Standing laparoscopy combined with a conventional inguinal approach to treat extended septic funiculitis in 12 horses.
Authors: Comino Francesco, Röcken Michael, Gorvy Dylan
Journal: Veterinary surgery : VS
Summary
# Editorial Summary: Standing Laparoscopy for Extended Septic Funiculitis Extended septic funiculitis—deep infection of the spermatic cord following castration—represents a serious complication requiring aggressive surgical management, yet conventional approaches carry substantial morbidity risk. Comino and colleagues retrospectively analysed 12 horses treated with a novel two-stage procedure combining standing laparoscopy with traditional inguinal access, allowing direct visualisation and complete resection of infected cord tissue whilst minimising trauma to surrounding structures. All 12 horses survived to discharge with only minor postoperative complications (incisional swelling in 2 cases, emphysema at laparoscopic portals in 3), and notably, intra-abdominal adhesions were identified in half the cohort—predominantly involving the colon—which the laparoscopic approach permitted safe management of without enterotomy. Follow-up data spanning 4–36 months post-discharge documented complete wound healing and zero recurrence of infection, suggesting this technique substantially reduces both immediate postoperative morbidity and long-term relapse compared to historical convention. For practitioners managing castration complications, this laparoscopic-assisted strategy warrants consideration in cases of suspected deep funiculitis, particularly where adhesions are anticipated, though access to standing surgical facilities and appropriate training remain essential prerequisites for implementation.
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Practical Takeaways
- •Standing laparoscopy combined with inguinal approach is a viable option for treating deep post-castration infections, avoiding major complications seen with traditional approaches
- •Expect adhesions in approximately half of extended septic funiculitis cases; laparoscopic visualization helps identify and manage these safely
- •This technique appears to significantly reduce recurrence risk and postoperative morbidity compared to conventional open approaches, worth considering in your surgical protocol
Key Findings
- •Complete resection of infected spermatic cord achieved without intraoperative complications in all 12 horses using laparoscopic-assisted approach
- •Intra-abdominal adhesions documented in 6 horses (50%), primarily involving colon
- •All 12 horses survived to discharge with minor postoperative complications (2 incisional swelling, 3 emphysema cases)
- •Zero recurrence of infection at long-term follow-up (4-36 months post-discharge)