Use of flank laparoscopy in the standing horse as a diagnostic aid in horses with chronic abdominal pain

Summary Background Reaching a specific diagnosis in horses with chronic or recurrent abdominal pain may be challenging and elusive. Objectives The aim of this study was to report indications, findings and outcomes of equine exploratory laparoscopy in a case series to support its diagnostic value and identify potential limitations. Study design Retrospective cases series. Methods Sixty‐nine client‐owned horses underwent laparoscopic exploration of the abdomen due to chronic colic symptoms. All horses were operated standing while sedated and under local anaesthesia. Diagnosis, follow‐up, surgical or medical interventions, as well as intra‐ and postoperative complications were recorded. Results A definitive diagnosis could be made by laparoscopy in 61 horses. However, no abnormal findings were found by laparoscopic exploration of the abdominal cavity in eight horses. Overall, the sensitivity of diagnostic laparoscopy in the standing horse in our study was 88% and its specificity was 15%. No severe intra‐ or postoperative complications occurred. Exploratory flank laparoscopy in the standing horse can be a valuable diagnostic tool for chronic abdominal pain. Main limitations The limitations of the present study are its retrospective nature, missing some details in the reports. In addition, no long‐term follow‐up was available for the horses which underwent surgical intervention, and whether the colic signs reoccurred after a period of time or complications occurred in the long‐term postoperative period are not known. No confirmation of the laparoscopic diagnosis was available in some horses, and a post‐mortem examination or histology of a biopsy sample would have been beneficial. Conclusions Exploratory flank laparoscopy in the standing horse can be considered in horses with chronic abdominal pain in view of the high sensitivity and low complication rate of this study.