Foramen epiploicum mesh closure (FEMC) through a ventral midline laparotomy. 2018

T van Bergen, and A Rötting, and P Wiemer, and S Schauvliege, and K Vanderperren, and F Ugahary, and A Martens
Department of Surgery and Anaesthesiology of Domestic Animals, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium.

BACKGROUND Preventive laparoscopic closure of the epiploic foramen (EF) has previously been described, but methods for EF closure during laparotomy for treatment of colic are lacking. OBJECTIVE To describe the foramen epiploicum mesh closure (FEMC) technique through a ventral midline laparotomy in horses under general anaesthesia and its outcome. METHODS Terminal surgical experiment and in vivo study. METHODS In a pilot study, a standard ventral midline laparotomy was performed under general anaesthesia in 10 experimental horses and a three-dimensional expandable diabolo-shaped mesh construct was manually introduced through the EF into the omental vestibule. The laparotomy incision was routinely closed after which the horses were subjected to euthanasia. Subsequently, the cadavers were extensively manipulated and finally mesh position was verified during necropsy. Thereafter, a ventral midline laparotomy, with simulation of abdominal manipulations during colic surgery was performed on six experimental horses. A three-dimensional expandable diabolo-shaped mesh with a radiological marker was introduced as in the pilot study. Clinical and laboratory parameters were recorded during the post-operative period. Four weeks after the intervention, abdominal radiography and laparoscopy were performed in all six horses. RESULTS Insertion of all 16 diabolo-shaped mesh constructs during laparotomy was uneventful. The 10 mesh constructs of the pilot study were positioned correctly at necropsy. No post-operative clinical or laboratory parameter alterations were noticed in the other six horses, apart from a transient leucocytosis and an increase in serum amyloid A. Abdominal radiography at 4 weeks revealed consistent positioning of the mesh marker. Laparoscopy confirmed that all six EFs were closed, without intestinal adhesions. CONCLUSIONS Mesh insertion in clinical cases and during clean contaminated surgery was not investigated. CONCLUSIONS The FEMC technique via laparotomy provides a fast, simple and reliable procedure to obliterate the EF and may be useful during EFE surgery to prevent recurrence of the disease, avoiding a subsequent laparoscopic procedure.

UI MeSH Term Description Entries
D007813 Laparotomy Incision into the side of the abdomen between the ribs and pelvis. Minilaparotomy,Laparotomies,Minilaparotomies
D008297 Male Males
D010865 Pilot Projects Small-scale tests of methods and procedures to be used on a larger scale if the pilot study demonstrates that these methods and procedures can work. Pilot Studies,Pilot Study,Pilot Project,Project, Pilot,Projects, Pilot,Studies, Pilot,Study, Pilot
D005260 Female Females
D006734 Horse Diseases Diseases of domestic and wild horses of the species Equus caballus. Equine Diseases,Disease, Equine,Disease, Horse,Diseases, Equine,Diseases, Horse,Equine Disease,Horse Disease
D006736 Horses Large, hoofed mammals of the family EQUIDAE. Horses are active day and night with most of the day spent seeking and consuming food. Feeding peaks occur in the early morning and late afternoon, and there are several daily periods of rest. Equus caballus,Equus przewalskii,Horse, Domestic,Domestic Horse,Domestic Horses,Horse,Horses, Domestic
D000818 Animals Unicellular or multicellular, heterotrophic organisms, that have sensation and the power of voluntary movement. Under the older five kingdom paradigm, Animalia was one of the kingdoms. Under the modern three domain model, Animalia represents one of the many groups in the domain EUKARYOTA. Animal,Metazoa,Animalia
D013526 Surgical Mesh Any woven or knit material of open texture used in surgery for the repair, reconstruction, or substitution of tissue. The mesh is usually a synthetic fabric made of various polymers. It is occasionally made of metal. Mesh, Surgical,Meshes, Surgical,Surgical Meshes

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