Marco Gandini

• DVM, PhD
• Professor (Associate) at University of Turin

Background The return to performance after colic surgery is crucial for competition horses. While studies have investigated racehorse performance following colic surgery by analysing racing participation and earnings, this approach does not apply to showjumping horses, leaving a gap in the literature regarding their objective performance evaluation...

Incisional hernia is a frequent complication after abdominal surgery. A previous study on rats evaluated the use of a Pectin–Honey Hydrogel (PHH)-coated polypropylene (PP) mesh for the healing of acute hernias. However, there are no studies investigating the use of PHH in association with PP mesh in chronic contaminated hernia. The aims of this stu...

The occurrence of colic could be influenced by the characteristics of a population, geographical area, and feeding management. The aim of this study was to report the short-term postoperative complications and survival rates and to identify factors that might affect the outcome of horses that underwent colic surgery in three Italian surgical referr...

Objective: To describe a technique for a side-to-side jejunocecal anastomosis in horses using radiofrequency thermofusion (TF) of the intestines supported by a Cushing oversew and to compare this anastomosis to handsewn and stapled techniques. Study design: Ex vivo study. Sample population: Intestinal tracts from 24 slaughtered horses. Method...

Background: Accurate reporting of postoperative complications is paramount to understanding procedural outcomes, comparing procedures and assuring quality improvement. Standardising definitions of complications in equine surgeries will improve the evidence of their outcomes. To this end, we proposed a classification for postoperative complications...

Background In jejunocaecal anastomosis leaving a necrotic ileal stump has been implicated in complications and poor outcomes. Elective inversion of the necrotic stump using a nasogastric tube has been previously described, although this procedure can be cumbersome and can cause caecocolic orifice occlusion. Objective To describe the use of a new d...

Background Postoperative complications frequently occur following equine colic surgery but there is a lack of consistency in their definitions and reporting. Objectives To perform a scoping review to identify current evidence on the definitions and classifications of postoperative complications in equine colic surgery. Study design Evidence revie...

Laparoscopy is a common approach in equine surgery and has the advantage of improved visibility and diagnostic accuracy, decreased morbidity and hospitalization time. However, despite the numerous benefits, there can be intraoperative and postoperative complications which could have important welfare and economic consequences. The aim of this study...

Reducing postoperative incisional infection is the main reason to administer postoperative antimicrobials (AMD) after emergency laparotomy in horses, while reducing inflammation and providing analgesia are the reasons to administer anti-inflammatory drugs (AID). The basis for postoperative AMD and AID administration is empirical and only recently h...

Background Transillumination has been described in human surgery to improve vessel visualization but has not been described in horses. Since the equine mesocolon contains a great amount of fat which restricts visualization of the vessels, this technique could be useful during small colon resection. Objectives To describe transillumination of the m...

CASE DESCRIPTION 7 horses (3 geldings, 2 mares, and 2 stallions) were examined because of acute colic caused by small intestinal obstruction involving the aborad portion of the jejunum and orad portion of the ileum. CLINICAL FINDINGS All horses underwent a routine colic examination on arrival and had a diagnosis of strangulating obstruction of the...

Background: Intestinal pathologies caused by adhesions or fibrous bands in the absence of previous abdominal surgery have been reported in humans but scarcely in horses. Objectives: To describe the clinical and surgical features of acute colic in horses caused by adhesions or fibrous bands in absence of previous abdominal surgery. Methods: Record...

Background:Incomplete ileocecal bypass can be performedin cases in which an ileal dysfunction is suspected butresection of the diseased ileum is not necessary.Objectives:To describe the clinicalfindings, the surgicaltechnique, and the outcome of 21 cases of colic with ilealpathologies that underwent an incomplete ileocecal bypass.Methods:Records of...

Background: Fever can be a common complication after colic surgery and definition of its cause is paramount to avoid antibiotics overuse. Tick-borne diseases are endemic in northern Italy and a common cause of pyrexia and hyperbilirubinaemia. Objectives: To evaluate the incidence of post-operative fever caused by piroplasmosis in horses recovered f...

Investigations about ventral hernia repair are focused on improving the quality, resistance, and biocompatibility of mesh. This study compared plain polypropylene mesh with a pectin-honey hydrogel-coated polypropylene mesh in an acute hernia model in rats. Forty Wistar rats, randomly assigned to two groups, were submitted to laparotomy, and a 1 cm...

Laminitis is one of the most devastating diseases in equine medicine, and although several etiopathogenetic mechanisms have been proposed, few clear answers have been identified to date. Several lines of evidence point towards its underlying pathology as being metabolism-related. In the carbonyl stress pathway, sugars are converted to methylglyoxal...

Background Intestinal pathologies caused by adhesions or fibrous bands in the absence of previous abdominal surgery have been reported in humans but rarely in horses. Objectives To describe the clinical and surgical features of acute colic in horses caused by adhesions or fibrous bands in the absence of previous abdominal surgery. Study design Re...

Nephrosplenic space (NSS) ablation has been demonstrated to be an effective technique for prevention of left dorsal displacement of the large colon and multiple laparoscopic techniques, among which ablation with mesh or with a barbed suture, have been proposed. Our objective was to compare two laparoscopic techniques for closure of the NSS in twent...

The current hypothesis proposed for strangulation of small intestine by a pedunculated lipoma in horses involves movement of the lipoma around the small intestine until it loops through its own pedicle. This mechanism is difficult to demonstrate during surgical correction. The objective was to examine an alternative explanation for strangulation by...

Background To resolve large colon impactions, frequent enteral administration of large volumes of water (8-10 liters in a 500 kg horse) has been suggested. Furthermore, in large colon volvulus, the simultaneous presence of gastric impaction has been described as a possible predisposing factor . Objectives To describe the clinical and surgical feat...

Background: Incomplete ileocecal bypass can be performed in cases in which an ileal disfunction is suspected but resection of the diseased ileum is not necessary. Objectives: To describe the clinical findings, the surgical technique, and the outcome of 21 cases of colic with ileal pathologies that underwent an incomplete ileocecal bypass. Metho...

Background: There are few guidelines for the appropriate mode of fluid administration during and after colic surgery, and is challenging to reach the right balance while avoiding overhydration. This study aimed to compare goal-directed fluid therapy (GDFT) and 'liberal' fluid regimens (LFRs) in horses undergoing small intestinal surgery. Methods:...

Background: In equine abdominal surgery, resection and anastomosis of strangulated intestine is a commonly performed procedure. To date, ligatures, vessel sealing devices and the ligate-divide stapler have been described for this use in horses. The objective of this study was to compare the application of haemostatic clips and ligatures to occlude...

Objective: To compare three surgical knots for preventing leakage from the vascular bundle during ligation in simulated equine open castrations. Study design: Randomized, case-control, in vitro study. Sample population: Testes (N = 60) collected from 30 horses. Methods: Testes were collected from 30 horses and randomly assigned to one of thr...

Background Hand-sewn intestinal anastomoses are a fundamental procedure in both open and laparoscopic intestinal surgery. Self-retaining barbed suture devices have been tested for a variety of surgical applications. With the exception of clinical reports and various experimental studies on enterotomy, little has been published so far on the use of...

During a laparotomy for colic signs in a 2‐year‐old male Thoroughbred, a portion of approximately 7 m of the jejunum was found entrapped in a fibrous band originating from the nephrosplenic ligament. The entrapped jejunum was necrotic and was removed. Two months after the first surgery, a laparoscopy was performed to close the nephrosplenic space a...

In this study the caecum and large colon were harvested from 24 slaughtered horses. On each sample, an 8‑cm long enterotomy was performed. Enterotomies were closed using either barbed or unbarbed glycomer‑631. We compared the time to close, appearance, length of suture material, bursting pressure, and costs associated with each type of material. Ou...

Colic is a serious disease for horses and the nutritional management of postoperative colic patients is an extremely important field. The aim of this retrospective study was to analyse the different factors, especially related to nutritional management, that may be associated with recovery length during hospitalization after a surgical intervention...

OBJECTIVE To determine the most effective hemostatic knot configuration performed by veterinary students following a brief training session with an experienced surgeon and a subsequent deliberate self-training period. DESIGN Experiment. SAMPLE 24 fourth-year veterinary students with no previous surgical knot–tying experience. PROCEDURES In a 1-hour...

Background: Novel pectin-honey hydrogels have been developed and characterized as medical device. Ideally, a wound dressing should maintain optimal fluid affinity, permit moisture evaporation, protect the wound from microbes, and have shape-conformability, biocompatibility, and antibacterial activity. Objective: A novel, simple and fast method t...

Background: Serra and Reimer emasculators are frequently used during equine orchiectomy. They differ in their jaw profile and haemostatic mechanism provided. Objectives: (1) To evaluate whether there is a difference between the haemostatic capacity of Reimer and Serra emasculators in open and closed castration and (2) compare haemostatic capacit...

Background The use of autologous platelet-rich plasma (PRP) and plasma rich in growth factors (PRGF) has been proposed for the treatment of several acute and chronic syndromes, such as corneal epithelial defects and dry eye syndrome, gum bleeding during oral surgery, and in orthopaedic surgery. We hypothesized that PRGF, rather than PRP, could be m...

Background Honey, alone or in combination, has been used for wound healing since ancient times and has reemerged as a topic of interest in the last decade. Pectin has recently been investigated for its use in various biomedical applications such as drug delivery, skin protection, and scaffolding for cells. The aim of the present study was to develo...

Background Adhesions are a common postoperative surgical complication. Liquid honey has been used intraperitoneally to reduce the incidence of these adhesions. However, solid barriers are considered more effective than liquids in decreasing postoperative intra-abdominal adhesion formation; therefore, a new pectin-honey hydrogel (PHH) was produced a...

CASE DESCRIPTION 8 horses (5 geldings and 3 mares) were evaluated for laparoscopic closure of the nephrosplenic space following a history of recurrent left dorsal displacement of the large colon. CLINICAL FINDINGS All horses underwent a physical examination and routine clinicopathologic testing. Transrectal palpation and transabdominal ultrasonogra...

Introduction: In this study, membranes composed of honey (Manuka or Honeydew) and pectin were developed, and the ISO 22196 method was used to evaluate their antibacterial activities against multidrug-resistant bacteria (i.e., Staphylococcus pseudointermedius, Escherichia coli, Proteus mirabilis, Pseudomonas aeruginosa) that cause wound infection i...

The objective of this study was to investigate whether cleaning surgical materials used to close pelvic flexure enterotomies with a wet sterile gauze will reduce contamination and whether the use of a full thickness appositional suture pattern (F) or a partial thickness inverting (or Cushing) suture pattern (C) would make a difference in the level...

Introduction: In this study single-port percutaneous laparoscopic gastropexy in dogs using barbed suture material in combination with ovariectomy is described. A single port preventive gastropexy was performed in 6 female German shepherds in combination with ovariectomy using a laparoscope. Surgery time, intraoperative, postoperative and follow up...

A one-month-old, Piedmontese female calf was admitted to the Department of Veterinary Sciences, University of Turin, for repair of a large ventral hernia. A large ventral hernia, approximately 20 cm long and 15 cm large was noticed extending from 3 cm caudal to the umbilicus down to the pubis. At ultrasonography the hernia content was represented b...

Introduction: Honey as a topical treatment for infected wounds dates back to ancient times. However, few studies have been reported concerning the medical properties of Italian honey. In this study, the microbial contamination, the antimicrobial activity and the antibiotic residues of 6 different varieties of Piedmont honeys were evaluated. The an...

Postoperative intra-abdominal adhesion formation has long been considered an inevitable consequence of laparotomy, and the incidence in abdominal surgery is ranging between 67 and 93% [1-3]. Liquid honey has been used intraperitoneally to reduce the incidence of these adhesions [4-6]. However, solid barriers are considered more effective than liqui...

Lameness evaluations with flexion tests are a routine procedure for equine practitioners and are commonly used in both lame and sound horses [1-6]. The force applied by the surgeon, during a flexion test, has a strong influence on the outcome of this test [2,3,5].The objective of this study wasto verify if a commercially available pressure-sensitiv...

Left dorsal displacement of the large colon is common condition in horses, with reported recurrence rates ranging from 3.2% to 21% [1]. A number of techniques for laparoscopic ablation of the nephrosplenic space have been described [2], with the most common being ablation with laparoscopic suturing [3]. Specifically, a new type of suture material h...

Castration is one of the most common surgical procedures in the horse. Although considered a routinary procedure, surgical complications constitute the most common cause of malpractice claims against equine veterinarians. Surgical removal of the testis can be performed using a open or closed castration as reported in literature. A modification of t...

The use of honey in wound healing is ancient. It could be used alone or in combination with other compounds and became a topic of interest in several investigation in last decade [1-2]. Pectin has been recently investigated for various biomedical applications, such as drug delivery, skin protection and as scaffold for cells [3]. Pectin is inexpensi...

Epidural anaesthesia has been described in cattle for various surgical procedures.[1] Combination of intravenous (IV) xylazine and caudal high volume epidural anaesthesia with xylazine and lidocaine has provided satisfactory analgesia for abdominal surgery.[2] This combination has good and prolonged analgesic effect but in young animals IV xylazine...

Umbilical infections, such as omphalophlebitis, omphaloarteritis and infection of the urachus are common during neonatal period in calves [1]. If medical treatment fails, resection of infected umbilical structures is usually performed [1-2]. Twenty-six Piedmontese calves referred to the OVU of the University of Turin for persistent umbilical diseas...

Castration is one of the most commonly performed surgical procedures in horses, and the most common complications encountered are bleeding, evisceration, eventration and septic funiculitis [1]. Septic funiculitis had historically been classified as “scirrhous cord” (infection of the spermatic cord remnant with Staphylococcus sp) or “champignon” (in...

Background: Adhesions formation are postoperative surgical complications. Liquid honey has been used intraperitoneally to reduce their incidence. Since solid barriers are considered more effective than solutions in decreasing postoperative intra abdominal adhesion formation, a new pectin-honey hydrogel (PHH) was produced and its effectiveness evalu...

Background: Novel honey-based membranes have been developed and characterized as a medical device. In this study, a novel, simple and fast method to produce pectin-honey wound dressings is described. An ideal wound dressing is yet to be developed. Ideally, a wound dressing should maintain optimal fluid affinity, permit moisture evaporation, protect...

Background: Ischemic and reperfusion (I/R) injuries are recognized after stroke, myocardial infarction, transplant, trauma and intestinal strangulation. IR tissue damage mechanism is not completely understood, but it was suggested that the oxidative stress leads to inflammatory mediators release, leukocytes activation, apoptosis and necrosis. Previ...

The force applied by the surgeon, during a flexion test, has a strong influence on the outcome of the test. The objective of this study was to verify if a commercially available pressure-sensitive glove could be used to standardize the force applied in the equine distal forelimb flexion test. Three experienced veterinary surgeons and three final-ye...

Purpose:: To evaluate the effects of an intraperitoneal solution of methylene blue (MB), lidocaine and pentoxyphylline (PTX) on intestinal ischemic and reperfusion injury. Methods:: Superior mesenteric artery was isolated and clamped in 36 adult male Sprague Dawley rats. After 60 minutes, clamp was removed and a group received intraperitoneally...

An 11-month old, Piedmontese bullock was admitted to the Department of Veterinary Science, University of Turin, for urolithiasis and suspected uroperitoneum owing to urinary bladder rupture. A first episode of uroperitoneum had been treated surgically one week previously. On admission, the animal underwent physical and haematological examination, f...

A 16-year-old Italian Saddle Horse gelding was referred for treatment of an incisional hernia that developed 7 months after a ventral midline laparotomy for treatment of acute abdominal pain. Physical examination revealed a hernia approximately 20 cm long and 15 cm wide on the ventral aspect of the abdomen. Ultrasonography revealed the dimensions o...

Reasons for performing study: In equine castration, application of a ligature on the spermatic cord to prevent complications such as haemorrhage and evisceration has been reported with controversial results. Characteristics of commonly used knots have not been studied. Objectives: To compare the modified transfixing and giant knots and the emasc...

Introduction Pelvic flexure enterotomy is one of the most common procedure performed in abdominal surgery of the horse. In a survey on the method for pelvic flexure enterotomy closure employed by ECVS and ACVS Diplomates, resulted that 58.3% of surgeons adopt measures to reduce contamination during closure of enterotomies. The most popular measure...

Introduction Pelvic flexure enterotomy are commonly performed in horses. Although it is a relatively straightforward surgery several complication may arise, some of them even fatal.In literature the technique to close the pelvic flexure enterotomy seems somehow standardized to a double layer handsewn pattern.We hypothesized that boarded veterinary...

Introduction Pelvic flexure enterotomy is one of the most common procedure performed in abdominal surgery of the horse. In a survey on the method for pelvic flexure enterotomy closure employed by ECVS and ACVS Diplomates, resulted that 58.3% of surgeons adopt measures to reduce contamination during closure of enterotomies. The most popular measure...

Introduction: Ventral and incisional hernias are common surgical problems in large animals. Ventral hernias may occur from midline or paramedian incision, trauma or for abomasal fistulization. Synthetic materials are used for the repair of abdominal wall defects, but some types carry a high risk of adhesions if placed intraperitoneally. In this wor...

Objective To compare 2 sutured techniques with a skin stapled technique for typhlotomy closure in bovines.Study DesignEx-vivo study.Sample PopulationBovine fresh cadaveric ceca (n = 27).Methods Typhlotomies (4 cm in length) were made on the cecal apex and closed with 1 of the following techniques: hand-sewn, 2-layer suture consisting of a continuou...

This study describes a novel end-to-end-jejunojejunal-anastomotic technique using skin staples following resection of compromised small intestine. Five horses were referred with colic and underwent exploratory laparotomy, resection and anastomosis. No long-term complications were recorded at 12 months. This safe and effective technique may be used...

Video recording and photography during surgical procedures are useful in veterinary medicine for several reasons, including legal, educational, and archival purposes. Many systems are available, such as hand cameras, light-mounted cameras, and head cameras. We chose a reasonably priced head camera that is among the smallest video cameras available....

The purpose of this study is to describe the construction method of a cost-effective, easy-to-make hemostasis simulator and to compare its effectiveness as a training tool to cadaver training. The simulator is made of materials commonly found in hospitals and clinics. These include a column manometer, a 500-ml saline bag, two intravenous fluid line...

The aim of this study is to compare handsewn and stapled jejunocecal anastomosis with different stomal lengths in terms of anatomical differences. Group 1 underwent a two-layer handsewn jejunocecal side-to-side anastomosis (HS); Group 2 received a stapled jejunocecal side-to-side anastomosis (GIA). Each group was divided into two subgroups (HS80 an...

Background: Stapled jejunocecal anastomoses are commonly performed in equine abdominal surgery. They carry higher complication rates compared to handsewn techniques. In human surgery various causes likely to lead to failure of stapled techniques have been evaluated, including staple line failure. Recently Freeman proposed a technique to perform a...

Background: In literature only one article describes and compares methods of achieving hemostasis in equine mesenteric arteries during jejunal resection and anastomosis, and most textbooks favor ligating-dividing mechanical devices. The latter method cannot always be used, not least because the devices are expensive and in some cases even contra-in...

Objective: To determine effects of staple size, precompression time, and tissue thickness on staple shape and tissue approximation in side-to-side jejunocecal anastomosis in equine specimens. Sample: Cecum, ileum, and jejunum specimens obtained from 18 healthy horses at an abattoir. Procedures: Specimens were allotted into 2 groups. Anastomose...

Background: Following exploratory laparotomy in horses is reported an higher incidence of abdominal wound dehiscence compared to other species (Smith, 2007). Abdominal incision dehiscence can be caused by suture material, knot or tissue failure (Freeman, 2002). In horses undergoing exporatory laparotomy abdominal wound healing is conditioned by sut...

Background: Hoof tissue explants (HE) culture possibly offers an interesting tool for study tissues and cells for the evaluation of laminitis. HE culture require simply of fresh tissue obtained immediately post mortem and instruments for dissection to obtain the HE. However at present few studies have used this methods that could represent an inter...

Background: Nutritional support of the critically ill horses hospitalizes after colic surgery, is not longer seen as an additional care but is essential for the recovery of the animals. The main goals of nutritional support in surgical patients are reducing consumption of self energy stores, minimize negative protein balance to obtain the best orga...

Background: In equine abdominal surgery stapled side-to-side jejunocecal anastomoses are commonly performed although carry higher risk of complications compared to handsewn techniques. Staple formation is essential to produce an effective anastomosis, to reduce haemorrhage and to avoid leakage. It depends from tissue thickness, to staple dimensions...

Many therapies have been proposed to prevent and treat postoperative ileus (POI) in horses, but to date none is considered fully effective. Various methods have been considered in the prevention of POI in humans too, and among these, gum chewing is gaining a role, reducing time from surgery to first fecal passage and hospitalization time. The aim o...

Background: There are limited reports of horses suffering from colic caused by foreign bodies. Horses are animals that carefully select the food before eating it. Among foreign bodies retrieved in horses, the most common are wooden splinters, while metal ones are less present (Farr et al, 2010; Lohman 2012). Even less frequent are cases of penetrat...

Background: Jejuno(ileo)cecal side-to-side anastomoses with resection are commonly performed in equine abdominal surgery whenever the ileum is damaged to such an extent that will not allow performing an end-to-end anastomosis. Nevertheless, the complication rates of these techniques are still high while survival rates are lower when compared to oth...

Background: Although resection and anastomosis are commonly performed in equine abdominal surgery, in the existing literature only one article describes and compare methods of providing hemostasis on mesenteric arteries during jejunal resection and anastomosis (Rumbaugh et al 2003). Extending the search on textbook there is lack of description of h...

Background: Double layer suture pattern techniques are the most popular in equine surgery for end-to-end jejunojejunostomies, although recently single layer suture pattern techniques have been evaluated. Single layer techniques are faster to perform, produce less inflammation and bursting strength is not significantly different from a double-layer...

Background: Barbed sutures are characterized by the presence of barbs cut into the body of the thread that allows knotless suturing. These sutures has proven effective in performing end-to-end anastomosis ex-vivo in dogs and horses but to date no experimental study evaluated the characteristics of such anastomoses in vivo. The aim of this study is...

Background: Laparoscopic trocars create small defects through which the bowel or omentum can herniate. Closure of such small wounds can be difficult and many techniques and devices have been developed for port sites closure. The aim of this study is to describe a new method for trocar site closure in pigs and to compare it with a previously describ...

Background: Autologous regenerative medicine has gained interest in different medical fields, and studies have been undertaken to examine the effect of platelet-rich plasma(PRP) on intestinal healing. The aim of this study is to compare the effects on intestinal healing of two different autologous plasma preparations: PRP and plasma rich in growth...

Background: Many skills in open surgery need to be practiced to achieve self-confidence and good technique. Among these, correctly placing ligatures on vessels to assure haemostasis is paramount. Aim of this study is to describe an easy-to-make haemostasis simulator that can provide hints about precision and effectiveness of vessel ligature placeme...