Standing laparoscopic ovariectomy technique with intraabdominal dissection for removal of large pathologic ovaries in mares.

Abstract

OBJECTIVE: To describe a standing laparoscopic ovariectomy technique with intraabdominal ovarian dissection inside a specimen retrieval bag for removal of large pathologic ovaries through small incisions. STUDY DESIGN: Case series. ANIMALS: Mares (n=43) aged 2-21 years and weighing 380-680 kg. METHODS: Unilateral laparoscopic ovariectomy was performed on 43 standing sedated mares. Ovaries were approached via 3 portal sites, 2 in the paralumbar fossa and a 3rd between the 17th and 18th ribs on the ipsilateral side. Ovaries were dissected free using either a LiNA Tripol-bipolar laparoscopic forceps or a Ligasure Vessel Sealing Device and removed by enlarging the proximal portal site ventrally using a grid technique. Use of a plastic specimen retrieval bag and cannula suction device facilitated intraabdominal dissection of very large ovaries into 2 or more pieces, before removal through small incisions. RESULTS: Regardless of size, all ovaries were removed successfully through small incisions (range, 5-10 cm), with no major complications and an excellent cosmetic result. All sport horses returned to previous levels of work or higher, with 93% of breeding mares successfully bred in the 1st season after surgery. CONCLUSIONS: Large pathologic ovaries can be easily and safely removed by standing laparoscopic ovariectomy on the mare. CLINICAL RELEVANCE: Standing laparoscopic ovariectomy combined with a small flank incision is a safe and highly effective technique for removal of large pathologic ovaries in the mare, negating the requirement for general anesthesia or large incisions.