Kira L Epstein1, Eric J Parente. 1. Department of Clinical Studies, University of Pennsylvania, New Bolton Center, Kennett Square, PA, USA. kirae@vet.upenn.edu
Abstract
OBJECTIVE: To report a laparoscopic technique for insertion of polypropylene mesh in the nephrosplenic space in horses and evaluate outcome. STUDY DESIGN: Descriptive experimental study. ANIMALS: Five healthy mature horses. METHODS: One laparoscope and 2 instrument portals were made on the left side of the horse. The nephrosplenic space was measured and appropriately sized polypropylene mesh was inserted and attached to the dorsolateral splenic capsule and perirenal fascia using helical titanium coils. All horses had repeat laparoscopy 4 weeks later and were necropsied at intervals 4-14 weeks after mesh placement. RESULTS: Mean time for laparoscopic mesh placement was 104 minutes. None of the horses had signs of colic and at 4 weeks all mesh implants were covered by fibrous tissue. One horse had a descending colon mesenteric adhesion to the mesh. At necropsy, the fibrous tissue covering the mesh had adhered to itself and pulled the splenic capsule and perirenal fascia into close apposition. Each mesh implant was firmly adhered to the spleen, nephrosplenic ligament, and perirenal fascia. CONCLUSIONS: Laparoscopic mesh placement was easily performed, well tolerated, and provided excellent fibrous obliteration of the nephrosplenic space. The single important complication observed was a mesenteric adhesion of the descending colon to the mesh in 1 horse. CLINICAL RELEVANCE: Laparoscopic placement of polypropylene mesh leads to obliteration of the nephrosplenic space within 4 weeks and should prevent entrapment of viscera in the nephrosplenic space.
OBJECTIVE: To report a laparoscopic technique for insertion of polypropylene mesh in the nephrosplenic space in horses and evaluate outcome. STUDY DESIGN: Descriptive experimental study. ANIMALS: Five healthy mature horses. METHODS: One laparoscope and 2 instrument portals were made on the left side of the horse. The nephrosplenic space was measured and appropriately sized polypropylene mesh was inserted and attached to the dorsolateral splenic capsule and perirenal fascia using helical titanium coils. All horses had repeat laparoscopy 4 weeks later and were necropsied at intervals 4-14 weeks after mesh placement. RESULTS: Mean time for laparoscopic mesh placement was 104 minutes. None of the horses had signs of colic and at 4 weeks all mesh implants were covered by fibrous tissue. One horse had a descending colon mesenteric adhesion to the mesh. At necropsy, the fibrous tissue covering the mesh had adhered to itself and pulled the splenic capsule and perirenal fascia into close apposition. Each mesh implant was firmly adhered to the spleen, nephrosplenic ligament, and perirenal fascia. CONCLUSIONS: Laparoscopic mesh placement was easily performed, well tolerated, and provided excellent fibrous obliteration of the nephrosplenic space. The single important complication observed was a mesenteric adhesion of the descending colon to the mesh in 1 horse. CLINICAL RELEVANCE: Laparoscopic placement of polypropylene mesh leads to obliteration of the nephrosplenic space within 4 weeks and should prevent entrapment of viscera in the nephrosplenic space.