Incisional hernia repair in horses: a cadaveric study of endoscopic component separation.

Abstract

OBJECTIVE: To report a technique for endoscopic component separation in horses and quantify the amount of body wall advancement obtained. STUDY DESIGN: Descriptive study. ANIMALS: Fresh cadaveric horses (n = 14). METHODS: After a preliminary anatomic study, 7 horses had unilateral endoscopic component separation involving transection of the external abdominal oblique fascia lateral to the rectus abdominis muscle. A laparoscope, placed using a balloon dissector, was used to create an intermuscular working space between the external abdominal oblique fascia and internal abdominal oblique muscle. A single instrument portal was created 10-12 cm medial to the laparoscope portal. Laparoscopic scissors were used to transect the external abdominal oblique fascia, lateral to its insertion to the external rectus sheath, from ≈ 20 cm cranial to the costochondral junction to the level of the superficial inguinal ring. Subsequently, a 30 cm ventral median celiotomy was created and the myofascial advancement was quantified at points 10 and 20 cm cranial to the umbilicus. RESULTS: Endoscopic component separation was successfully completed in all horses. Component separation provided a net mean (± SD) abdominal wall advancement of 3.5 ± 1.3 cm and 3.4 ± 0.5 cm, 10 cm, and 20 cm cranial to the umbilicus, respectively. CONCLUSION: Endoscopic component separation in horses is technically feasible but, as conducted, results in modest abdominal wall advancement.