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Laparoscopic (Key Hole) Bitch Spays

LAPAROSCOPIC (KEY HOLE) BITCH SPAYS

We have now been perfoming laparoscopic ovariectomies in place of the traditional bitch spay for over a year and are the only veterinary surgery to offer this service on the Isle of Wight.

Laparoscopic surgery (also commonly known as key hole surgery) is the gold standard for a wide range of operations in humans, but sadly is still only rarely performed in animals. Just as in humans, the very small incisions mean a much faster recovery, less risk of post-operative infections, less risks of post-operative wound complications, and most importantly, significantly less pain than with old-fashioned open abdominal surgery.

What is laparoscopic surgery?

Laparoscopy also commonly referred to as "keyhole" surgery, minimally invasive surgery, or endosurgery, is a method of performing abdominal (or other body cavity) surgery by inserting a surgical telescope or endoscope, and very thin, specially designed instruments through tiny incisions in the body. In many cases the wounds are only 5mm in size. Prior to inserting the tools, the abdomen is filled with medical carbon dioxide to aid visualisation. The tools are then inserted down small cannulae which are placed in the abdominal wall through tiny incisions. Specialised surgical sealing devices are used to minimise surgical bleeding and negate the requirement to put surgical suture material or hands within the abdomen. The surgeon can see everything on a magnified screen fully illuminated with a xenon light source.

In keeping with our innovative ethos and drive to provide the best possible care for our patients, we at the mobile Vet felt it was a worthy investment to offer this additional service.

Is "Keyhole" surgery the same as laparoscopic surgery?

While in human surgery the layman's term "keyhole" surgery is usually taken to mean laparoscopy, this is not always so in veterinary practice. Unfortunately it may occasionaly be misused to mean performing normal open surgery, just through a small incision. The two should not be confused. Laparoscopic sugery is minimally invasive, but still visual surgery, where everything can be seen well via the video endoscope, making it safe surgery. Performing open surgery through a small incision is actually worse than open surgery from a reasonable sized wound. A surgeon pulling on organs he/she can't see through a small hole is neither safe surgery, nor painfree - animals are often really painful after this poor form of surgical technique. Make sure if its keyhole surgery that it is laparoscopic surgery!

Is laparoscopic surgery more expensive than old-fashioned "open" surgery?

Laparoscopic surgery is slightly more expensive than old-fashioned open abdominal surgery, so if you want the cheapest option, then this may not be for you. The slightly higher fees are however not unreasonable for all the advantages. Laparoscopic surgery equipment is also costly to purchase and maintain.

Ovariectomy vs Ovariohysterectomy

This is an important point as it often causes confusion. During a laparoscopic ovariectomy only the ovaries are removed (ovariectomy) which shortens surgical time, reduces the risks involved during & after surgery & reduces the pain involved significantly in contrast to cthe old fashioned ovariohysterectomy; where the ovaries and uterus are removed through a larger incision involving tearing of ligaments, etc. 

Why leave the uterus behind? Decades of clinical research show that there are no medical advantages to removing the healthy uterus and the long term health outcomes are the same for both ovariectomy and ovariohysterectomy. This is why it has been performed for over 25 years in Europe. Both will stop the bitch from coming into season and both will prevent uterine pyometra (life threatening infection in the uterus) as the ovaries are required for this condition to develop.
(In dogs older than 8 years of age, the uterus may need to be removed at the same time, however this will be discussed at the pre spay examination).

Laparoscopic Technique

Key hole surgery involves operating through two tiny incisions in the abdomen and utilising cameras & specialised tools through the holes. The small surgical sites and excellent vision inside the abomen during surgery makes it less painful on recovery for our patients and therefore they are up and about much faster. The improved surgical visualisation makes it easier to spot any other problems in the abdomen and means minimal haemmorhage and a safer surgery compared to a traditional spay. There is also minimal tissue handling as our hands never enter the abdomen! A more rapid recovery means no more head collars, no post operative pain relief is required, you do not have to take days off work to look after your pet and an all round much less stressful experience.

We all expect key hole surgery when we go to the hospital so why are we not offering it for our pets? Good question! Well now we are... A standard gall bladder removal in human patients is performed using key hole surgery in 95% of cases; these patients leave the hospital the same day. The equivalent procedure performed via an open incision inviolves a weeek long hospital stay! 

Ok, so the fee is a little more to cover the additional costs involved for us but this is a small price to pay for your loved pets to receive the best possible surgical experience and minimal pain.

Lap spays start at £200 for cats & £350 for bitches and vary according to the size of your pet. Call us for more info!

1 The ovary is grasped2  2 The ovary is raised upwards against the abdominal wall2  3 The ovarian ligament is sealed2  4 The ovarian ligament is cut2

1] The ovary is grasped           2] Ovary is lifted upwards        3] Ovarian ligament is sealed      4] Ovarian ligament is cut

5 The uterus is sealed cut2  6 Any remaining fatty tissue is sealed cut2  7 The ovary is grasped removed2  8 There is no haemmorhage2

5] Uterus is sealed & cut      6] Remaining fat is sealed & cut     7] Ovary is grasped & removed    8] There is no haemmorhage

 

Other laparoscopic surgery

The use of key hole surgery with cameras is not limited to bitch spays alone. It is also excellent for taking biopsies, minimally invasive exploratory surgery of the abdomen and cryptorchid castrations amongst others.

References

1. BV Goethem, A Schaefers-Okkens, J Kipensteijn. making a rational choice between ovariectomy and ovariohysterectomy in the dog: A discussion on the benefits of either technique. Vet Surgeon 2006; 35:136-143

2. Okkens, AC, Kooistra, HS, Nickel RF. Comparison of long term effects of ovariectomy versus ovariohysterectomy in bitches. Der Praktische Tierarzt 2003; 84:98-101.

3. CM Devitt, RE Cox, JJ Hailey. Duration, complications, stress, and pain of open ovariohysterectomy versus a simple methosd of laparoscopic-assisted ovariohysterectomy in dogs. J AM Vet Med Assoc 2005; 227:921-92

4. Davidson EB, Moll HD, Payton ME. Comparison of laparoscopic ovariohysterectomy and ovariohysterectomy in dogs. Vet Surg. 2004 Jan-Feb; 33(1):62-9.

5. WTN.Culp, VMD, Diplomate ACVS, PD.Mayhew, BVM&S, Diplomate ACVS, and DC Brown, DVM, Diplomate ACVS The Effect of Laparoscopic Versus OPen Ovariectomy on Post surgical Activity in Small Dogs. Veterinary Surgery 38:811-817, 2009.

 

 

                                                 

 

 

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