A Slew of Surgeries

            Although Cleveland Equine does not staff a full time surgeon, I have found myself in the surgery suit quite often lately. Dr. Robertson, a retired surgeon from Ohio State, flew in for a day to take care several elective procedures. His surgery team consisted of Dr. Wilson (for anesthesia), Dr. Hill (to assist), two technicians, and me. We started the day by scoping the horses with respiratory complaints. One turned out to have infected, pus filled guttural pouches, which we flushed and put on antibiotics. The next was a classic example of epiglottic entrapment- the epiglottis was caught in the aryepiglottic fold, causing an airway obstruction. The epiglottis had been entrapped for so long that the exposed aryepiglottic fold was ulcerated. When Dr. Robertson cut the fold with a hooked bistoury to release the epiglottis, we were able to see that the area under the fold was also disrupted. The final respiratory case came in with the concern of dorsal displacement of the soft palate, so Dr. Robertson performed the palate lasering and myectomy that I described earlier this summer.

            After the respiratory horses were taken care of, we moved on to three closed castrations. Here, “closed” not only refers to a castration that does not open the vaginal tunic, it also refers to a primary closure of the skin. Some clients prefer the closed castration for the cosmetics, the minimal aftercare required, or the reduced concern about flies. Since the scrotum is sutured, closed castrations need to be preformed in sterile conditions instead of standing. Although Dr. Hill assisted Dr. Robertson for his three closed castrations, I assisted Dr. Genovese the following day when he performed a closed castration. He even let me man the emasculators and throw in some horizontal mattress sutures for the skin closure.

            The final surgeries for the week were two foals with umbilical masses. The first was a typical umbilical hernia, soft and reducible. Dr. Genovese freed the hernial sac from the surrounding tissues without cutting into the sac itself. He then reduced the hernia back into abdomen and closed the body wall with a “Vest over Pants” suture that I was not familiar with. This method avoids opening the abdomen, so abdominal adhesions and infection are less of a concern. The second umbilicus was firm and non-reducible - an infected umbilicus. The body wall had closed properly, but the remaining cord had become a well-encapsulated pocket of pus. Dr. Genovese removed the mass with Dr. Hill assisting and then Dr. Hill closed with me assisting. The doctors here also do a myriad of standing procedures from open castrations to screwing in fracture lines, but there is just not enough time to discuss them all.