Indications, surgical technique, and long-term experience with laparoscopic closure of the nephrosplenic space in standing horses.
Authors: Röcken Michael, Schubert Christine, Mosel Gesine, Litzke Lutz F
Journal: Veterinary surgery : VS
Summary
# Laparoscopic Closure of the Nephrosplenic Space in Standing Horses Left dorsal displacement of the left colon (LDDLC) affects approximately 6% of horses presenting with colic, with a concerning 21% recurrence rate following initial treatment—a problem that prompted surgeons to develop a minimally invasive preventative approach. Röcken and colleagues performed laparoscopic obliteration of the nephrosplenic space in 44 horses with recurrent LDDLC, using intravenous etilefrin to induce splenic contraction and facilitate suture placement of the dorsal splenic margin to the nephrosplenic ligament whilst the horse remained standing. Over the follow-up period (up to three years), no horses experienced recurrent LDDLC, despite five developing subsequent colic episodes; notably, four of these involved ascending colon displacement between the spleen and body wall rather than LDDLC. The technique proved uncomplicated and efficient, offering surgeons a standing surgical option that addresses the anatomical predisposition to this painful recurrent condition. For practitioners managing horses with a history of LDDLC—particularly those at higher risk of repeat episodes—this procedure represents a viable preventative strategy worth discussing with referring veterinarians, though understanding that alternative colic types may still occur postoperatively.
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Practical Takeaways
- •Laparoscopic nephrosplenic space closure is a viable preventive option for horses with recurrent LDDLC, eliminating future displacement of this specific location.
- •Etilefrin-induced splenic contraction facilitates the standing laparoscopic procedure and improves surgical efficiency and safety.
- •Consider this procedure for horses with a history of recurrent LDDLC, as the 21% recurrence rate with standard treatment justifies a more definitive surgical approach.
Key Findings
- •Laparoscopic closure of the nephrosplenic space was successfully performed in all 44 standing horses without complications using etilefrin-induced splenic contraction.
- •Zero recurrence of LDDLC occurred in treated horses during follow-up (≤3 years), despite 5 horses experiencing subsequent colic episodes.
- •LDDLC incidence was 6% among 4,852 horses treated for colic over 16 years, with 21% recurrence rate in affected horses.
- •Four horses developed displacement of the ascending colon between spleen and body wall as a different complication post-operatively.