Initial Evaluation of a Technique for Complete Cecal Bypass in the Horse

Abstract

To describe a novel stapling technique for creation of a complete cecal bypass, without ileal transection in horses. Experimental study. Four adult horses. 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. 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. 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. 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.