Evaluation of a transvaginal laparoscopic natural orifice transluminal endoscopic surgery approach to the abdomen of mares.

OBJECTIVE

To report natural orifice transluminal endoscopic surgery (NOTES) using laparoscopic and endoscopic instrumentation transvaginally into the mare's abdomen and identify structures visible using this approach.

DESIGN

Descriptive experimental study.

ANIMALS

Mares (n=8).

METHODS

A standing, transvaginal approach was made in the cranial vaginal vault at either the 1 (right; 4 mares) or 11 (left; 4 mares) o'clock position relative to the cervix. The abdomen was visually explored and the viscera evaluated using a 2 m flexible endoscope followed by a 62 cm laparoscope. Incisional healing was monitored by vaginoscopy at days 3 and 7.

RESULTS

Abdominal exploration was adequate through either a left or a right transvaginal approach. Endoscopically, the left kidney, spleen, nephrosplenic space, stomach, cecum, duodenum, left and right ovaries, diaphragm, and caudal peritoneal reflection were consistently observed and the liver inconsistently. Similar views of the caudal abdomen were obtained with the laparoscope; however, we were unable to view cranially beyond the nephrosplenic space or base of the cecum and lateral mobility of the laparoscope was limited. Incisional closure was evident at 3 days. Complications in 1 mare included mild colic behavior that resolved with conservative treatment.

CONCLUSIONS

The NOTES transvaginal approach is seemingly well tolerated and safe and provides adequate observation of most structures within the dorsal caudal region of the abdomen on the side of endoscope or laparoscope insertion.

CLINICAL RELEVANCE

NOTES transvaginal approach may be a useful tool in the diagnosis of intraabdominal disorders in mares.