Delvescovo Barbara, McOnie Rebecca, Pearson Garett, Pugliese Brenna, Hackett Eileen S
Department of Clinical Sciences, Cornell University College of Veterinary Medicine, Ithaca, NY 14853, USA.
Animals (Basel). 2024 Aug 2;14(15):2252. doi: 10.3390/ani14152252.
Persistent hemorrhage of testicular vessels is a potentially life-threatening complication of equine castration. Frequently, general anesthesia is required to retrieve and ligate the bleeding vasculature when standing wound packing and retrieval of the spermatic cord are unsuccessful. We propose standing laparoscopic ligation of the testicular arteries via the paralumbar fossa as a rapid, effective means of halting hemorrhage while avoiding castration site trauma as well as the cardiovascular and recovery risks of general anesthesia.
Two geldings, 6 and 9 months old, presented for emergency treatment of severe post-castration hemorrhage of 10 and 24 h durations, respectively. Both geldings underwent standing laparoscopy under light sedation and the testicular vessels were ligated using a bipolar vessel-sealing device.
Testicular vessel sealing was successfully performed in both geldings by standing laparoscopy and resulted in immediate cessation of hemorrhage. In one case, a left paralumbar fossa approach allowed coagulation of both the left and right spermatic vessels. The procedure time was 25 and 35 min. No complications occurred, and both geldings recovered uneventfully.
Standing, laparoscopic ligation of the testicular arteries is a feasible emergency treatment in young geldings and can be applied in cases of uncontrolled post-castration hemorrhage.
睾丸血管持续出血是马去势术一种潜在的危及生命的并发症。当站立时伤口填塞及精索回纳不成功时，通常需要全身麻醉来找到并结扎出血的脉管系统。我们提出经腰旁窝进行站立式腹腔镜下睾丸动脉结扎术，作为一种快速、有效的止血方法，同时避免去势部位创伤以及全身麻醉带来的心血管和恢复风险。
两匹分别为6个月和9个月大的公马，分别因去势后10小时和24小时的严重出血前来接受紧急治疗。两匹马均在轻度镇静下接受站立式腹腔镜检查，并使用双极血管闭合装置结扎睾丸血管。
通过站立式腹腔镜检查，两匹马的睾丸血管均成功闭合，出血立即停止。在一例中，经左腰旁窝入路实现了左右精索血管的凝固。手术时间分别为25分钟和35分钟。未发生并发症，两匹马均顺利康复。
站立式腹腔镜下睾丸动脉结扎术对年轻公马是一种可行的紧急治疗方法，可应用于去势后出血无法控制的病例。
