Laparoscopic hernioplasty in recumbent horses using transposition of a peritoneal flap.
Authors: Rossignol Fabrice, Perrin Roland, Boening K Josef
Journal: Veterinary surgery : VS
Summary
# Editorial Summary: Laparoscopic Hernioplasty in Horses Strangulated inguinal hernias represent a surgical emergency in horses, yet recurrence rates remain problematic following conventional repair. Researchers evaluated a novel laparoscopic approach using peritoneal flap hernioplasty (PFH) to seal the vaginal ring in nine horses and ponies without prior herniation history and four horses with documented strangulation events. Under general anaesthesia, surgeons elevated peritoneum adjacent to the vaginal ring, transposed it to cover the defect, and secured it with either intra-corporeal sutures (six cases) or laparoscopic staples (seven cases). Post-operative laparoscopic inspection at seven days demonstrated complete vaginal ring coverage in eight of nine preventative cases with no adhesion formation, whilst all four clinical cases remained free from re-herniation over a follow-up period ranging from six months to four years. For equine practitioners, this technique offers meaningful advantages beyond simple defect closure: the peritoneal flap provides a biological barrier that may reduce spermatic cord irritation and inflammation, potentially preserving breeding function—a critical consideration in valuable animals. Although the case numbers remain modest, the absence of recurrence in high-risk animals and minimal post-operative complications suggest laparoscopic PFH warrants consideration as a definitive management option for horses with strangulation history, particularly where preservation of fertility is a priority.
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Practical Takeaways
- •Laparoscopic peritoneal flap hernioplasty offers a minimally invasive option for horses with recurrent inguinal hernias, with no reoccurrence in this small cohort.
- •This technique may be preferable to open surgery because it reduces spermatic cord trauma and inflammation, preserving breeding capability in stallions.
- •Requires standing laparoscopic follow-up at 7 days post-op to confirm complete vaginal ring closure; larger case series needed before widespread adoption.
Key Findings
- •Laparoscopic peritoneal flap hernioplasty successfully closed the vaginal ring in 12 of 13 cases (92%) with no postoperative adhesions observed.
- •In 4 horses with history of strangulated inguinal hernia, zero recurrence of SIH was documented over 6 months to 4 years of follow-up.
- •The technique preserved spermatic cord integrity without inflammation or irritation, potentially protecting breeding function.