Emergency Standing Laparoscopic Treatment of Uncontrolled Post-Castration Hemorrhage in Two Geldings.
Authors: Delvescovo Barbara, McOnie Rebecca, Pearson Garett, Pugliese Brenna, Hackett Eileen S
Journal: Animals : an open access journal from MDPI
Summary
# Editorial Summary Post-castration haemorrhage from testicular vessels represents a genuine surgical emergency, yet traditional management—either packing the castration wound or resorting to general anaesthesia for retrieval and ligation—carries significant morbidity and mortality risks. Delvescovo and colleagues presented two clinical cases in which standing laparoscopic ligation of the testicular arteries via the paralumbar fossa successfully controlled uncontrolled bleeding when conventional standing techniques had failed. The procedure allowed direct visualisation and vessel ligation without requiring general anaesthesia or revisiting the original castration site, thereby eliminating anaesthetic complications and minimising additional trauma to the surgical field. For equine practitioners managing post-castration haemorrhage that has not responded to initial standing intervention, this laparoscopic approach merits consideration as a middle-ground option—potentially faster and safer than general anaesthesia, whilst more effective than continued conservative management. Whilst the evidence base remains limited to these two cases, the technique demonstrates sufficient promise to warrant inclusion in emergency protocols and further documentation of outcomes across multiple centres.
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Practical Takeaways
- •Standing laparoscopic ligation of testicular arteries offers a rapid emergency alternative to general anesthesia when post-castration hemorrhage cannot be controlled with standing wound packing
- •This technique avoids the cardiovascular risks and prolonged recovery associated with general anesthesia in hemorrhaging horses
- •Consider standing laparoscopy via paralumbar fossa as a viable option before proceeding to general anesthesia for persistent testicular hemorrhage
Key Findings
- •Standing laparoscopic ligation of testicular arteries via the paralumbar fossa successfully controlled persistent hemorrhage in two geldings
- •The technique avoided the need for general anesthesia and its associated cardiovascular and recovery risks
- •Standing laparoscopic approach prevented additional trauma to the castration site compared to general anesthesia retrieval methods