Standing flank laparotomy reduction of strangulated inguinal hernia in two Percheron horses

Summary Acquired inguinal herniation requires immediate intervention due to the high risk of intestinal strangulation. Initial management includes manual reduction, but surgical intervention is necessary if ischaemic compromise is suspected. This article describes two draught horses successfully treated through a standing flank laparotomy, and in one case a hand‐assisted laparoscopic approach (HALS). Both horses presented colic symptoms, tachycardia and ultrasonographic evidence of small intestinal strangulation. Due to the higher perioperative risks associated with general anaesthesia in draught horses, a standing surgical approach was chosen. Case 1 underwent a modified right flank laparotomy with laparoscopic assistance, allowing manual hernia reduction. Case 2 required intestinal resection and anastomosis via right flank laparotomy. Despite intrinsic limitations such as partial evaluation of the digestive tract and in case of inguinal hernia, the impossibility to safely castrate the horse or to close the inguinal canal, both horses recovered from the standing laparotomy without complications and underwent laparoscopic inguinal hernioplasty several weeks later.