ISSN 2398-2977      

Ovary: ovariectomy - laparoscopic approach

pequis

Introduction

  • With the development of surgical instruments and techniques in the past decade laparoscopic ovariectomy in the standing horse has become a frequently used surgical procedure.
  • Specialist knowledge of the technique is required for its successful use.

Uses

  • Sterilization: removal of ovaries bilaterally from mares not intended for breeding to eliminate estrous behavior.
  • Removal of ovarian neoplasia    Ovary: neoplasia - overview  , hematoma, teratoma.

Advantages

  • Minimally invasive.
  • Ovaries are easy to locate and manipulate because they are suspended from the mesovaria.
  • Avoids costs, morbidity risk and potential complications of general anesthesia.
  • Useful when facilities for general anesthesia and laparotomy are unavailable.

Disadvantages

  • Technically difficult requires specialist training.
  • Requires specialist equipment.
  • Limitations of triangulation   Abdomen: laparoscopy  imposed by a paralumbar approach.
  • Two incisions have to be made for bilateral ovariectomy.
  • Risks involved with operating on a conscious patient.

Requirements

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Preparation

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Procedure

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Aftercare

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Outcomes

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Prognosis

  • Depends upon primary reason for surgery. 
  • Guarded for behavioral reasons - although normal estrus cycles are prevented, this may not alleviate the abnormal behavior. 
  • Guarded for ovarian granulosa theca cell tumors    Ovary: neoplasia - granulosa / theca cell  .
  • Unilateral resection: mares return to estrus in mean of 8.5 months. Once the normal cycle has started, fertility appears to be unaffected. Most must go through winter anestrus following tumor removal before normal cycle resumes.

Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Greet T R C (2012) Complications associated with laparoscopic ovariectomy in mares. Equine Vet Educ 24 (7), 331-333 WileyOnline
  • Madron M S, Caston S S, Tracey A K & Kersh K D (2012) Instrument associated complication of a laparascopic ovariectomy. Equine Vet Educ 24 (7), 325-330 VetMedResource.
  • Heijltjes J M et al (2009) Removal by laparoscopic partial overiohysterectomy of a uterine leiomyoma assumed to have caused fetal death in a mare. Equine Vet Educ 21 (4), 198-203 VetMedResource.
  • Lloyd D et al (2007) Electrosurgery as the sole means of haemostasis during the laparoscopic removal of pathoogically enlarged ovaries in mares: a report of 55 cases. Equine Vet J 39 (3), 210-214 PubMed.

Other sources of information

  • Palmer S E (2002) Laparoscopic Ovariectomy in the Standing Horse. In: Equine Diagnostic & Surgical Laparoscopy. W B Saunders, USA. pp 189-195. ISBN: 0 7216 7925 0.

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