Development of a new laparoscopic Foramen Epiploicum Mesh Closure (FEMC) technique in 6 horses.
Authors: van Bergen T, Wiemer P, Bosseler L, Ugahary F, Martens A
Journal: Equine veterinary journal
Summary
# Editorial Summary: Laparoscopic Foramen Epiploicum Mesh Closure in Horses Epiploic foramen entrapment (EFE) represents a significant life-threatening cause of colic in horses, yet remains potentially preventable through prophylactic closure of the epiploic foramen in high-risk individuals. Van Bergen and colleagues evaluated a novel laparoscopic technique using a diabolo-shaped mesh to occlude the foramen in six standing sedated horses, achieving successful closure in a median operative time of 22 minutes (range 18–27 minutes) with minimal post-operative complications—only one horse required treatment for large colon impaction. Four weeks post-intervention, repeat laparoscopy confirmed complete foramen closure in all six horses without pathological adhesion formation, findings that were substantiated by gross and histopathological examination in three euthanised horses and six months of clinical observation in the remaining three. For practitioners managing high-risk patients or those with previous colic episodes suggestive of EFE, this minimally invasive approach offers a straightforward, time-efficient preventive option, though further prospective data on larger populations and long-term outcomes would strengthen recommendations for broader clinical application.
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Practical Takeaways
- •This minimally invasive laparoscopic technique offers a preventative option for horses at high risk of epiploic foramen entrapment, reducing time away from work compared to emergency colic surgery
- •The procedure is quick (18–27 minutes) and can be performed in standing sedated horses, making it practical for field or clinic use
- •Long-term follow-up to 6 months shows the mesh closure is durable and well-tolerated without causing problematic adhesions or complications
Key Findings
- •Laparoscopic foramen epiploicum mesh closure (FEMC) technique successfully closed the epiploic foramen in all 6 horses with median surgery time of 22 minutes
- •At 4-week repeat laparoscopy, all 6 epiploic foramina remained closed with no undesired adhesions
- •Necropsy and histopathology of 3 euthanised horses confirmed complete closure without adverse tissue reactions
- •Three horses followed for 6 months post-operatively remained clinically normal