Laparoscopic closure of the nephrosplenic space for prevention of recurrent nephrosplenic entrapment of the ascending colon.
Authors: Farstvedt Ellis, Hendrickson Dean
Journal: Veterinary surgery : VS
Summary
# Editorial Summary: Laparoscopic Nephrosplenic Space Closure for Left Dorsal Displacement Prevention Left dorsal displacement of the left colon (LDDLC), or nephrosplenic entrapment, is a painful and potentially life-threatening condition that can recur in affected horses; Farstvedt and Hendrickson investigated whether laparoscopic closure of the nephrosplenic space—the anatomical gap between the kidney and spleen through which the colon can become trapped—might prevent such recurrence in horses with a history of the condition. Over a mean follow-up period of 22 months, ten horses underwent laparoscopic nephrosplenic space closure using polyglyconate suture material and custom-designed cannulae; none experienced recurrent LDDLC, and the cohort showed a statistically significant reduction in overall colic episodes and need for ventral celiotomy compared to their preoperative histories, though three horses did require surgical intervention for other colic-related conditions. These findings suggest that prophylactic laparoscopic closure is an effective strategy for eliminating the specific risk of nephrosplenic entrapment in predisposed individuals, whilst practitioners should remain cognisant that closure does not prevent other forms of colic or abdominal surgical disease. For equine surgeons managing horses with recurrent LDDLC, this minimally invasive technique offers a definitive anatomical solution with favourable outcomes, though owners should understand that the procedure addresses one colic mechanism rather than conferring complete colic immunity.
Read the full abstract on PubMed
Practical Takeaways
- •Laparoscopic nephrosplenic space closure is effective at preventing recurrent LDDLC in horses with previous episodes—consider this preventive approach for repeat offenders
- •While this procedure eliminates LDDLC recurrence, horses may still experience colic from other causes, so ongoing management and owner education about colic signs remains important
- •This minimally invasive technique reduces need for repeat ventral celiotomy, meaning faster recovery and less abdominal trauma compared to repeated open surgery
Key Findings
- •Laparoscopic nephrosplenic space closure prevented recurrence of LDDLC in all 10 horses over 22-month mean follow-up
- •Significant decrease in total incidence of colic (P<0.05) and ventral celiotomy procedures post-operatively
- •3 of 10 horses (30%) required subsequent surgical intervention for colic from other causes
- •Polyglyconate suture material and custom cannula design were used successfully with no complications