Pericardiotomy by Transdiaphragmatic Thoracoscopy Singleport in Horses.
Authors: Lorga Andressa Duarte, Gomes Anny Raissa Carolini, Strugava Lucimara, Moreno Juan Carlos Duque, Dornbusch Peterson Triches
Journal: Journal of equine veterinary science
Summary
# Editorial Summary: Transdiaphragmatic Single-Port Pericardiotomy in Horses Pericardial disease in horses requires surgical intervention, yet current minimally invasive approaches rely exclusively on intercostal thoracoscopy, limiting access to certain anatomical regions. Researchers developed and evaluated a novel single-port transdiaphragmatic thoracoscopic technique for pericardiotomy using six cadaveric horses positioned in dorsal recumbency, accessing the thorax via an 11 mm trocar introduced cranial to the xiphoid process through the diaphragm. The procedure successfully visualised the caudal thoracic structures and pericardium with a mean surgical time of 24 minutes, enabling extensive pericardiotomy initiated via the phrenic-pericardial ligament, and necropsy examination revealed no inadvertent injuries to surrounding tissues. Single-port transdiaphragmatic access represents a promising alternative to existing intercostal methods, potentially offering improved visualisation of the caudal thorax and both hemithoraxes whilst reducing the number of portal sites, though clinical validation on living horses with naturally occurring pericardial pathology remains necessary before widespread adoption in equine practice.
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Practical Takeaways
- •A new minimally invasive single-port transdiaphragmatic approach to pericardiotomy is now available as an alternative to traditional intercostal thoracoscopy in horses
- •The procedure can be completed in approximately 24 minutes and allows adequate visualization and manipulation of pericardial structures for therapeutic intervention
- •This technique may offer advantages for horses requiring pericardial drainage or window procedures, though clinical validation in live cases is still needed
Key Findings
- •Single-port transdiaphragmatic thoracoscopy successfully visualized and accessed the pericardium in all six cadavers
- •Mean surgical time was 24.16 ± 7.03 minutes, allowing extensive pericardiotomy
- •The technique provided visualization of caudal thoracic structures and allowed safe pericardial manipulation without reported major inadvertent injuries
- •Transdiaphragmatic access proved viable as an alternative to previously described intercostal thoracoscopic approaches for equine pericardial procedures