Initial evaluation of a technique for complete cecal bypass in the horse.
OBJECTIVE
To describe a novel stapling technique for creation of a complete cecal bypass, without ileal transection in horses.


METHODS
Experimental study.


METHODS
Four adult horses.


METHODS
Through a ventral median celiotomy, jejunocolostomy was made with an intraluminal anastomosis device (ILA-100) and oversewn with a Cushing pattern to reinforce the staple line. Immediately distal to the anastomosis, 4 rows of staples were applied using a thoracoabdominal stapling device (TA-90) to occlude the lumen of the distal jejunum and proximal ileum. Necropsy exams were performed at least 60 days after surgery.


RESULTS
No intraoperative complications occurred. Cecal bypass was functional in all horses at necropsy. The most oral staple line across the ileum partially failed in 1 horse; however cecal bypass was functional.


CONCLUSIONS
Complete cecal bypass without ileal transection is a viable alternative to traditional methods of complete cecal bypass. Two sets of staple lines across the ileum are recommended. Longer term follow-up is warranted before clinical use of this technique.


CONCLUSIONS
Cecal bypass without ileal transection is technically simple and effectively bypasses the cecum. It also should intuitively require less time and have a reduced risk of contamination compared with complete cecal bypass with ileal transection.
Symm
William A
WA
Veterinary Medical Teaching Hospital and the Department of Surgical and Radiological Sciences, Comparative Gastroenterology Laboratory, School of Veterinary Medicine, University of California-Davis, Davis, CA, USA.
Nieto
Jorge E
JE
Van Hoogmoed
Linda
L
Snyder
Jack R
JR
D000714:Anastomosis, Surgical / Q000379:methods / Q000662:veterinary*; D000818:Animals; D001696:Biomechanical Phenomena; D002429:Cecal Diseases / Q000601:surgery / Q000662:veterinary*; D002432:Cecum / Q000601:surgery*; D006734:Horse Diseases / Q000601:surgery*; D006736:Horses; D007082:Ileum / Q000601:surgery; D066298:In Vitro Techniques; D011183:Postoperative Complications / Q000453:epidemiology / Q000662:veterinary; D017792:Surgical Stapling / Q000379:methods / Q000662:veterinary*; D013536:Suture Techniques / Q000662:veterinary*; D016896:Treatment Outcome