Standing Ovariectomy in Mares Using a Transvaginal Natural Orifice Transluminal Endoscopic Surgery (NOTES®) Approach

Abstract

Using specialized instruments, transvaginal NOTES® ovariectomy is technically feasible in mares.

Left paralumbar fossa approach combined with mesocolon fenestration for bilateral equine ovariectomy

“…Although the use of a morcellator reduces incisional complications, this procedure requires the additional cost to purchase a morcellator and has potential for iatrogenic injury to the uterine horn . Transvaginal natural orifice transluminal endoscopic surgery via colpotomy incision requires customized instrumentation and has decreased visual observation of the caudal abdomen, leading to bilateral ovariectomy not being achievable in all mares . Fatal hemorrhage from the colpotomy incision, a positive peritoneal microbial culture, and development of adhesions were also limitations .…”

“…Minimally invasive surgery continues to evolve, with recent research focused on further decreasing morbidity and mortality and increasing cosmesis in mares undergoing laparoscopic ovariectomies. Examples include bilateral paralumbar fossa approach with both ovaries extracted through a single unilateral enlarged incision, use of a morcellator in which only 2 portal incisions are created in each paralumbar fossa, and transvaginal natural orifice transluminal endoscopic surgery via colpotomy incision …”

How to perform ovariectomy through a colpotomy

“…; Palmer ; Pader et al . ). A practical technique of bilateral ovariectomy that can be performed easily without anaesthetising the mare and without a surgical facility is ovariectomy through a colpotomy, with the use of an écraseur.…”

“…Complications of ovariectomy performed through a colpotomy are uncommon when the mare is prepared properly for the procedure and when the correct precautions are taken during and after the procedure (Nichols ; Moll and Slone ; Embertson ; Pader et al . ).…”

“…Both ovaries are sometimes removed from mares to eliminate the regular oestrous cycle, create a teaser mare, or produce a recipient mare for embryo transfer (Hooper et al 1993). Surgical approaches described for bilateral ovariectomy of mares include celiotomy through one or both flanks, or through the vagina (Hooper et al 1993;Palmer 1993;Pader et al 2011). A practical technique of bilateral ovariectomy that can be performed easily without anaesthetising the mare and without a surgical facility is ovariectomy through a colpotomy, with the use of an ecraseur.…”