Improving mare fertility via broad ligament imbrication with barbed suture and intracorporeal suturing device

Abstract

In this short case series, we report the outcome of four mares undergoing mesometrial imbrication (uteropexy) using barbed suture and an automated laparoscopic suturing device. Medical records of four mares infertile because of delayed uterine clearance (DUC) that underwent laparoscopic mesometrial imbrication to elevate a vertically positioned uterus using an intracorporeal suturing device and barbed suture were reviewed. Retrieved data included signalment, anaesthesia, surgical time and recommendations for post-operative management. Long-term outcome was determined by telephone communication with each owner. The uterus of all four mares was elevated to a more horizontal position. Three mares became pregnant the same year they underwent uteropexy, and each produced a live foal in each of the three subsequent years. Uteropexy also improved poor perineal conformation. Uteropexy using an automated, laparoscopic suturing device with barbed suture was performed more rapidly than previously reported techniques of uteropexy. We concluded that uteropexy of barren mares having poor uterine conformation may allow the mares to conceive and carry a foal to term the same year as uteropexy and in subsequent years. Using barbed suture and an automated laparoscopic suturing device can shorten the previously reported times of uteropexy. The clinical significance of this is that uteropexy corrects poor perineal conformation and improves the fertility of mares barren because of DUC caused by poor uterine positioning by returning a vertically oriented uterus to a more horizontal position. Suturing with an automated laparoscopic suturing device and using barbed suture eases laparoscopic uteropexy.