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Indications, Surgical Technique, and Long-term Experience with Laparoscopic Closure of the Nephrosplenic Space in Standing Horses

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Objective

To describe surgical technique and outcome after laparoscopic closure of the nephrosplenic space for treatment of recurrent left dorsal displacement of the left colon (LDDLC) in standing horses. Study Design

Retrospective study. Animals

Forty-four horses with LDDLC. Methods

Laparoscopic portals were located in the left flank region. After administration of etilefrin intravenously to contract the spleen, the dorsal splenic margin was sutured to the nephrosplenic ligament to obliterate the nephrosplenic space. Horses were re-examined (≤3 years) for history of recurrence. In addition, medical records of 4,852 horses treated for colic over 16 years were evaluated to establish incidence of LDDLC and recurrence after treatment. Results

Splenic contraction facilitated suture placement and closure of the nephrosplenic space was achieved without complications. LDDLC recurrence did not occur although 5 horses had subsequent episodes of colic; 4 horses had displacement of the ascending colon between the spleen and body wall. Review of medical records revealed an incidence of LDDLC of 6% and recurrence of 21% in a population of horses with signs of colic. Conclusion

Laparoscopic closure of the nephrosplenic space, facilitated by etilefrin-induced splenic contraction can be efficiently performed in standing horses. Clinical Relevance

Laparoscopic ablation of the nephrosplenic space should be considered in horses that are predisposed to recurrent LDDLC.
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Keywords: etilefrin; horse; laparoscopy; left dorsal displacement of the large colon; nephrosplenic entrapment; nephrosplenic space; recurrent colic

Document Type: Research Article

Affiliations: From the Veterinary Clinic Starnberg; and the Department of Equine Surgery, School of Veterinary Medicine, Justus-Liebig University, Giessen, Germany.

Publication date: November 1, 2005

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