Page 604 - Equine Clinical Medicine, Surgery and Reproduction, 2nd Edition

Reproductive system: 2.3 Equine castr ation 579

VetBooks.ir SURGICAL TECHNIQUES

Several surgical techniques can be used to perform
tunic are incised, exposing the testicle. Some peri-
castration. The differences between them relate to The subcutaneous layers, tunica dartos and vaginal
two aspects of the procedure. The first aspect is toneal fluid might be present in the vaginal sac and
the approach, which can be scrotal, parainguinal or blood or a haematoma may also be seen if intrates-
inguinal. The other aspect relates to the layers of tis- ticular infiltration of local anaesthetic has been per-
sue incised and whether ligatures are placed around formed. The ligament of the epididymis maintains
them or not. Laparoscopic-assisted castration can the testicle’s attachment to the vaginal tunic, and
also be performed. this ligament can be transected at this stage, allow-
Emasculation is a key step in the procedure, as it ing the testicle to prolapse further. The testicular
provides haemostasis and testicular removal simulta- vessels and the ducts deferens can now be emascu-
neously. The emasculators should be left in place for lated jointly or separately. All layers incised are left
at least 2 minutes (Fig. 2.177). open to heal by second intention.
The combination of these two aspects leads to
various valid permutations in the technique, and the Postoperative care
surgeon should be aware of the advantages and dis- The patient is stable rested for 12–24 hours and light
advantages of each technique and choose the appro- exercise (small paddock or hand walking) should be
priate one for each case. encouraged to maintain drainage for a week.

SCROTAL OPEN CASTRATION Advantages
This is a fast and technically easy technique that can
Procedure be performed under standing sedation.
A scrotal incision from the cranial to the cau-
dal pole of the testicle is performed lateral to the Disadvantages
median raffe, with the testicle held tight against the As no ligatures are placed, there is an increased risk
scrotal skin. It is important to ensure that the inci- of postoperative haemorrhage and eventration. As
sion is in the most dependent part of the scrotum. wounds are left to heal by second intention, there is
an increased risk of infection (acute and chronic) and
delay in return to exercise.
2.177
SCROTAL CLOSED CASTRATION

Procedure
This approach differs from the previous one in
that the vaginal tunic is not incised. Blunt dissec-
tion of the tunica dartos and subcutaneous tissues
is usually achieved with a dry swab. The proper
ligament of the testis can prove difficult to break,
but this step is essential for correct exteriorisation
of the testicle. Care should be taken not to cause
excessive trauma to the cremaster muscle during
dissection, as this may cause unnecessary bleed-
ing (Fig. 2.178). Once this dissection has exposed
Fig. 2.177 Applying emasculators to the dissected the tubular portions of the testicle (still within the
spermatic cord of a 2-year-old Thoroughbred colt vaginal tunic) a transfixing (4 or 5 metric synthetic
during an open standing castration. Note that they are absorbable) ligature is placed using the cremaster
applied well clear of the testicle. muscle as an anchor point (Fig. 2.179). Once the