Simini Surgery Review: Equine Edition
In this episode of the Simini Equine Surgery Podcast, we explore the orthopedic research from the February 2026 issue (Issue 2) of Veterinary Surgery, where three studies showcase how refinements in equine tenoscopic surgery are expanding what surgeons can accomplish through minimally invasive techniques. Together, they highlight a common goal: improving surgical access while preserving critical anatomy and optimizing long-term athletic outcomes. From preserving tendon blood supply during manica flexoria resection, to a new tenoscopic treatment for proximal digital annular ligament desmitis, and the development of a medial portal for carpal flexor tendon sheath surgery, these papers demonstrate how thoughtful surgical innovation continues to improve patient care. In this episode: ✅ Racine et al. presented a refined two-portal tenoscopic technique for resection of torn proximal manica flexoria (MF) while preserving the mesotendons (MTs) of the deep digital flexor tendon. Using a four-step approach—including a novel Kocher-Ochsner clamp twisting technique to detach the remaining areolar tissue—the authors successfully preserved the mesotendons while minimizing iatrogenic trauma. Among 30 horses, 96.4% achieved successful tendon sheath healing, and 75% returned to their previous or higher level of athletic performance. By maintaining the extrinsic vascular supply of the deep digital flexor tendon, this modified approach may improve long-term tendon healing while reducing surgical morbidity. ✅ Wood et al. described a tenoscopically guided proximal digital annular ligament (PDAL) desmotomy for horses with proximal digital annular ligament desmitis. After validating the technique in 10 cadaver limbs, the procedure was successfully performed in five clinical cases, with four horses returning to their previous level of exercise following surgery. The study also demonstrates that pathologic thickening of the PDAL actually facilitates surgical identification during tenoscopy, while emphasizing the importance of performing a palmar or plantar annular ligament desmotomy first to improve instrument maneuverability and protect the superficial digital flexor tendon. ✅ Woods et al. investigated the feasibility of creating a medial tenoscopic portal into the equine carpal flexor tendon sheath using contrast-enhanced CT and cadaver specimens. The authors identified a reproducible portal location approximately 5 mm proximal and 32 mm caudal to the distal medial radial physis, providing 120–140° of instrument triangulation when combined with the standard lateral portal. Although superficial flexor carpi radialis tendon impingement occurred during early testing, careful blunt dissection and transillumination from the lateral portal allowed safe placement while preserving major neurovascular structures. The technique offers surgeons improved visualization and access to previously difficult-to-reach lesions within the carpal sheath. Together, these studies demonstrate that the future of equine tenoscopy lies not in larger incisions, but in smarter portal placement, preservation of normal anatomy, and continual refinement of minimally invasive surgical techniques. 🎓 Journal Articles Discussed * Racine et al. — Four-step tenoscopic technique to resect a torn proximal manica flexoria while sparing the mesotendons of the deep digital flexor tendon in 30 horses * Wood et al. — Tenoscopically guided proximal digital annular ligament desmotomy for the treatment of proximal digital annular ligament desmitis * Woods et al. — Feasibility of a medial tenoscopic portal in the equine carpal flexor tendon sheath in cadavers 📚 From the February 2026 Issue (Issue 2) of Veterinary Surgery 🎁 Want to learn more about Simini Protect Lavage or request a sample? Learn More: www.simini.com [http://www.simini.com] Request a Sample: https://www.simini.com/evaluation-kit [https://www.simini.com/evaluation-kit]
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