Laparoscopic surgical technique for repair of rectal and colonic tears in horses: an experimental study.
Authors: Brugmans F, Deegen E
Journal: Veterinary surgery : VS
Summary
# Editorial Summary Rectal and colonic tears represent serious surgical emergencies in equine practice, yet traditional open repair carries significant morbidity. Brugmans and Deegen evaluated three laparoscopic repair techniques using an equine pelvitrainer model, cadaveric specimens, and live horses under general anaesthesia, comparing manual suturing with needle holders, automated suture devices, and stapling techniques. Manual needle-holder repair and automated suturing produced significantly higher bursting pressures (>140 mm Hg) than stapling, with no meaningful differences in operative time or luminal narrowing between methods; importantly, laparoscopic repair of iatrogenic rectal lacerations in live horses proved feasible with no major complications and histologically confirmed healing by post-operative day 7. Whilst this work demonstrates proof-of-concept for minimally invasive rectal repair in controlled conditions, the technique's applicability to acute clinical tears—which present with contamination, inflammation, and compromised tissue integrity—remains to be established through clinical trials. For equine surgeons and veterinary teams managing acute rectal injuries, these findings suggest laparoscopic repair warrants further investigation as a potential alternative to open approaches, particularly where preserved anal sphincter function and reduced peritoneal contamination might confer clinical advantages.
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Practical Takeaways
- •Laparoscopic rectal tear repair is technically feasible in horses under general anesthesia with adequate healing at 7 days, offering a minimally invasive alternative to conventional approaches
- •Use needle holders or automatic suture devices rather than staplers for laparoscopic bowel repair to achieve stronger wound bursting pressure
- •This technique shows promise for iatrogenic rectal tears but requires further research in spontaneous clinical cases before widespread clinical adoption
Key Findings
- •Laparoscopic needle holders and automatic suture devices produced higher bursting pressures than stapling technique in bowel repair models
- •Laparoscopic repair of iatrogenic rectal lacerations in horses achieved adequate healing with bursting strength >140 mm Hg at 7 days postoperatively
- •No significant difference in repair time or luminal narrowing between three laparoscopic repair techniques (needle holders, automatic suture device, stapling)
- •No major complications recorded in 3 horses with laparoscopically repaired rectal tears followed for 7 days postoperatively