Surgical Technique and Short-Term Outcome for Experimental Laparoscopic Closure of the Epiploic Foramen in 6 Horses

Objective: To describe a laparoscopic technique for, and short-term outcome after, closure of the epiploic foramen (EF) in horses. Study Design: Descriptive, experimental study. Animals: Healthy, adult horses (n=6). Methods: Laparoscopic portals to approach the EF were identified in standing horses. Under laparoscopic observation, the gastropancreatic fold and right lobe of the pancreas were grasped with Babcock forceps and secured to the caudate hepatic lobe using helical titanium coils to obliterate the EF. Surgical procedure time and intra- and postoperative complications were recorded. Serial analysis of select serum enzymes was used as an indication of involvement of the pancreas and liver. Closure was reevaluated at 4 weeks using repeat laparoscopy, and necropsy was performed immediately after. Results: At initial surgery, EF closure was successful in all 6 horses; median surgical time was 40.5minutes (range, 22-110minutes). Serum gamma-glutamyl transferase (GGT) and sorbitol dehydrogenase (SDH) were not significantly altered by the surgical procedure; however, aspartate aminotransferase (AST) and amylase (AMY) were transiently increased. At repeat laparoscopic reevaluation, closure was complete in 5 horses, with partial closure of the EF observed in 1 horse. No complications related to the procedure were noted during or after surgery in any horse. Conclusions: EF closure in the standing horse can be accomplished without complications to the surrounding organs and vessels. © 2013 by The American College of Veterinary Surgeons.