Surgical time and complications of total transvaginal (total-NOTES), single-port laparoscopic-assisted and conventional ovariohysterectomy in bitches

Abstract

The recently developed minimally invasive techniques of ovariohysterectomy (OVH) have been studied in dogs in order to optimize their benefits and decrease risks to the patients. The purpose of this study was to compare surgical time, complications and technical difficulties of transvaginal total-NOTES, singleport laparoscopic-assisted and conventional OVH in bitches. Twelve bitches were submitted to total-NOTES (NOTES group), while 13 underwent single-port laparoscopic-assisted (SPLA group) and 15 were submitted to conventional OVH (OPEN group). Intra-operative period was divided into 7 stages: (1) access to abdominal cavity; (2) pneumoperitoneum; approach to the right (3) and left (4) ovarian pedicle and uterine body (5); (6) abdominal or vaginal synthesis, performed in 6 out of 12 patients of NOTES; (7) inoperative time. Overall and stages operative times, intra and postoperative complications and technical difficulties were compared among groups. Mean overall surgical time in NOTES (25.7±6.8 minutes) and SPLA (23.1±4.0 minutes) groups were shorter than in the OPEN group (34.0±6.4 minutes) (P<0.05). The intraoperative stage that required the longest time was the approach to the uterine body in the NOTES group and abdominal and cutaneous sutures in the OPEN group. There was no difference regarding the rates of complications. Major complications included postoperative bleeding requiring reoperation in a bitch in the OPEN group, while minor complications included mild vaginal discharge in four patients in the NOTES group and seroma in three bitches in the SPLA group. In conclusion, total-NOTES and SPLA OVH were less time-consuming then conventional OVH in bitches. All techniques presented complications, which were properly managed.Keywords: canine, spay, laparoscopy, operative time, transvaginal approach Palavras-chave: caninos, castração, laparoscopia, tempo operatório, abordagem transvaginal RESUMO O emprego de novas técnicas minimamente invasivas de ovário-histerectomia (OHE) vem sendo estudado em cães com o intuito de otimizar seus benefícios e reduzir os riscos aos pacientes. O presente estudo objetivou comparar o tempo cirúrgico, as complicações e dificuldades técnicas entre as abordagens por total-NOTES transvaginal, videoassistida com único portal e por celiotomia para ovário-histerectomia (OVH) em cadelas. Foram operados 12 animais por total-NOTES (grupo NOTES), 13 pela técnica videoassistida (grupo SPLA) e 15 pela técnica convencional (grupo OPEN

Laparoscopic ovum pick-up in spotted paca ( Cuniculus pacas )

“…with goats. Times of manipulation and ovarian punctures proved to be the most complex steps in LapOPU procedure, possibly due to the number and size of follicles, these results corroborate those found by Teixeira et al (2015), in addition to the lateralization of animals facilitating access and manipulation of both ovaries, as shown by Silva et al (2015).…”

Single‐port laparoscopic‐assisted ovariohysterectomy with a modified glove‐port technique in dogs

“…The results of our study were compared to those of 14 previous reports . Mean age (17.4–54.60 months; range 4–138) and median age (10.5 months and 30 months) did not differ from those in the present study ( P = .869; Table ).…”

“…Median and mean total durations of LOHE with the glove‐port technique and nonarticulated instruments were comparable or shorter than those reported in previous studies (Table ). We are aware of only 1 study comparing natural orifice transluminal endoscopic surgery (NOTES), conventional OHE, and single‐port laparoscopic‐assisted OHE in which the median surgical time with a SILS port was slightly faster than that in our study …”

“…Laparoscopic surgery has gained popularity in human and veterinary surgery because of its reduced postoperative pain, faster recovery with shorter hospital stay, and superior cosmetic outcome . Laparoscopic sterilization has become a widely available alternative to open laparotomy in dogs and can be achieved via laparoscopic ovariectomy (LOE)* or laparoscopic ovariohysterectomy (LOHE). † Reducing the number of ports in laparoscopic surgery minimizes tissue trauma and improves recovery in human and veterinary medicine.…”

“…‡ Most published techniques for LOHE involve the use of 3 or 4 ports. § Two‐port techniques and transvaginal approaches have recently been described, commercially available single‐port multiaccess devices for LOHE have been used in only 2 studies …”