Efficacy and safety of knotless barbed sutures in inguinal hernioplasty in horses: 39 cases
Bulnes F1, Vázquez FJ2, Argüelles Capilla D*3, Muñoz Morán JA*4, Genton M*5, Méndez Angulo JL*6, Climent F7, Roquet I8, Vitoria A2, Iglesias M*1, Saitua A3, Romero A2, Ezquerra Calvo LJ*1, Prades M*7, Rossignol F*5, López-sanromán FJ*9
1Veterinary Teaching Hospital University of Extremadura, Cáceres, Spain, 2University of Zaragoza, Zaragoza, Spain, 3University of Córdoba, Córdoba, Spain, 4Equine Hospital Sierra de Madrid, Madrid, Spain, 5Equine Clinic de Grosbois, Paris, France, 6Mendez Equine Hospital, Córdoba, Spain, 7Universitat Autónoma Barcelona, Barcelona, Spain, 8Equine Veterinary Services, Barcelona, Spain, 9Complutense University Madrid, Madrid, Spain.
Objectives:
Acquired strangulating inguinal herniation (IH) is a potentially life–threatening condition in stallions and several studies have investigated the presentation, diagnosis, and treatment. To prevent recurrence of IH in the contralateral vaginal ring (VR), several laparoscopic hernioplasty techniques preserving testicles have been described. The use of barbed sutures (BS) avoids the need of intracorporeal knots, this way less suture material is exposed in the tissue, also, shortens the length of procedure since knotting is not needed.
Methods:
Retrospective study included 39 cases gathered from 9 equine surgery services. The inclusion criteria were laparoscopic hernioplasty using BS. The study included both cases of post–IH hernioplasties and prophylactic surgeries in horses without a primary IH episode. The technique for each VR closure was described, identifying whether barbed suture was used alone or in combination with other methods.
Results:
Six individuals underwent prophylactic surgery and 33 were operated following an IH episode. In 92.3% of cases, an automated laparoscopic suturing device with BS was used for VR closure. Only in three cases was a laparoscopic needle holder used for the suture. BS was applied in 58 VR:45 of them with barbed suture only and 13 combining BS and other additional methods. In the 54.4% of the cases, suturing started just cranial to the vascular structures within the mesorchium. Only two cases developed an inguinal hernia in the follow up.
Conclusions:
Laparoscopic hernioplasty using BS is technically less demanding than other techniques and provides an efficient and secure closure of the VR.