73 research outputs found

    Occurrence and Definitions of Intra and Postoperative Complications Related to Laparoscopy in Equids: A Scoping Review

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    SIMPLE SUMMARY: Laparoscopy and laparoscopic-assisted procedures in equines are nowadays common procedures with several advantages compared to laparotomy. However, despite the numerous benefits of minimally invasive surgery, there can be surgical complications which could have important welfare and economic consequences. Nevertheless, standard definitions of intra and postoperative complications are rarely reported and there is a lack of standard criteria to define and classify complications, limiting comparison of complication rates between studies. Thus, there is a need for implementation of rigorous criteria for defining complications and for greater numbers of research study with high quality of evidence. Adoption of classification systems and standard definitions would help surgeons to have a complete picture of the efficacy of a procedure or treatment and it is also essential to allow comparisons between studies, centers or time periods. ABSTRACT: Laparoscopy is a common approach in equine surgery and has the advantage of improved visibility and diagnostic accuracy, decreased morbidity and hospitalization time. However, despite the numerous benefits, there can be intraoperative and postoperative complications which could have important welfare and economic consequences. The aim of this study was to perform a scoping review to identify current evidence on the occurrence, definition and classification of intra and postoperative complications in equine laparoscopy. A scoping review was conducted in scientific databases. Peer-reviewed scientific articles in the English language on laparoscopy in equids between 1992 and 2022 were included. Data on the study method, sample size, surgical procedure, intra and postoperative complications were extracted and charted. One hundred sixty-four articles met the final inclusion criteria. A definition of “intraoperative complication” was given in one study. Difference between “minor” or “major” intraoperative complications were reported in 12 articles and between “minor” or “major” postoperative complications in 22 articles. A total of 22 intraoperative and 34 postoperative complications were described. The most reported intraoperative complication was hemorrhage from ovary or mesovary (12.7%), while the most reported postoperative complications were incisional complications (64.2%) and postoperative pain (32.7%). There is a need for implementation of criteria for defining complications. The adoption of classification systems and standard definitions would help surgeons to make decisions about the most appropriate treatment, and it is also essential to allow comparisons between research results

    Hypothesis on the pathophysiology of small intestinal strangulation by a pedunculated lipoma

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    SummaryThe current hypothesis proposed for strangulation of small intestine by a pedunculated lipoma in horses involves movement of the lipoma around the small intestine until it loops through its own pedicle. This mechanism is difficult to demonstrate during surgical correction. The objective was to examine an alternative explanation for strangulation by pedunculated lipomas that is logical and consistent with intraoperative findings by the analysis of the anatomical features of 11 cases of lipoma strangulation in horses. In the proposed hypothesis, the stalk of the lipoma is tensed by the weight of the lipoma alone or by external forces on it from adjacent intestine. This produces a slit‐like aperture formed by the stalk and the contiguous mesentery. One or more loops of intestine pass across the lateral edge of the stalk before turning into this aperture, either because of lack of space in the abdominal cavity or through the effects of peristalsis. The weight of the intestine itself causes the loop to 'fall' into the aperture and become entrapped. This creates a half‐hitch knot in which the loop of intestine uses the lipoma pedicle as a 'post' around which it becomes strangulated. It was concluded that the proposed hypothesis differs from the existing one by requiring intestinal movement to create the strangulation, which is more plausible than the current proposal that the strangulation is caused by movement of the lipoma itself. It is also more consistent with surgical findings