Laparoscopic closure of the vaginal rings in the standing horse using a tacked intraperitoneal slitted mesh (TISM) technique.
Authors: Wilderjans Hans, Meulyzer Michael
Journal: Equine veterinary journal
Summary
# Editorial Summary: Laparoscopic Vaginal Ring Closure in Stallions Indirect inguinal herniation presents a significant clinical challenge in breeding stallions, potentially compromising both welfare and reproductive value. Wilderjans and Meulyzer evaluated a novel minimally invasive approach—the tacked intraperitoneal slitted mesh (TISM) technique—in 17 stallions with a history of IIH, performing 32 laparoscopic vaginal ring closures via flank approach whilst the horses stood. The procedure involves positioning a commercially available mesh across the vaginal ring, creating a slitted configuration that allows the spermatic cord and ductus deferens to pass underneath whilst securing the mesh with laparoscopic tacks; remarkably, no recurrence occurred across the cohort, no major complications arose intra- or postoperatively, and nine of thirteen active breeding stallions returned to stud with maintained semen quality. This technique preserves testicular function and eliminates the need for castration, though practitioners should note that three stallions experienced transient postoperative discomfort resolving within six months, and the small sample size and lack of veterinary follow-up examinations limit definitive conclusions about long-term outcomes. For equine practitioners managing herniated stallions, the TISM technique represents a promising minimally invasive alternative that addresses both the surgical requirement and the breeding objectives of these valuable animals.
Read the full abstract on PubMed
Practical Takeaways
- •The TISM technique offers a viable minimally invasive alternative to castration for stallions with IIH, preserving breeding potential while preventing recurrence
- •Standing laparoscopic surgery via flank approach is technically feasible with good safety profile and rapid return to function for most breeding stallions
- •Long-term success is achievable, though follow-up should include both owner assessment and veterinary examination to monitor for delayed complications or recurrence
Key Findings
- •32 laparoscopic vaginal ring closures were successfully performed in 17 stallions with no major intra- or postoperative complications
- •Zero recurrence of indirect inguinal hernia was observed in all treated horses during long-term follow-up
- •9 of 13 active breeding stallions resumed breeding with similar semen quality; 4 of 13 scheduled to resume in next breeding season
- •Testicle function and morphology were preserved in all horses; post-operative pain resolved within 6 months in 3 cases