Laparoscopy and thoracoscopy are endoscopic surgical techniques similar to arthroscopy but performed within the peritoneal (abdominal) or pleural (chest) cavities. It is an application of the same principles of triangulation as in arthroscopic surgery using a rigid fiberoptic telescope and specialized instrumentation for surgical manipulation. Advantages of laparoscopic surgery in humans include improved visualization of the abdominal cavity, shorter hospitalization time, decreased incisional morbidity, and quicker postoperative return to normal physical activity. Specific surgical procedures adapted for use in humans include gallbladder removal, hernia repair, appendectomy, ovariohysterectomy, surgical biopsies, gastrointestinal surgery and lung lobe resections.

Recently, these endoscopic surgical techniques have been adapted for use in horses. They improve visualization of the peritoneal (abdominal) or pleural (chest) cavities.  The smaller incisions result in less soft tissue trauma at surgery, which decreases convalescent time and incisional complications allowing horses a quicker return to athletic activities. The technique requires a 55-60 cm long rigid telescope, an insuflattor to distend the abdominal cavity with carbon dioxide to improve visualization, long specialized instruments which permit organ manipulation or stapling from outside the abdominal cavity, and in cases performed under general anesthesia, a special table that permits positioning of the horse at a 30 degree angle with the head down (Trendelenberg position). The instrumentation is expensive, surgical time is not shorter, cost is not reduced and the technique requires time to master. However, the reduced patient morbidity and invasiveness may be an attractive feature for many horse owners.

Laparoscopic techniques have been used in horses to remove retained abdominal testicles (cryptorchids), ovarian removal for granulosa cell tumors or behavior modification (spaying), organ biopsy, and diagnostically for horses with non-specific pleural or peritoneal disease. Laparoscopy has also been used to repair ruptured bladders in foals, removal of bladder uroliths (stones) in geldings, and left ventral colon colopexy in broodmares with recurrent colon displacements.

Laparoscopy has been used successfully in Central and South America for many years to manipulate and monitor reproductive events in camelids (llamas and alpacas). Research and development may allow the technique to be adapted for use in mares for intra fallopian tube transfer of oocytes or in vitro derived embryos. It may be of benefit in confirming the presence of a uterine torsion before surgery or to determine the definitive source of postpartum hemorrhage or cause of colic in peripartum mares. It may be useful for determining if a lack of oviduct patency or ovarian adhesions is a cause of infertility in mares. The technique could be adapted for the repair of rectal or uterine tears.

The LSU Veterinary Teaching Hospital and Clinics has acquired the equipment necessary to perform laparoscopic surgery in horses. It will permit us to perform techniques that have already proven successful, and to conduct research to develop other techniques that may improve the health and reproductive efficiency in horses.

Laparoscopic view of the equine large colon – Pelvic flexure with dorsal and ventral colons visible.

Laparoscopic view of the normal equine liver.

Laparoscopic view of the normal equine lung.