Figure 5
Patient preparation and the anaesthesiological protocol were the same as those used in the previous surgery. The surgical procedure was performed with he mare in a standing position. A dorso-ventral left 20 cm linear skin incision, lateral to the previous one, was made over the hernia content (Figure 6.b.). The surgeon proceeded by means of a blunt dissection of the skin and the underlying fascia until the semimembranosus muscle which was exposed and isolated from the surrounding structure was identified (Figure 6c). The muscle was transected using an emasculator, and the distal part was ligated with a transecting suture using a 2 USP multifilament adsorbable suture (Figure 6d,e). The muscular fascia was completely opened with the aim of exposing the semimembranosus muscular belly (Figure 6f). At this point, the semimembranosus muscle was reversed proximo-medially, and a 45° degree transposition was obtained, and was sutured using simple interrupted sutures to the vaginal wall, external anal sphincter, sacrotuberosus ligament, and periosteum of the ischium using a 2 USP multifilament adsorbable suture (Figure 6,g,h.). The muscular fascia was closed using a simple interrupted suture (Figure 6i). The subcutaneous tissue was sutured by applying the same suture material in a simple continuous suture pattern. The skin was closed using a 1 USP monofilament nylon suture with a series of horizontal mattress suture (Figure 6j).