equis - Articles
Abdomen: laparotomy
Introduction
- To assess, either palpably or visually, all of the abdominal organs.
- Laparotomy in the horse is most frequently performed for gastrointestinal problems.
- Successful abdominal surgery requires a thorough knowledge of the abdominal anatomy and a technique to thoroughly explore it.
- The best abdominal approach for exposure and exploration and the most commonly used is a ventral midline celiotomy Abdomen: surgical approaches. The abdomen can also be explored via paramedian, inguinal/parainguinal and flank approaches.
- The paramedian approach can be used for colic operations Abdomen: pain - adult and is favored by some surgeons if wound healing is compromised. This incision seems to heal well and is less prone to hernia formation than the ventral midline. It can also be used in relaparotomy where there may be inflammation, infection or adhesions in the midline.
- Flank approaches are usually used in the standing patient and only give limited access to the abdomen. Uterine torsion in the mare Uterus: torsion can be corrected in some cases via this approach.
- Inguinal or parainguinal approaches are mainly used in surgery of the cryptorchid horse Testis: cryptorchidism or inguinal/scrotal hernias Inguinal ring: hernia in the stallion.
Uses
- Exploration of the abdominal cavity in cases of acute or chronic abdominal pain Abdomen: pain - adult.
- Exploration of the abdominal cavity in cases of loss of weight or where biopsy samples are required.
- Surgery of the male and female reproductive tract such as removal of ovaries Ovary: ovariohysterectomy - laparotomy approach and testes Testis: castration - overview and caesarean section Uterus: caesarean section.
- Allows access to the urinary system, specifically the bladder, ureters and kidneys.
Advantages
- Easily performed via a ventral midline celiotomy.
- Whole of gastrointestinal (GI) tract is palpable, and 75% can be exteriorized.
- If followed in a logical manner, all of the abdominal organs can be assessed either palpably or visually.
- There is minimal hemorrhage from the linea alba incision, it is easily extended, and provides strong fibrous tissue for closure of the incision.
Disadvantages
- General anesthesia Anesthesia: general - overview and dorsal recumbency required.
- Not all of the GI tract can be exteriorized or visible.
- If a more caudal incision is required in the male animal, then the prepuce and penis limit access and may be required to be reflected laterally to improve access.
Alternative techniques
- Evaluation of abdominal contents Abdomen: laparoscopy Abdomen: surgical approaches Ultrasonography: abdomen.
- Laboratory evaluation of the gastrointestinal system.
Time required
Preparation
- General anesthetic induction and maintenance - 20 min.
- Aseptic preparation and draping - 10-15 min.
Procedure
- Ventral midline laparotomy including suturing - 20-30 min.
- Surgical exploration of abdominal contents - 15-30 min.
Decision taking
Criteria for choosing test
- See acute abdominal pain Abdomen: pain - adult, eg intestinal tympany and flatulent colic Gastrointestinal: tympany / flatulent colic and spasmodic colic Abdomen: pain - spasmodic colic.
Risk assessment
- Increased general anesthetic risks in acute abdominal disease.
Requirements
Subscribe To View
This article is available to subscribers.
Try a free trial today or contact us for more information.
Preparation
Subscribe To View
This article is available to subscribers.
Try a free trial today or contact us for more information.
Technique
Subscribe To View
This article is available to subscribers.
Try a free trial today or contact us for more information.
Aftercare
Subscribe To View
This article is available to subscribers.
Try a free trial today or contact us for more information.
Outcomes
Subscribe To View
This article is available to subscribers.
Try a free trial today or contact us for more information.
Further Reading
Publications
Refereed papers
- Recent references from PubMed and VetMedResource.
- Anderson S L et al (2015) Occurrence of incisional complications after closure of equine celiotomies with USP 7 polydioxanone. Vet Surg 44 (4), 521-526 PubMed.
- Munoz E et al (2008) Retrospective analysis of exploratory laparotomies in 192 Andalusian horses and 276 horses of other breeds. Vet Rec 162 (10), 303-306 PubMed.
- Smith L J et al (2007) Incisional complications following exploratory celiotomy: does an abdominal bandage reduce the risk? Equine Vet J 39 (3), 277-283 PubMed.
- Wilson D A, Baker G J & Boero M J (1995) Complications of celi