Endo Stitch device than with the original technique using a laparoscopic needle holder and large needle. Viewing the left uterine horn 6 weeks post-surgery in one mare showed no evidence of a significant scar along the broad ligament. There is also concern for return to the original sagging position of the uterus after foaling. There are reports from the pioneers of the procedure of second pregnancies and no reports of an increased incidence of haemorrhage. The cost of the procedure is prohibitive in some mares. A further encountered and serious complication is failure of the procedure to achieve pregnancy despite apparent functional and anatomical improvement in uterine behaviour. Our res ults for conception have been disappointing having not mirrored the Northern Hemisphere results which have returned about 80% pregnancy. We have not had a pregnancy in 7 mares that have been served with one mare not served as yet. All mares have had a horizontally positioned uterus at the end of the procedure and at subsequent reproductive examinations. In one mare a postsurgery re-laparoscopic look at a left side uteropexy showed a nicely elevated uterus. After failure to conceive subsequent uterine biopsies showed severely chronically inflamed uteri. Only one mare with a mild to moderately affected uterus has undergone a uteropexy and she will not be served until next season. It is likely the mares we have performed the procedure on would still have had the surgery even if biopsies had been performed pre-surgery due to the expense of the mares and poor breeding history (empty for 2 to 7 years). Despite the poor results for pregnancy we believe the procedure does have a role in the treatment of a certain group of problem mares before their uterus becomes too damaged. There is no doubt fluid retention has been dramatically less and usually insignificant at post surgery examinations. The protocol we now follow is a uterine biopsy prior surgery to assess the state of the uterus to gauge the prognosis. We would still perform the procedure on a severely chronically inflamed uterus in a well-bred expensive mare as a last resort but our more preferred mare would be older to middle aged, empty the previous year or two, a history of fluid retention, and a mild to moderately inflamed uterus at worst with preferably a greater acute than chronic inflammatory picture. A study is underway comparing the uterine health with subjective values pre and post uteropexy. The long term effect of this surgery also needs evaluation. Oviduct examination, prostaglandin gel deposition, embryo collection and transfer of gametes.
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