Laparoscopic intestinal exploration and full-thickness intestinal biopsy in standing horses: a pilot study.
Authors: Schambourg Morgane M, Marcoux Marcel
Journal: Veterinary surgery : VS
Summary
# Editorial Summary: Standing Laparoscopic Intestinal Biopsy in Horses Obtaining full-thickness intestinal biopsies in horses has traditionally required general anaesthesia and ventral median celiotomy, carrying considerable surgical risk. Schambourg and Marcoux developed and tested a standing right flank laparoscopic technique in seven adult horses, comparing accessibility to different intestinal segments and assessing the safety of obtaining duodenal and caecal biopsies using a two-stage procedure with intracorporeal suturing and peritoneal lavage. Standing right-sided access visualised all major small intestinal segments except approximately 15–20 cm of duodenum and 40 cm of ileum, actually providing access to roughly 50% more ileum than conventional ventral median celiotomy; critically, all four horses undergoing biopsy experienced no complications, adhesion formation, bacterial peritonitis, or postoperative pain during six-day monitoring including repeat laparoscopy. This minimally invasive approach represents a significant advance for diagnostic intestinal sampling in standing horses, potentially reducing anaesthetic risks and hospitalisation requirements, though the authors appropriately note the technique warrants evaluation in clinical patients with gastrointestinal disease before widespread adoption in general practice. The method expands diagnostic capability for chronic enteropathies and conditions requiring histopathological confirmation without resorting to exploratory celiotomy.
Read the full abstract on PubMed
Practical Takeaways
- •Standing right flank laparoscopy offers a less invasive alternative to exploratory celiotomy for obtaining intestinal biopsies in normal horses, avoiding general anesthesia risks
- •This technique provides superior access to ileal segments (50% more than celiotomy) and allows safe full-thickness biopsy collection with intracorporeal repair
- •Consider this approach when diagnostic intestinal biopsy is needed, though further evaluation in clinical (diseased) patients is warranted before routine adoption
Key Findings
- •Standing right flank laparoscopy provided access to all small intestinal segments except 15-20 cm of duodenum and approximately 40 cm of ileum compared to ventral median celiotomy
- •Full-thickness duodenal and cecal biopsies were successfully obtained using a 2-stage procedure with intracorporeal suturing in 4 horses with no complications or adhesions
- •No postoperative abdominal pain, peritoneal bacterial growth, or clinical complications were observed in any horses monitored through day 6