Minimally invasive repair of congenital inguinal hernias in nine foals using an automated laparoscopic suturing device and barbed suture

Summary Background Laparoscopic herniorrhaphy using staples or smooth suture has been shown to be safe and effective for the surgical treatment of congenital inguinal hernia in colts and gives the possibility to spare the testicles. An automated laparoscopic suturing device combined with barbed suture reduces the technical challenges of laparoscopic suturing. Objectives The objective of the study was to describe the application of the Endo Stitch™ automated suturing device in combination with V‐Loc™ unidirectional barbed suture for laparoscopic herniorrhaphy in foals with congenital inguinal hernia, share experiences and provide long‐term follow‐up regarding the outcome. Study design Retrospective case series. Methods Medical records of all foals that had laparoscopic herniorrhaphy using the Endo Stitch™ combined with V‐Loc™ unidirectional barbed suture at two equine referral hospitals between May 2015 and July 2022 were reviewed. Long‐term follow‐up was conducted by telephone interviews with the owners using a standardised questionnaire. Results Nine foals aged 0.5–13 weeks suffering from unilateral (seven cases) or bilateral (two cases) indirect inguinal hernia underwent unilateral (two cases) or bilateral (seven cases) laparoscopic herniorrhaphy using the described technique. In two animals, the testicles were spared, five animals were bilaterally castrated, and two were unilaterally castrated at the time of herniorrhaphy. No major intraoperative complications occurred. Postoperatively, foals were bright and alert and none of them had significant complications attributable to the surgery. Median long‐term follow‐up was 8 months. No re‐herniation was observed in any of the cases at any time postoperatively. Main limitations Retrospective study design and follow‐up period of less than 6 months in three cases. Conclusions Laparoscopic herniorrhaphy using the Endo Stitch™ laparoscopic suturing device and V‐Loc™ barbed suture is technically less demanding than previously described laparoscopic techniques and effective in preventing re‐herniation in foals suffering from congenital inguinal hernia. A fast and uncomplicated postoperative recovery can be expected.