Recurrent Perineal Hernia in a Female Cat Diagnosed by Positive-Contrast Vaginourethrocystogram.

A 9 yr old female spayed domestic shorthair was presented with a 12-day history of stranguria. Six years previously, the cat had a bilateral perineal herniorrhaphy with cystopexy and pubic osteotomy. At presentation, survey radiographs and a positive-contrast vaginourethrocystogram were performed, which revealed cystolithiasis and recurrent bilateral perineal hernias with bladder retroflexion. A cystopexy was repeated, followed by bilateral perineal repairs using the internal obturator muscle flap transposition. To the authors' knowledge, this is the first reported case of a perineal hernia with recurrent bladder retroflexion after cystopexy diagnosed with positive-contrast vaginourethrocystogram in a female cat.

MINIMALLY INVASIVE SURGICAL REPAIR FOR ABDOMINAL WALL HERNIAS IN NONHUMAN PRIMATES, TWO CASES IN WESTERN LOWLAND GORILLAS (GORILLA GORILLA GORILLA).

A 33-yr-old female Western lowland gorilla (Gorilla gorilla gorilla) was diagnosed with a congenital umbilical hernia that was reducible and asymptomatic; change in the hernia was noted after parturition and concerns regarding increased risk of bowel incarceration developed. The hernia was successfully repaired with robot-assisted laparoscopic surgery. A 5-mon-old male Western lowland gorilla presented with bilateral inguinal hernias that were repaired via elective laparoscopic repair. In both cases, the gorillas did well without complications and never appeared to acknowledge wounds or exhibit signs of pain postoperatively. A literature review and interinstitutional survey was conducted to determine success rate of minimally invasive versus open repair of hernias in nonhuman primates (NHP). Of the cases identified, recurrence and/or wound morbidity was seen in 0% of laparoscopic repairs and 50% of open repairs. NHP may benefit from elective, minimally invasive surgical techniques that may reduce hernia recurrences and wound morbidity.

Cardiovascular changes, laboratory findings and pain scores in calves undergoing ultrasonography-guided bilateral rectus sheath block before herniorrhaphy: a prospective randomized clinical trial.

BACKGROUND: The study aimed to assess the clinical utility of a multiparametric approach to measure the impact of bilateral ultrasound-guided rectus sheath blocks (RSB) on heart rate, serum cortisol concentrations, and pain in calves undergoing herniorraphy. Fourteen calves were randomly assigned to receive either the RSB (RSB group, n = 7, injected with 0.3 mL/kg of bupivacaine 0.25% and 0.15 µg/kg of dexmedetomidine per side) or a sham injection (CG group, n = 7, injected with an equivalent volume of sterile saline solution). Monitoring included (i) continuous Holter recording from 120 min pre-surgery to 120 min post-surgery; (ii) serum cortisol concentration (SC) at -150 min pre-surgery (baseline), induction time, skin incision, end of surgical procedure (EP-t), and then 30 min, 45 min, 60 min, 120 min, 360 min after recovery; (iii) UNESP-Botucatu pain evaluation at -150 min pre-surgery and 30 min, 45 min, 60 min, 120 min, 240 min, 360 min after recovery. RESULTS: A significant difference in the heart rate was observed within the RSB group, in the time frame between 120 min to induction compared to the time frame between induction to EP-t period. The SC concentration was significantly higher in the CG at the skin incision. Calves in the RSB group recorded significantly lower pain scores at 45 min, 60 min, 120 and 240 min after recovery. CONCLUSIONS: The study demonstrated that monitoring heart rate and serum cortisol concentrations effectively quantified the effects of RSB during surgery. At the same time, the UNESP-Botucatu pain scale identified effects post-surgery when the calves regained consciousness. Overall, ultrasound-guided RSB appeared to enhance the well-being of calves undergoing herniorrhaphy.

Abdominal hernia as a rare manifestation of feline mammary gland carcinoma: a case report.

A 15-year-old, spayed female, Scottish Straight cat without any traumatic history was presented with swollen abdomen and diagnosed as an abdominal wall hernia. Abdominal ultrasound revealed thickened, irregular, and hypoechoic change of abdominal wall muscle adjacent to defect. During the herniorrhaphy, multiple nodules were identified in the subcutaneous tissue around the defect. Histological examination of the nodular tissue was performed, and it was confirmed as mammary gland tumor. After the surgery, metastatic changes of the pancreas were identified, and pleural effusion and ascites were also confirmed. The patient deteriorated rapidly and died 78 days after the surgery. This is the first case presenting abdominal wall hernia induced by malignant tumor in veterinary medicine.

Complications and outcome of traumatic diaphragmatic hernia repair without post-operative chest drain: Retrospective study in 90 cats.

Background: Diaphragmatic herniorraphy is the treatment of choice for traumatic diaphragmatic hernia (TDH). Several methods have been described for the removal of residual air and fluid during and after surgery, such as the insertion of chest drains, intercostal thoracentesis, and transdiaphragmatic thoracentesis. However, there are no indications regarding the most useful technique and the impact that choice of technique could have in the immediate postoperative period. Aim: To evaluate the development of complications and outcomes associated with the use of intraoperative transdiaphragmatic thoracentesis in cats undergoing diaphragmatic herniorrhaphy for TDH. Methods: Medical records of cats treated for acute and chronic TDH between 2010 and 2019 were reviewed. Cats were included if intraoperative pneumothorax was treated with transdiaphragmatic thoracentesis, without the use of intercostal chest drain. Outcome, intra- and post-operative complications were recorded. Results: Intraoperative and postoperative complication rates were 3.3% and 12.4%, respectively. Development of postoperative pneumothorax was associated with the presence of comorbidities (p = 0.046). The overall survival rate was 93.3%. Long-term survival had a significant association with the presence of comorbidities (p = 0.045), if the procedure was performed as an emergency (p = 0.041) or in older cats (p = 0.011). Conclusion: Intraoperative transdiaphragmatic thoracentesis could be considered an effective method for the removal of residual air after surgery for TDH, because it ensures a good outcome for the patient, with low development of complications, especially for uncomplicated cases. The presence of comorbidities, the need to perform a surgical procedure in emergency, and the age of the patient can be considered factors influencing the development of complications. Critical patient selection, based on assessment of potential risk factors for complications is warranted to understand which patient will benefit from thoracostomy tube placement.

Development of a laparoscopic technique for inguinal hernioplasty in standing horses.

BACKGROUND: Most previously described techniques for laparoscopic inguinal hernioplasty (IH) in horses require advanced laparoscopic skills. Our objective was to describe a new laparoscopic IH technique using a surgical anchoring system. METHODS: Standing laparoscopic IH was performed unilaterally in eight experimental stallions, using the contralateral inguinal canal (IC) as a control. A polyether ether ketone harpoon was anchored in the craniolateral aspect of the vaginal ring, and an extracorporeal knot was used to fix the device. Clinical evaluation, including testicular palpation and lameness examination, was conducted before and for 4 weeks after surgery. Repeat laparoscopy was performed 28 days later. RESULTS: Standing laparoscopic IH was performed in all horses with a surgical time of 38 ± 12.85 minutes. In two animals, a small peritoneal tear occurred that did not require repair. No other complications were recorded. On repeat laparoscopy, all devices were in place, and the IC remained partially closed in all horses. LIMITATIONS: The procedure was performed on normal experimental horses and has not been employed on horses that have had an inguinal hernia. CONCLUSIONS: This new standing laparoscopic hernioplasty technique provides another potential method for simple partial closure of the IC in stallions at risk of or with history of inguinal herniation.

Combined transposition of internal obturator and superficial gluteal muscles for perineal hernia treatment in dogs: 17 cases (2017-2020).

OBJECTIVES: To report the results of the combined transposition of the internal obturator muscle and superficial gluteal muscle for perineal hernia treatment in dogs. MATERIALS AND METHODS: Retrospective case series of dogs treated with this technique from November 2017 to May 2020, including pre- and post-operative clinical findings, outcome and complications. RESULTS: Seventeen dogs were included in the study. Twelve dogs were presented with unilateral perineal hernia and five dogs with bilateral perineal hernias. Mean duration of clinical signs before presentation was 9 months. All perineal hernias were successfully repaired using a transposition of the internal obturator muscle to cover the ventral aspect of the perineal hernia and the superficial gluteal muscle to cover the dorsal aspect of the hernia with minimal tension. All dogs regained normal defecation within 24 hours post-surgery. Average follow-up time was 16 months. No recurrence of clinical signs or rectal deviation was observed. Five dogs developed a superficial minor partial necrosis of the T-shaped incision and two had surgical site infections. CLINICAL SIGNIFICANCE: Perineal herniorrhaphy using a combined transposition of the internal obturator and the superficial gluteal muscles is feasible and offered excellent results in this cohort of dogs. It may be considered as a technique for repairing chronic and extensive unilateral and bilateral perineal hernias.

Laparoscopic peritoneopericardial herniorrhaphy in 2 dogs.

Two peritoneopericardial hernias (PPDH) repaired laparoscopically are reported. Both PPDHs were approached with the dog in dorsal recumbency. Herniated organs (gallbladder and 2 liver lobes in Case 1 and omental fat in Case 2) were dissected and reduced. Hernias were closed in a 2-layer horizontal mattress pattern using 2-0 polyester (Case 1), and in a single-layer simple continuous pattern using 0 barbed polyglyconate (Case 2). Reduction and herniorrhaphy were achieved without conversion. Moderate to severe systemic hypotension was observed in both dogs which responded rapidly to reducing abdominal insufflation. Ten- and 7-month follow-up confirmed good clinical outcome in both dogs.

Herniorraphie péritonéo-péricardique laparoscopique chez deux chiens. Deux hernies péritonéopéricardiques (PPDH) réparées par laparoscopie sont rapportées. Les deux PPDHs ont été réalisées avec le chien en décubitus dorsal. Les organes herniés (vésicule biliaire et deux lobes hépatiques dans le cas 1 et graisse épiploïque dans le cas 2) ont été disséqués et réduits. Les hernies ont été fermées avec un patron de suture matelas horizontal à deux couches en utilisant du polyester 2-0 (cas 1) et avec un modèle de suture continu simple à une seule couche en utilisant du polyglyconate barbelé 0 (cas 2). La réduction et l'herniorraphie ont été réalisées sans conversion. Une hypotension systémique modérée à sévère a été observée chez les deux chiens qui ont répondu rapidement à la réduction de l'insufflation abdominale. Un suivi de dix et sept mois a confirmé de bons résultats cliniques chez les deux chiens.(Traduit par Dr Serge Messier).

Comparative evaluation of different techniques for herniorrhaphy in calves.

Umbilical hernia is one of the most common problems in young calves. This problem occurs in dairy sector as well as in the local farmers. Present study was conducted to compare outcomes of four different techniques of herniorrhaphy. Twenty four young calves (n=24) were divided in 4 groups (A, B, C, and D) which underwent four different surgical techniques. Group A underwent vicryl plus suture material and pants-over-west technique, Group B underwent mesh application with Dexon suture material by using simple interrupted suture pattern, Group C underwent closed method with Nylon No. 3 suture material by using vertical mattress suture pattern and Group D underwent clamp application method with Silk No. 2 suture material by using simple interrupted suture pattern. The result showed that mesh application method was comparatively better with respect to feed intake, body weight gain and healing time. There was no reoccurrence with non-significant hematological changes (p≤0.05). It is concluded that mesh application method is safer than other three techniques and there are no systemic effects of this surgical intervention on calves' health.

Outcome of surgical treatment of perineal hernia in cats: 36 cases (2013-2019).

OBJECTIVES: To report the clinical presentation, complications, and long-term outcomes of cats treated for perineal hernia with modified internal obturator muscle transposition. METHODS: The medical records of cats surgically treated for perineal hernia between 2013 and 2019 were reviewed and an owner questionnaire was conducted to determine long-term outcome. RESULTS: Thirty-six cats were included in the study: 34 had bilateral and two unilateral hernias. Of these 36, 24 (67%) were male neutered with a median age of 10 (range: 1 to 18) years. The complication rate was low, however, one cat experienced a major postoperative complication: rectal prolapse requiring revision surgery 48 hours postsurgery. Short-term outcomes were available for 32 of 36 (89%) cats. Of the 32, 23 were examined 6 weeks postoperatively, and a telephonic consultation was performed for an additional nine of 32. Of the 23 cats examined directly, none had recurrence. Overall 12 of 32 experienced short-term postoperative tenesmus which resolved in nine of 12 (75%). Long-term outcomes were available for 31 of 36 cats (86%), with a median of 18.5 (6 to 89) months follow-up. A good outcome was achieved in 23 of 31 (74%) whereas three of 31 (10%) had fair outcomes and five of 31 (16%) had a poor outcome. Of the five cats with a poor outcome, two required subtotal colectomy to manage clinical signs related to megacolon, two were euthanised following a return of clinical signs, and one developed unilateral recurrence. CLINICAL SIGNIFICANCE: Perineal hernia should be considered in cats presenting with tenesmus or recurrent obstipation. Surgical treatment of perineal hernias in cats can result in good owner-assessed long-term outcome.

Perineal hernia repair in dorsal recumbency in 23 dogs: Description of technique, complications, and outcome.

OBJECTIVE: To describe repair of perineal hernias in dogs positioned in dorsal recumbency. STUDY DESIGN: Retrospective case series. SAMPLE POPULATION: Twenty-three dogs with perineal hernias treated by herniorrhaphy, with or without adjunctive procedures. METHODS: Medical records from 2016 to 2020 were reviewed for technique description and animal outcomes, and owners and referring veterinarians were contacted for follow-up information. RESULTS: Internal obturator muscle transposition (IOMT) was performed in 22 dogs, and polypropylene mesh repair was performed in one dog. Transection of the internal obturator tendon was feasible in all dogs undergoing IOMT. Eighteen dogs underwent abdominal pexy procedures, castration, or both during the same anesthetic period. No intraoperative complications were noted. Postoperative complications were noted in the hospital in 14 dogs and after release in 11. Incisional infection/drainage and persistent urinary incontinence were reported in four and two dogs, respectively. Hernias reoccurred in four dogs and tended to be more common in dogs that had undergone previous herniorrhaphies (p = .053). Recurrence rates were lowest in dogs that had no prior hernia repair or organ pexy (p = .035). CONCLUSION: Perineal hernia repair was feasible in dorsal recumbency. Complication and recurrence rates of perineal herniorrhaphy in dorsal recumbency were similar to those reported for dogs undergoing the procedure in sternal recumbency. CLINICAL SIGNIFICANCE: Positioning of patients for perineal hernia repair can be dictated by surgeon preference. Perineal hernia repair in dorsal recumbency allows a single-stage abdominal and perineal approach without repositioning.

Repair of a delayed, traumatic dorsal diaphragmatic hernia using a single paracostal approach in a dog.

CASE HISTORY: A 1-year-old German Shepherd dog presented for delayed onset of a traumatic, dorsal diaphragmatic hernia of the pars lumborum. CLINICAL FINDINGS AND TREATMENT: Herniorrhaphy via a ventral midline celiotomy (with and without a paracostal extension) were unsuccessful and the hernia recurred. The hernia was successfully repaired using a single lateral paracostal surgical approach. This approach provided excellent exposure and should be considered for dorsal pars lumborum diaphragmatic hernia repairs. DIAGNOSIS: Dorsal diaphragmatic hernia of the pars lumborum. CLINICAL RELEVANCE: Whilst uncommon, tears to the dorsal aspect of the diaphragm should be considered as well as the more common radial or circumferential pars costalis tears. Pre-operative computed tomographic imaging can identify the exact location of the hernia in order to allow the best surgical approach to be determined. A lateral paracostal approach should be considered as an alternative to a ventral midline celiotomy with or without paracostal extension for repair of dorsal diaphragmatic hernias affecting the pars lumborum, as it provides excellent exposure. A single lateral paracostal approach has not been reported previously for diaphragmatic hernia repair in dogs.

Laparoscopic closure of the vaginal rings in the standing horse using a tacked intraperitoneal slitted mesh (TISM) technique.

BACKGROUND: Indirect inguinal herniation (IIH) is a potentially life-threatening condition in stallions. The ideal preventive measure for breeding stallions ensures a minimally invasive closure of the vaginal ring that avoids recurrence of IIH while preserving both testicles. OBJECTIVES: To describe a minimally invasive laparoscopic tacked intra-peritoneal slitted mesh (TISM) technique in the standing horse to close the vaginal rings and to evaluate its efficacy in preventing recurrence of IIH in stallions. STUDY DESIGN: Retrospective case series. METHODS: Medical records of 17 stallions with a history of IIH were reviewed retrospectively. The surgical procedure was performed on the standing horse through a flank approach using four laparoscopic portals. The vaginal ring was covered with a commercial mesh. The mesh was partially cut to create a slitted mesh with two flaps: the dorsal flap was passed under the spermatic cord and ductus deferens and the ventral flap above. The mesh was secured in place with laparoscopic tacks. Long-term follow-up was obtained by a structured telephone interview of the owners. RESULTS: A total of 32 laparoscopic vaginal rings closures were successfully performed in 17 horses. No major intra- or postoperative complications occurred. None of the horse suffered from re-occurrence. Nine of the 13 active breeding stallions were breeding again with similar semen quality as before treatment, 4/13 will resume their breeding activity during the next breeding season. None of the horses were castrated and none of the owners reported abnormal size or shape of the testicles. In three stallions, post-operative pain and activity limitations were noted that gradually resolved after 6 months. MAIN LIMITATIONS: The lack of large numbers to compare the results of different mesh and tack combinations, the lack of follow-up veterinary examinations and the limited number of laparoscopic rechecks. CONCLUSION: The TISM technique is an effective minimally invasive technique to surgically reduce the size of the vaginal ring and thereby prevent recurrence of IIH.

Use of a new device for gasless endosurgery in a laparoscopic diaphragmatic hernia repair ex vivo canine model: A pre-clinical study.

OBJECTIVES: To test the feasibility of a new device for gasless laparoscopy in providing working space for diaphragmatic hernia repair in an ex vivo canine model as a pre-clinical study. STUDY DESIGN: Technical feasibility study. ANIMAL: Eight beagles and two greyhound cadavers (not client-owned). METHODS: The new device was used for abdominal traction in gasless laparoscopic reconstruction of diaphragmatic hernias produced in dog cadavers. It consists of three main parts (vertical and horizontal rods, a three-piece structure, and a 3D-printed unit that incorporates slots for haemostatic forceps). Composite hernias (two incisions of about 4 cm) were closed by an intra-corporeal suture [suture group (GS), n = 5] or by a central suture and a polypropylene mesh [mesh group (GM), n = 5]. Surgical steps were T1 (primary port access up to third port placement), T2 (defect development), and T3 (diaphragmatic reconstruction). Total surgical time (TT) was also recorded. RESULTS: The defect was successfully developed and reconstructed in all cadavers. To close the defect, 7.0 ± 0.7 crossed mattress sutures were required in the GS, and 15.2 ± 1.9 hernia staples and one intra-corporal suture were used in the GM. T3 was longer (p = 0.0076) in GS (50.00 ± 16.46 min) than in GM (23.24 ± 5.25 min). TT was 87.22 ± 19.23 min in GS and 66.45 ± 6.38 min in GM (p = 0.0547). CONCLUSIONS: Gasless laparoscopic diaphragmatic hernia repair using the developed device is feasible in the canine cadaver model. Both suture and mesh graft techniques for experimental diaphragmatic herniorrhaphy can be performed using this new device in this pre-clinical model. CLINICAL SIGNIFICANCE: This new device for gasless laparoscopy allows diaphragmatic herniorrhaphy by intra-corporeal suture or mesh implantation in ex vivo canine model. The device demonstrates potential for future use in clinical cases.

Laparoscopic inguinal herniorrhaphy with barbed suture in a ram.

A 7-month-old Hampshire ram, with no history of trauma or breeding, was referred for treatment of acute, unilateral scrotal swelling. Physical examination revealed a moderately sized, soft, left-sided, non-reducible swelling of the proximal scrotum and mild swelling of the scrotal neck. Ultrasound evaluation of the scrotum revealed morphologically normal testicles and a mild accumulation of free fluid in the left vaginal tunic. Unilateral, laparoscopic inguinal herniorrhaphy under general anesthesia was performed. The herniated omentum was reduced and barbed suture was used to imbricate the internal inguinal ring and the vaginal ring. No recurrence of herniation was reported 5 months after surgery. Key clinical message: Laparoscopic inguinal herniorrhaphy with barbed suture can be a safe and effective means of scrotal hernia resolution in a ram. When performed by a competent surgeon experienced in laparoscopy, this treatment for inguinal and scrotal herniation may minimize post-operative pain, provide a rapid return to function, and preserve normal testicular and scrotal anatomy.

Herniorraphie inguinale laparoscopique avec suture barbelée chez un bélier. Un bélier Hampshire âgé de 7 mois, sans antécédent de traumatisme ou de reproduction, a été vu pour traitement d'un gonflement unilatéral aigu du scrotum. L'examen physique a révélé une tuméfaction modérée, molle, du côté gauche, non réductible du scrotum proximal et une légère tuméfaction du col scrotal. L'examen échographique du scrotum a révélé des testicules morphologiquement normaux et une légère accumulation de liquide libre dans la tunique vaginale gauche. Une herniorraphie inguinale unilatérale laparoscopique sous anesthésie générale a été réalisée. L'épiploon hernié a été réduit et une suture barbelée a été utilisée pour imbriquer l'anneau inguinal interne et l'anneau vaginal. Aucune récidive de hernie n'a été rapportée 5 mois après la chirurgie.Message clinique clé:La herniorraphie inguinale laparoscopique avec suture barbelée peut être un moyen sûr et efficace de résolution de la hernie scrotale chez un bélier. Lorsqu'il est effectué par un chirurgien compétent et expérimenté en laparoscopie, ce traitement des hernies inguinales et scrotales peut minimiser la douleur postopératoire, permettre un retour rapide à la fonction et préserver l'anatomie testiculaire et scrotale normale.(Traduit par Dr Serge Messier).

Jejunal strangulation and incarceration associated with bilateral perineal hernias in a neutered male dog.

CASE DESCRIPTION: An 8-year-old 6.8-kg neutered male Dachshund was presented for evaluation of vomiting, diarrhea, anorexia, and swelling over the right perineal region. The dog had a history of a bilateral perineal herniorrhaphy and castration 14 months prior to presentation. CLINICAL FINDINGS: Bilateral perineal hernias were confirmed by digital rectal examination. Abdominal ultrasonography confirmed the presence of intestine within the right hernia. Three days after admission to the hospital, the region of the right perineal hernia became painful, erythematous, and edematous. Computed tomography revealed jejunal incarceration within the right hernia with dilation of 1 jejunal segment that indicated intestinal obstruction. TREATMENT AND OUTCOME: Abdominal exploratory surgery was performed, during which irreducible small intestinal incarceration was confirmed. Intra-abdominal jejunal resection and anastomosis was performed, and an approximately 13-cm-long section of the jejunum was resected. Bilateral perineal herniorrhaphies with internal obturator and superficial gluteal muscle transposition were performed. Six months after surgery, digital rectal examination of the dog revealed that the repair was intact. The dog had no perineal hernia-related clinical signs at the time of the recheck examination. CLINICAL RELEVANCE: For the dog of the present report, surgical management of small intestinal strangulation associated with a perineal hernia was successful. Although a portion of the small intestines can frequently be found within perineal hernias in dogs, perineal hernia-related small intestinal strangulation has not been previously described, to the authors' knowledge. Veterinarians and clients should be aware of this potential complication secondary to perineal hernia and be prepared to perform an abdominal surgical procedure to address small intestinal incarceration in affected dogs.

Surgical management and outcome of acquired inguinal hernias in mature bulls: 13 cases (2005-2017).

OBJECTIVE: To describe rates of surgical complications, survival, and return to breeding soundness following herniorrhaphy for bulls with inguinal hernias. ANIMALS: 13 sexually mature bulls with acquired inguinal hernias. PROCEDURES: Medical record databases of 3 veterinary teaching hospitals were searched to identify records of bulls that underwent herniorrhaphy for correction of an inguinal hernia from 2005 to 2017. Information extracted from the medical records included breed, age, duration and side of the hernia, surgical procedure details, postoperative complications, and information regarding subsequent fertility. RESULTS: All 13 bulls had a left inguinal hernia and were anesthetized and underwent herniorrhaphy via an inguinal approach. The left testicle was removed during the surgical procedure in 2 bulls. Nylon or polypropylene mesh secured with size-5 polyester suture was used to facilitate inguinal ring closure in 2 bulls. The inguinal ring was closed with size-5 or size-2 polyester suture in the remaining bulls. Postoperative complications included hernia recurrence (n = 4), excessive scrotal swelling (3), and transient radial nerve paralysis (1). Follow-up information was available for 7 bulls. All 7 bulls had impregnated cows or heifers following surgery, including 1 bull that had hernia recurrence and underwent unilateral castration during the second herniorrhaphy. CONCLUSIONS AND CLINICAL RELEVANCE: Inguinal herniorrhaphy with or without mesh was a safe and effective procedure for inguinal hernia repair in bulls and was associated with a good prognosis for subsequent fertility. However, sparing the ipsilateral testicle during the herniorrhaphy procedure might increase the risk for hernia recurrence.

Diagnostic and Treatment Challenges for Diaphragmatic Hernia in Equids: A Concise Review of Literature.

Diaphragmatic hernia (DH) represents an acute abdominal crisis, but respiratory symptoms may be occurring. Different types of diaphragmatic hernias (DHs) like typical DH, Morgagni hernia, hiatal hernia and diaphragmatic diverticulum have been recorded in equids. These DHs have various clinical presentations and prognoses. Early diagnosis and prompt surgical repair are highly recommended in order to diminish the ischemic changes to thoracic and abdominal viscera, thus improving the overall prognosis of equids with DH. Over last decade, the prognosis of DH in equids was better than previously believed due to improvements in diagnostic tools, general anesthesia of equids, (particularly those with systemic compromise) and gastrointestinal surgery, development of thoracoscopic techniques and use of staples for surgical repair. Nevertheless, several diagnostic and treatment challenges are still present during management of DH in equids. Diagnostic challenges include inconsistent clinical signs of DH, acute nature of the associated colic and absence of highly qualified diagnostic tools. Increased awareness of the case, good clinical observation and availability of diagnostic tools are recommended to overcome these challenges. Also anesthesia, reduction of large herniated organs and herniorrhaphy are major challenges. Preoperative stabilization, careful monitoring, selection of the most accessible surgical approach and good intraoperative as well as postoperative support are highly recommended to overcome these challenges. Surgical repair, particularly prosthetic herniorrhaphy seems to be effective to close the diaphragmatic defect and prevent recurrences. The present review describes the different types of DHs in equids, their diagnostic and treatment challenges and how to overcome these challenges.

A case report on ventrolateral herniorrhaphy in sheep: The novel way of using vest-over-pants closure technique.

OBJECTIVES: To describe the surgical management of ventrolateral hernias by using the vest-over-pants closure technique. ANIMALS: On two local breed sheep that were kept under an extensive management system. STUDY DESIGN: Case report. STUDY METHODS: Patient history and clinical findings, diagnosis, and treatment. OUTCOMES: After frequent follow-up and well post-operative care, the patient were recovered. CONCLUSION: The herniorrhaphy and closure performed in both sheep were highly successful and effective in apposing hernial ring by maintaining equal tensions with minimal wound dehiscence, unlike other closure techniques.

Laparoscopic esophagopexy, fundopexy, and hiatal herniorrhaphy for refractory regurgitation in a racing Alaskan husky sled dog.

A 2-year-old intact female Alaskan husky sled dog was presented with a history of chronic exercise-induced regurgitation refractory to medical management. Previous diagnostics were unremarkable except for an endoscopic examination and histopathologic evaluation of the upper gastrointestinal tract that revealed the presence of Helicobacter spp. and mild non-specific inflammation of the proximal duodenum. A laparoscopic hiatal herniorrhaphy, esophagopexy, fundopexy, and ovariectomy were performed without complications in anesthesia or surgery and clinical improvement was observed with continued follow-up for 8 months after surgery. Key clinical message: Surgical treatment for hiatal hernia may be considered in racing Alaskan sled dogs with regurgitation refractory to gastric protectant therapy.

Oesophagopexie laparoscopique, fundopexie et herniorraphie hiatale pour régurgitation réfractaire chez un chien de course de traîneau husky de l'Alaska. Une chienne de traîneau husky de l'Alaska, âgée de 2 ans, a présenté des antécédents de régurgitation chronique induite par l'effort réfractaire à la prise en charge médicale. Les diagnostics antérieurs n'étaient pas remarquables, sauf pour un examen endoscopique et une évaluation histopathologique du tractus gastro-intestinal supérieur qui a révélé la présence d'Helicobacter spp. et une légère inflammation non spécifique du duodénum proximal. Une herniorraphie hiatale laparoscopique, une oesophagopexie, une fundopexie et une ovariectomie ont été réalisées sans complications sous anesthésie ou en chirurgie et une amélioration clinique a été observée avec un suivi continu pendant 8 mois après la chirurgie.Message clinique clé :Un traitement chirurgical de la hernie hiatale peut être envisagé chez les chiens de traîneau de course de l'Alaska présentant une régurgitation réfractaire au traitement protecteur gastrique.(Traduit par Dr Serge Messier).