Laparoscopic, or “key hole”, surgery is seen as gold standard in human medicine and is now making the transition to the veterinary world. It is well documented that it causes fewer complications and less post-operative pain in people, compared to traditional surgery, and we are now seeing data in animals which supports this.
Laparoscopic procedures have the advantage of:
- Reduced tissue handling
- Greater precision
- Less trauma
- Haemorrhage (bleeding) is often reduced and more easily controlled
- The whole abdomen can be examined to ensure there is no unexpected disease evident
- Procedure time may be reduced
This procedure can offer a quicker recovery time often allowing dogs off the lead and running around three days after surgery. The wounds are also smaller meaning your pet is less likely to lick them and cause complications.
The procedure is performed by a small needle being placed into the abdomen which is then used to inflate the patient with carbon dioxide. This creates a space for the camera to be placed and gives the surgeon room to move instruments around. Three small tubes are then placed into the abdomen which act as ports for instruments to pass down and through which the ovaries can be removed. The wounds are small and are closed without external stitches.
Traditionally in the UK we have performed ovariohysterectomy where the ovaries and the whole of the uterus are removed. In mainland Europe and the US ovariectomy has always been used whereby the ovaries are removed but the uterus is left in place. The rationale in the UK for removing everything was to eliminate risk of pyometra, an infection in the uterus. This has now been disproven, as pyometra does not occur when the ovaries are removed and this data shows that we only need to perform an ovariectomy. Therefore in laparoscopic surgery only the ovaries are removed which further reduces tissue handling and trauma to the patient.
The procedure is highly successful with great results following surgery however as with all procedures there are risks and potential complications. If at any point the surgeon is unhappy with how the procedure is going, i.e. due to equipment failure, abnormal bleeding etc, the decision may be made to convert to an ‘open’ surgery. This decision would always be made with the safety of the patient in mind.