Spay
Ovariohysterectomy is one of the most common surgical procedures performed in the United States. Research has shown that laparoscopic ovariectomy (OVE)/ovariohysterectomy (OVH) enables us to perform the same procedure while reducing the amount of post-operative pain experienced. These patients have also been shown to experience a faster return to normal activity than those animals undergoing sterilization via celiotomy. Although OVH has long been considered the “gold standard” for elective female sterilization, studies have demonstrated no difference in the incidence of intraoperative complications and long-term urogenital problems such as endometritis, pyometra, and urinary incontinence. While uterine neoplasia is still possible following OVE the reported risk of uterine tumor development is only 0.03%, with 85-90% of those tumors being benign leiyomyomas. Given the lack of evidence supporting removal of the uterus, development and improvement of laparoscopic sterilization techniques have concentrated on LapOVE rather than LapOVH. In the hands of an experienced laparoscopic surgeon the procedure can be performed as quickly and efficiently as the open technique. Usually animals are operated in dorsal recumbency and the procedure requires two ventral midline incisions. One just caudal to the umbilicus allowing insertion of the laparoscope (5mm), and one on ventral midline (5-10mm) between the umbilicus and pubis allowing insertion of laparoscopic instruments. Because of the need to manipulate and triangulate instruments within the insufflated abdominal cavity, the technical difficulty of the procedure is dependant on the size of the patient. Smaller patients make the procedure more technically demanding but with the appropriate equipment and experience this technique can be applied even to small dogs and cats.