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Laparoscopic Ovariectomy

Samantha Lane BVSc BSAVAPGCertSAS MRCVS

Laparoscopic Ovariectomy

Samantha Lane BVSc BSAVAPGCertSAS MRCVS

Laparoscopic ovariectomy (or keyhole spay) is a service which we offer to all clients as an alternative to an open spay. During this procedure small incisions are made in the body wall (three 0.5cm muscle incisions) which enable the ovaries to be removed using a camera and vessel sealing equipment.

Why choose a laparoscopic ovariectomy over open spay?

  • There is a decrease in post-operative pain following a laparoscopic spay. One study showed a 62% decrease in movement following open spay when compared to the day before surgery; laparoscopic ovariectomy showed only a 25% decrease in activity. This decrease in activity (even with pain relief administered) is likely due to increased pain levels following open surgery.
  • As the incisions in the body wall are much smaller when compared to open surgery, the recovery time following surgery is shorter and activity restriction in the post-operative period is less critical. We would still recommend lead exercise only for 10 days following a laparoscopic ovariectomy but the distances walked can be longer than following open spay surgery.
  • There are fewer post-operative complications reported with laparoscopic ovariectomy than for open spays (wound infection, breakdown and hernia formation).
  • A camera with magnification is used to visualise the blood supply to the ovary and a vessel sealing device is used so the risk of blood loss is often less than open spay surgery.

Cases which we would particularly recommend laparoscopic ovariectomy for:

  • Laparoscopic ovariectomy can be performed in bitches of any size but the particular advantages are those who weigh more than 7kg.
  • Large and giant breeds who are at risk of gastric dilation-volvulous (GDV/bloat) are able to have a gastropexy (where the stomach is attached to the body wall to prevent twisting) during the same procedure without having to convert to a full open procedure. This is particularly recommended in deep-chested breeds such as Great Danes, Weimaraners, St Bernards, Irish Setters and Dobermans.
  • Young and active animals: as the exercise restriction is less essential in the post-operative period, we would recommend laparoscopic ovariectomy to decrease post-operative complications (especially wound healing complications).
  • Bitches who are showing signs of oestrus after previous spay surgery where we suspect an ovarian remnant.

Cases which we would recommend open spay for:

  • Older animals with abnormalities in the uterus – if there are already changes in the uterus we would recommend to remove the uterus along with the ovaries in an open procedure. If the uterus is not removed this may cause problems in the future and require removal.
  • Dogs who have large ovarian masses which we would not be able to remove via the small body wall incisions.

Cases in which we would recommend delaying any spay procedure:

  • Bitches showing signs of false pregnancy. If the ovaries are removed during a false pregnancy, milk production and behavioural changes may continue and be difficult to resolve.
  • Bitches currently in season due to an increase in blood supply to the ovaries at this point in the cycle. We would recommend waiting until the bitch is mid-cycle before spaying.
  • Bitches who are showing signs of urinary incontinence that we have not investigated.
  • Bitches who are pre-season and have signs of a discharge or skin infection surrounding the vulva. This will often resolve following a season and we would recommend waiting until after the first season before spaying.
  • We would advise waiting until after the first season before spaying bitches who are at increased risk of urinary incontinence (English Springer Spaniel, Old English Sheepdog, Doberman, Rottweiler, Irish Setter).

Risks of laparoscopic ovariectomy

  • All procedures have an anaesthetic risk but this is very low in young and healthy patients.
  • There is a risk of bleeding with all spay procedures. This is low in laparoscopic ovariectomy as the vessels are directly visualised with a camera and a vessel sealing device seals the vessels to prevent bleeding. We always check that there is no bleeding at the end of surgery before removing the camera from the abdomen.
  • There is a possibility that we need to convert to open surgery. This is most common in animals who have had previous abdominal surgery and adhesions prevent visualisation of the ovaries. It may also be necessary in cases of uncontrolled bleeding. We will clip the hair from the abdomen in case conversion is required.
  • In the years following surgery, if hormone drugs are administered, there is a risk of uterine disease so these should be avoided.

What should I expect in the post-operative period?

  • Your dog may be more sleepy than usual and wanting to eat less in the evening following their anaesthetic.
  • It is likely that your dog will come home wearing a pet bodysuit or a buster collar to prevent interference with the wounds.
  • A short course of anti-inflammatory pain relief will be dispensed for you to continue at home.
  • The sutures in the wounds will need to be checked after 2 days and 10 days.
  • We would recommend no play activity until the sutures have been removed. Lead walks only (10-15 minutes, 2-3 times daily) are recommended on dry ground.
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