Use of a Barbed Knotless Suture for Laparoscopic Ablation of the Nephrosplenic Space in 8 Horses

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Objective:To evaluate use of a knotless suture for laparoscopic closure of the equine nephrosplenic space.Study Design:Experimental in vivo study.Animals:Normal horses without previous history of abdominal surgery (n=8).Methods:The nephrosplenic space was closed under laparoscopic visualization using a unidirectional, barbed 0 metric absorbable suture (copolymer of glycolic acid and trimethylene carbonate). Intracorporeal suturing of the nephrosplenic space was performed in a cranial-to-caudal direction in a simple continuous fashion. Repeat evaluation was performed laparoscopically in 2 horses and by necropsy in 6 horses. The length of closure was measured and nature of the healed tissue was evaluate grossly.Results:Total surgery time was 65–167 minutes (mean ± SD, 89.6 ± 22.6). Suturing time was 30–65 minutes (40.4 ± 16.3). Second laparoscopy in 2 horses was performed at days 198 and 227. Necropsy was performed at day 69–229 postoperatively (132.7 ± 63.0) in 6 horses. The closure measured 12–14 cm in length (13 ± 1) and consisted of mature fibrous tissue bridging the splenic capsule and the nephrosplenic ligament. No residual suture material was identified grossly in any horses. The procedure was easily performed; extracorporeal suture management to hold it taut was unnecessary since the barbs had excellent purchase in the apposed tissues, and intracorporeal knot tying was not required.Conclusion:The barbed knotless suture appears to be a valid alternative to facilitate laparoscopic closure of the nephrosplenic space in normal horses; however, further work is necessary to investigate its suitability in clinically affected horses.

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