What is a Diplomate?
The term "ACVS Diplomate" refers to a veterinarian who has been board certified in veterinary surgery. Only veterinarians who have successfully completed the certification requirements of the ACVS are Diplomates of the American College of Veterinary Surgeons and have earned the right to be called specialists in veterinary surgery.Exploratory celiotomy (or “colic surgery”) is the name given to the procedure of performing exploratory surgery in the abdomen of the horse. Typically, this is performed to correct life-threatening abnormalities of the gastrointestinal (GI) tract (intestines) that cause colic; however, exploratory celiotomy can also be performed to address reproductive issues or lesions in other organs found within the abdominal cavity.
To perform a colic surgery, the patient is anesthetized and placed on its back so that the abdomen can be accessed. The entire abdomen is clipped to removed hair and scrubbed using sterile technique. As with any surgery, the area is draped sterilely by the surgeon and a longitudinal incision is made on midline starting near the umbilical scar (belly button). On occasion, a surgeon may choose to make a longitudinal incision to the right or to the left of midline (most commonly right). Regardless of the exact approach, from the incision a number of procedures can be performed including correction of displaced intestines, resection of necrotic intestines, or removing intraluminal obstructions. There are many different types of colic surgery and the exact procedure that occurs when the abdomen is approached depends on the condition (lesion) that is found at the time of surgery.
- Large intestinal lesions
- Right dorsal displacement of the large colon
- Left dorsal displacement of the large colon (nephrosplenic entrapment)
- Large colon volvulus
- Large colon impaction
- Cecocecal and cecocolic intussusception
- Cecal impaction
- Enterolith/Fecalith
- Small colon impaction
- Small intestinal lesions
- Jejunal intussusception
- Ileocecal intussusception
- Ascarid impaction
- Epiploic foramen entrapment
- Gastrosplenic entrapment
- Strangulating lipoma
- Segmental volvulus
- Mesenteric volvulus
- Small intestinal entrapment in a mesenteric rent
Alternate Procedures/Techniques:
While most cases of colic that require surgical intervention undergo the above-described procedure, there are a few specific kinds of colic that can be managed with alternate techniques. One procedure is anesthetizing and rolling a horse to treat left dorsal displacement of the large colon (nephrosplenic entrapment). This procedure can be successful in confirmed cases of nephrosplenic entrapment, but will not be successful for other types of colic. Another procedure that can be performed is standing flank approach for small intestinal biopsies or small intestinal lesions. This procedure is performed in the standing sedated horse and does not allow full exploration of the entire abdomen. In some cases of non-strangulating colic, medical (non-surgical) management can be pursued. Ultimately, a horse that continues to show signs of abdominal pain despite medical treatment merits surgical exploration.
- Direct visualization and correction of life-threatening causes of colic
- Allows for complete exploration of the entire abdomen, not only correction of the lesion
- Biopsies can be obtained in cases of chronic or recurrent colic
- General anesthesia allows for a controlled environment for both the patient and the surgeon
- Exploratory celiotomy requires general anesthesia
- Requires post-operative rest (2–3 months from work)
- Requires advanced training for the veterinary surgeon
