Laparoscopy

Laparoscopy is key-hole surgery of the horses abdomen.  It is used most commonly for the removal of ovaries and testicles but can also be used for examination of the abdomen, taking biopsies, hernia repair and bladder stone removal. 

For an ovariectomy in a standing mare the laparoscopic camera is inserted into the flank through a 2cm skin incision.  One or two additional holes are made for instruments and the ovarian pedicle can be cauterised and transected under visual guidance to assess for heamorrhage and without any tension on the pedicle.  The ovary is then taken out of the abdomen via the flank or it can be removed through a colpotomy incision in the vagina. 

For the castration of a cryptorchid, the intra-abdominal testicle/s can be identified/visualised within the abdomen.  The blood supply to the testis is ligated or cauterised,the testis dissected free and removed. This is done either on the operating table under general anaesthesia or whilst standing in stocks.

The LigaSure is a fantastic device that is a feedback controlled cautery unit that causes haemostasis and then allows the tissue to be transected.  It is able to 'seal' large vessels quickly and effectively.  The instrument comes as a long handled device with jaws that are able to be used within the horses abdomen for castration and ovariectomy.

Less commonly older mares with fertility problems can have a 'drooping or sagging' uterus, elevated to improve uterine drainage, referred to as a uteropexy.  Also with older mares with fertility problems the oviduct/s can become blocked with mucus and cells preventing the ovum from reaching the uterus.  Laparoscopically, prostaglandin can be applied topically the oviduct causing contractions that force the blockage through the oviduct allowing the ovum to pass into the uterus and the mare to get in foal or embryos to be collected for embryo transfer.