Development of a new laparoscopic Foramen Epiploicum Mesh Closure (FEMC) technique in 6 horses

Epiploic foramen entrapment (EFE) is, based on the number of reports in the literature, a relatively important life-threatening cause of colic in horses that could be prevented by closing the epiploic foramen (EF) in horses at risk of developing EFE.

To describe the laparoscopic foramen epiploicum mesh closure (FEMC) technique and its outcome.

Descriptive experimental study.

The EF of 6 horses was closed with the FEMC technique. A diabolo-shaped constructed mesh was introduced into the omental vestibule through the EF under laparoscopic visualisation in the standing sedated horse. Clinical and laboratory parameters were recorded during the post operative period. Four weeks after the intervention, repeat laparoscopy was performed in all horses. Three horses were subjected to euthanasia one, 2 and 3 months after the intervention, and were examined on necropsy and histopathology. The remaining 3 horses were followed clinically for 6 months.

The 6 FEMC procedures were performed successfully in a median surgery time of 22 min (range 18-27 min). One horse was treated for large colon impaction in the immediate post operative period. On repeat laparoscopy at 4 weeks all 6 EFs were closed and no undesired adhesions were identified. This was confirmed on gross and histopathological examination of the 3 horses that were subjected to euthanasia. The 3 remaining horses were clinically normal in the 6-month post operative observation period.

This FEMC technique provides a fast, simple, reliable and safe procedure to obliterate the EF and may be useful in horses at risk for EFE.