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Veterinary surgery : VS2021; 51 Suppl 1; O174-O182; doi: 10.1111/vsu.13687

Hybrid natural orifice transluminal endoscopy surgery (NOTES) to perform bilateral ovariectomy in mares.

Abstract: To combine laparoscopic techniques with natural orifice transluminal endoscopic surgery (hybrid NOTES) to minimize number and enlargement of paralumbar laparoscopic portals for bilateral ovariectomy in standing, sedated mares. Methods: Case series. Methods: Six horses. Methods: Six mares with palpably normal ovaries were restrained in stocks, sedated, and had caudal epidural anesthesia performed. A 7.5 MHz ultrasound probe was used transvaginally to select placement of vaginotomy. An attempt was made to remove both ovaries with 70 cm esophageal forceps through the vaginotomy, while visualized and transected via ipsilateral paralumbar fossa laparoscopic portals. Surgical time, intraoperative, and postoperative complications were recorded. Vaginoscopy was performed at days 0, 3, 7, and 14 postoperatively. After 14 days, mares were euthanized and necropsied. Results: Hybrid NOTES allowed successful bilateral ovariectomy in all six mares, with a mean surgical time of 70 ± 25 min. In two mares, one ovary was dislodged from the forceps during vaginotomy extraction. Abdominal retrieval of the ovary was successful with reapplication of forceps or a surgeon's hand via vaginotomy. At necropsy, five mares had no adhesions within the abdominal cavity or at the vaginotomy site. One mare in which hand retrieval of the ovary was necessary, developed an adhesion between the bladder and the vaginotomy. Conclusions: This technique appears to offer a safe alternative for bilateral ovariectomy with minimal postoperative complications. Conclusions: Decreased number and size of paralumbar laparoscopic incisions could decrease complications associated with exteriorization of ovaries through the flank.
© 2021 American College of Veterinary Surgeons.
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Publication Date: 2021-07-17 PubMed ID: 34272894DOI: 10.1111/vsu.13687Google Scholar: Lookup
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Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

This research presented a surgical method that combines laparoscopic technique with natural orifice transluminal endoscopic surgery (hybrid NOTES) to perform bilateral ovariectomy in mares. The study showed promising results, reducing the number and enlargements of paralumbar laparoscopic portals, thus potentially decreasing postoperative complications.

Overview of the Research Method

  • The study was carried out as a case series featuring six mares with palpably normal ovaries. The horses were held in stocks, sedated, and caudal epidural anesthesia was performed.
  • A 7.5 MHz ultrasound probe used transvaginally to identify where the vaginotomy (an incision in the vaginal wall) should be placed.
  • The objective was to remove both ovaries with a 70 cm esophageal forceps via the vaginotomy. Meanwhile, the surgeons kept tabs on the procedure and transected the ovaries using ipsilateral paralumbar fossa laparoscopic portals.
  • The surgical time, intraoperative, and postoperative complications were recorded. Vaginoscopy (examination of the vagina using a scope) was performed on days 0, 3, 7, and 14 postoperatively.
  • After two weeks, the mares were euthanized and necropsied (post-mortem examination) to further evaluate the effects of the procedure.

Results of the Research

  • The hybrid NOTES method proved effective for bilateral ovariectomy in all six tested mares, with a mean surgical duration of 70 ± 25 minutes.
  • In two cases, one ovary was inadvertently let go from the forceps during the extraction through the vaginotomy. In these instances, abdominal retrieval of the ovary was accomplished with the reapplication of forceps or the surgeon’s hand through the vaginotomy.
  • Upon necropsy, five of the mares had no adhesions (bands of scar tissue that can form between tissues and organs) within the abdominal cavity or at the site of the vaginotomy. One mare, in which hand retrieval of the ovary was performed, developed an adhesion between the bladder and the vaginotomy site.

Conclusion of the Research

  • The hybrid NOTES technique appears to offer a safe alternative for bilateral ovariectomy, with minimal postoperative complications.
  • The study also suggests that reducing the number and size of paralumbar laparoscopic incisions could likely decrease complications associated with the removal of ovaries through the flank (side area of the horse between the ribs and hip).

In summary, this research presented a helpful alternative surgical option for performing bilateral ovariectomy in mares while potentially reducing associated complications.

Cite This Article

APA
Velloso Alvarez A, Boone L, Horzmann K, Hanson RR. (2021). Hybrid natural orifice transluminal endoscopy surgery (NOTES) to perform bilateral ovariectomy in mares. Vet Surg, 51 Suppl 1, O174-O182. https://doi.org/10.1111/vsu.13687

Publication

Veterinary surgery : VS
ISSN: 1532-950X
NlmUniqueID: 8113214
Country: United States
Language: English
Volume: 51 Suppl 1
Pages: O174-O182

Researcher Affiliations

Velloso Alvarez, A
  • Department of Clinical Science, Auburn University, Auburn, Alabama, USA.
  • University Cardenal Herrera CEU, Valencia, Spain.
Boone, Lindsey
  • Department of Clinical Science, Auburn University, Auburn, Alabama, USA.
Horzmann, Katharine
  • Department of Pathobiology, Auburn University, Auburn, Alabama, USA.
Hanson, R Reid
  • Department of Clinical Science, Auburn University, Auburn, Alabama, USA.

MeSH Terms

  • Animals
  • Colpotomy / veterinary
  • Female
  • Horse Diseases
  • Horses / surgery
  • Laparoscopy / methods
  • Laparoscopy / veterinary
  • Natural Orifice Endoscopic Surgery / methods
  • Natural Orifice Endoscopic Surgery / veterinary
  • Ovariectomy / methods
  • Ovariectomy / veterinary
  • Postoperative Complications / veterinary
  • Pregnancy

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