Broad uterine ligament plication by toggle use during laparoscopic surgery

Souto, A.P.F.; Silva, J.R.; Moreno, J.C.D.; Freitag, F.A.V.; Dornbusch, L.P.T.C.; Dornbusch, P.T.

doi:10.1590/1678-4162-12363

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Veterinary Medicine • Arq. Bras. Med. Vet. Zootec. 74 (2) • Mar-Apr 2022 • https://doi.org/10.1590/1678-4162-12363 copy

Broad uterine ligament plication by toggle use during laparoscopic surgery

[Plicatura do ligamento largo do útero com utilização de toggle por videocirurgia]

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

The aim of the present study is to describe the surgical technique and complications of uterine elevation by laparoscopic surgery, using the broad uterine ligament plication with toogles. Five mares of different breeds, weight and age were selected, presenting poor perineal conformation and pendulous uterus. The surgical technique was performed with a toogle applicator, 0.6mm sterile nylon thread and toogles, using three portals on each side of the flank. After one month, a new laparoscopy was performed, with only one portal on each side, to observe uterine positioning and healing. The average surgical time reached in this study was 82 minutes per procedure, and the uterus of all mares was successfully raised, remaining in a more horizontal orientation and presenting satisfactory healing. There are only two articles published with uteropexy in mares, where the proposed techniques take longer, which consequently increases the surgical risk.

Keywords:
Horse; infertility; reproduction; videolaparoscopy; uteropexy

Animal	Surgical Time - Left Side	Surgical Time - Right Side
Mare 1	47min	51min
Mare 2	42min	46min
Mare 3	40min	42min
Mare 4	35min	32min
Mare 5	35min	40min

Animal	Evidence of luminal content	Luminal epithelium	Inflammatory Changes	Degenerative Changes	Other cells present
Mare 1	Purulent exudate, abundant neutrophils and macrophages	Cuboid with occasional areas of pleomorphism	Mild diffuse lymphocyte and neutrophil infiltration	Absence of endometrial glands	Absent
Mare 2	Absent	Mostly cuboid, columnar aspect areas and pseudostratification	Absent (small foci of lymphocytes in all sample)	Presence of rare foci of mild fibrosis involving branches of endometrial glands	Occasional hemosiderocytes
Mare 3	Absent	Cuboid	Mild inflammation surrounding some glandular nests	Multiple foci of glandular nests. Some endometrial glands in glandular nests exhibit ectasia. Presence of lymphatic gaps	Absent
Mare 4	Absent	Cuboid	Mild diffuse monomorphonuclear infiltration	Incipient fibrosis surrounding branches of uterine glands. Rare glandular nests surrounded by very mild fibrosis. Presence of lymphatic gaps	Absent
Mare 5	Absent	Absent	Diffuse neutrophil infiltration	Dilated glands, many exhibit mild periglandular fibrosis. Apparent diffuse fibrosis	Absent

Animal	Evidence of luminal content	Luminal epithelium	Inflammatory Changes	Degenerative Changes	Other cells present
Mare 1	Absent	Bass columnar to cuboid	Presence of small and rare foci of lymphocytes, some neutrophil capillaries, observe some neutrophils through the luminal epithelium.	Decreased endometrial glands (mild to moderate atrophy), lymphatic gaps across endometrial and myometrium thickness	Absent
Mare 2	Absent	Columnar with pseudostratification	Absent	Some sets of endometrial glands exhibit incipient fibrosis without dilation	Rare hemosiderocytes and eosinophils
Mare 3	Absent	Low columnar, discrete multifocal pseudostratification	Absent	Multifocal periglandular fibrosis, moderate to severe intensity. Mild atrophy of the endometrium. Very mild and occasional dilation of endometrial glands with slight content retention	Absent
Mare 4	Absent	Cuboid	Mild diffuse lymphocyte infiltration	Mild periglandular multifocal fibrosis. Endometrium exhibits moderate atrophy. Presence of many lymphatic gaps reaching myometrium	Absent
Mare 5	-	-	-	-	-

Universidade Federal de Minas Gerais, Escola de Veterinária Caixa Postal 567, 30123-970 Belo Horizonte MG - Brazil, Tel.: (55 31) 3409-2041, Tel.: (55 31) 3409-2042 - Belo Horizonte - MG - Brazil
E-mail: abmvz.artigo@gmail.com

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[1] *Corresponding author: jerodrigues_vet@yahoo.com.br