intraoperative immobilisation and analgesia; only one animal experienced a minor complication—incisional seroma and transient fever—both resolving with medical management. This approach substantially reduces surgical trauma and eliminates general anaesthetic risks whilst maintaining complete visualisation of critical vascular and ureteral structures during dissection and ligation. For equine practitioners managing unilateral renal conditions, this technique represents a valuable alternative that warrants consideration as a less invasive option, particularly for geriatric or compromised patients for whom general anaesthesia presents heightened risk.
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Practical Takeaways
- •Laparoscopic-assisted nephrectomy is a viable alternative to general anesthesia for unilateral kidney removal, reducing anesthetic risk in horses with renal disease.
- •This standing surgical approach using regional anesthesia and minimal invasive technique reduces surgical trauma and recovery time compared to traditional open nephrectomy.
- •Practitioners should consider this technique for horses with nephrolithiasis or hydronephrosis where general anesthesia poses higher risk, though the small sample size means further experience is needed to define complications.
Key Findings
- •Laparoscopic-assisted nephrectomy was successfully performed in 3 horses (2 left-sided, 1 right-sided) using standing sedation with detomidine and levomethadone combined with local anesthesia.
- •No intraoperative complications occurred; 1 horse developed incisional seroma and fever on postoperative days 3-4 that resolved with medical management.
- •Standing sedation and local anesthesia provided adequate immobilization and analgesia for the procedure using a 2-portal technique with mini-laparotomy.