Advances in Equipment and Instrumentation in Laparoscopic Surgery.

The practice of veterinary laparoscopic surgery has grown in the past decade. Surgical devices routinely used in human laparoscopy have become available to the veterinary surgeon, at a cost the veterinary market can bear. This includes electrosurgical generators, access ports, stapling devices, tissue dissectors, and a wide array of laparoscopic handpieces. With the development of the laparoscopic clip applier in the 1990s, laparoscopic cholecystectomy came to be commonly performed in people. During this time, numerous training programs were developed to rapidly bring human surgeons up to speed.

Laparoscopic inguinal hernioplasty in a ram.

CASE DESCRIPTION: A 4-month-old Hampshire ram underwent open right inguinal herniorrhaphy and unilateral castration following herniation that developed after a kick injury. Seven months later, the ram was reevaluated because of scrotal swelling of 1 month's duration as well as suspected left inguinal hernia. CLINICAL FINDINGS: The ram had marked scrotal swelling. Palpation of the left testicle revealed no abnormalities. Ultrasonographic examination revealed heterogenous tissue within the cranial and medial portions of the scrotum with pronounced accumulation of hypoechoic fluid at the scrotal apex. Examination findings indicated left-sided indirect inguinal herniation of omentum. TREATMENT AND OUTCOME: To preserve fertility, left inguinal hernioplasty without castration was performed. The ram was anesthetized and placed in dorsal recumbency, and laparoscopic abdominal evaluation revealed omental entrapment within the left inguinal ring. The omentum was removed, and a polypropylene mesh was secured over the internal inguinal ring with an articulating hernia stapler. Following mesh placement, a dorsally based peritoneal flap was elevated and secured over the mesh repair. The ram recovered well from surgery; there was no repeated herniation following the surgical correction, and the ram was able to breed successfully without complication. CLINICAL RELEVANCE: Laparoscopic mesh hernioplasty can be successful in rams with inguinal hernias when preservation of fertility is preferred.