Complications in Laparoscopic Access in Standing Horses Using Cannula and Trocar Units Developed for Human Medicine

SIMPLE SUMMARY: Accessing the abdominal cavity is one of the most delicate moments of laparoscopic procedures in horses. Laparoscopic cannula and trocar units have been specifically developed for horses; however, in mixed veterinary practices (small and large animals) it can be advantageous to use instruments designed for human patients, as these are suitable for both small animals and horses. Nevertheless, the body condition of the horse might influence the effectiveness of such devices. The aim of this work is to compare the efficacy and associated complications of the use of different devices developed for human medicine when used for laparoscopic access in the standing horse, analysing also the influence of body condition on the type and incidence of observed complications. A retrospective study was carried out including cases of laparoscopic access in standing horses in which devices for human surgery were used. The results showed that laparoscopy devices designed for human medicine can be used for laparoscopic access in the standing horse, but high body condition could be a risk factor for the appearance of complications. In addition, the use of optical devices, in particular optical helical cannula, minimizes the appearance of these complications, especially in horses that are overweight (OW). ABSTRACT: First cannulation is a critical manoeuvre in equine laparoscopy. This retrospective study aimed at the comparison of the frequency and type of complications detected when using different human laparoscopy devices for laparoscopic access in standing horses, and the influence of body condition in such complications. Forty-four procedures were included, and retrieved data comprised cannula insertion technique, body condition, and type and frequency of complications. Laparoscopic access techniques were classified into five groups: P: pneumoperitoneum created using Veress needle prior to cannulation; T: sharp trocar; D: direct access via surgical incision; V: Visiport optical trocar and H: optical helical cannula (OHC). In groups T, D, V and H, access was achieved without prior induction of pneumoperitoneum. Complications were registered in 13/44 procedures, of which retroperitoneal insufflation was the most common (6/13). Statistically significant association was found between the complication incidence and the type of access, with group D showing the highest complication frequency (80%) and group H the lowest frequency (0%). The majority of complications (9/13) were observed in overweight horses. We conclude that devices designed for human patients can be used for laparoscopic access in standing horses, with the use of OHC minimizing the appearance of complications, especially in overweight horses with OW.