Laparoscopic removal of a large abdominal testicular teratoma in a standing horse.
Authors: Cribb Nicola C, Bouré Ludovic P
Journal: Veterinary surgery : VS
Summary
# Editorial Summary A young Thoroughbred presented with a cryptorchid testicle containing a large teratoma (24 × 19 cm) that proved too substantial for removal via the conventional inguinal approach under general anaesthesia, necessitating an alternative surgical strategy. Rather than repeat general anaesthesia with its associated risks, the surgical team elected to perform standing laparoscopic removal via a paralumbar fossa approach, first aspirating fluid from the mass to reduce its volume and facilitate manipulation. The teratoma was successfully ligated at the mesorchium and ductus deferens using extracorporeal knots and retrieved within a laparoscopic specimen pouch, preventing loss of pneumoperitoneum and potential spillage of neoplastic material. This case demonstrates significant practical advantages of standing laparoscopy for cryptorchid neoplasm removal: minimised trauma, superior visibility of anatomical structures, avoidance of general anaesthesia complications, and containment of potentially hazardous fluid. For equine practitioners managing cryptorchid testicular masses, particularly those of unusual size or complexity, standing laparoscopic surgery merits serious consideration as a first-line approach rather than a salvage procedure.
Read the full abstract on PubMed
Practical Takeaways
- •Standing laparoscopic surgery is a viable and minimally invasive alternative for removing large cryptorchid testicular tumours when standard inguinal approaches are impractical
- •Pre-operative ultrasound-guided fluid aspiration can significantly reduce tumour mass and improve surgical access and handling during laparoscopic retrieval
- •Specimen pouches should be used during laparoscopic removal of testicular neoplasms to maintain pneumoperitoneum and prevent potential tumour cell dissemination
Key Findings
- •A 24 × 19 cm fluid-filled testicular teratoma was successfully removed via standing laparoscopy in an 11-month-old Thoroughbred after failed inguinal approach under general anesthesia
- •Ultrasound-guided fluid aspiration of the mass prior to laparoscopic removal reduced size and improved ease of manipulation
- •Use of a laparoscopic specimen pouch during retrieval prevented loss of abdominal insufflation and reduced risk of neoplastic cell seeding