Use of Knotless Barbed Sutures in Laparoscopic Inguinal Hernioplasty in Horses: 40 Cases

Abstract

Inguinal hernias (IHs) occur uni- or bilaterally when intestinal loops enter the vaginal ring (VR), exiting the abdominal cavity. They are a relatively common problem in foals and mature horses, mostly affecting intact male animals. In stallions (acquired hernias), the clinical scenario presents with colic and is an emergency, life-threatening condition, while in foals (congenital hernias), conservative management could be carried out. However, surgical treatment may be necessary as a preventive or therapeutic measure to close the VR. Several laparoscopic techniques have been reported, each with different results and postoperative complications. This retrospective study describes the results using barbed sutures. Barbed sutures are characterized by the presence of “barbs” along their length, which provide better tissue engagement and eliminate the need for knots, which is a great advantage in minimally invasive surgery. This technique was applied to 40 animals, successfully closing a total of 59 VRs. Barbed sutures were used alone or in combination with other techniques, and postoperative follow-up data was gathered from owners and/or referring veterinarians. This multicentric retrospective study suggests that laparoscopic hernioplasty using barbed sutures is a safe and effective method for the treatment and prevention of inguinal hernias in horses.

Inguinal hernias (IHs) and ruptures are a relatively common condition in horses, occurring in foals (congenital) and adult (acquired) animals. A retrospective observational analysis was conducted on 40 cases that underwent laparoscopic surgery to close the VRs using barbed sutures alone or combined with other techniques. Signalment, clinical presentation, surgery, and follow-up data were obtained. In total, fifty-nine VRs were closed using barbed sutures (alone or in combination with other methods), with six cases performed prophylactically and forty-four due to acquired IH. Of the forty-four cases with IH, four were non-strangulated hernias, while thirty presented with strangulated small intestines (twenty-eight acquired and two congenital). The results obtained in this study suggest that laparoscopic hernioplasty with barbed sutures is an effective and safe surgical procedure that could be recommended as a standard practice for managing inguinal hernias in horses, particularly when sparing testicles or preserving reproductive capabilities is a priority.