All cannulas are removed and the external abdominal oblique muscle of the third portal is sutured using size 0 Maxon in a
simple, continuous pattern. The skin of all portals is then closed with size 2-0 Monosoft in a cruciate pattern (Photo 6).
Photo 6: The flank after skin closure.
Postoperative plan: The horse was reintroduced to feed about six hours postoperative. Phenylbutazone was continued at 1 gm BID for five days.
Exercise consisted of stall confinement with hand walking for two weeks and return to strenuous exercise after four weeks.
This approach can be challenging to perform, but the long-term results are excellent. This horse has not had a recurrence
of nephrosplenic displacement since surgery. The visualization is much better than with the similar approach through a rib
resection. If surgery has been performed to reduce a nephrosplenic entrapment, we prefer to wait for at least two weeks to
perform the laparoscopic nephrosplenic space ablation. If the entrapment was reduced conservatively by administration of phenylephrine
and forced exercise or by rolling, laparoscopy can be performed as soon as reasonably possible.
Dr. Hendrickson is an associate professor of surgery and American College of Veterinary Surgeons diplomate. He joined the
equine surgery faculty at Colorado State University (CSU) as an assistant professor in December 1994. He received his veterinary
medical degree from CSU in 1988 and the next year completed an equine medicine and surgery internship at the University of
Sydney in Sydney, Australia. Following the internship, he completed a combined residency/master's program in large animal
surgery in 1992 at Cornell University. His research has focused on articular cartilage resurfacing in the horse using free
chondrocyte grafts embedded in a fibrin matrix and the development of laparoscopic surgical techniques. He has authored manuscripts
and book chapters on laparoscopic surgery and has presented on various topics pertaining to laparoscopic surgery.