We are now able to offer laparoscopy (keyhole surgery) as part of our commitment to be at the forefront of veterinary care. This type of surgery has become the gold standard in many types of human surgery but it is still very new on the veterinary front and few practices have access to the equipment required.
What is Laparoscopy?
Laparoscopy describes the use of a small incision (keyhole) to allow entry of a narrow telescope into the abdomen. The telescope is attached to a camera which projects a magnified image onto a video screen. One or two further tiny holes are made to allow entry of specialised instruments to perform the operation required.
The same type of equipment can be used for other areas of the body:
Thoroscopy - Chest
Arthroscopy - Joints
Rhinoscopy - Nose
Cystoscopy - Bladder
Otoscopy - Ear
The incisions are just a few millimetres long and so the technique is described as minimally invasive. This allows for faster recoveries, less scarring and reduced pain for our patients in exactly the same way as it does in human medicine. The video image is magnified, which enables better visualisation of organs and more accurate surgery. Small areas of disease which using traditional surgery might be missed can be seen. The keyhole wounds are minor so repair is rapid, helping to reduce time under anaesthetic.
Traditionally, spays are done through a 4-8cm incision through the body wall in the mid abdomen. The ovarian ligaments are torn from the body wall and pulled up in order to tie off the vessels and cut the attachments. The uterus is then tied off at the cervix and removed. The removal of the ovaries and uterus is called an ovariohysterectomy. The tearing of the ligaments is painful, requires a deeper level of anaesthesia and is a source of post-operative pain and possible adhesions. Our patients normally go home the same day, unlike their human counterparts, but it is major surgery.
We can now spay bitches using a keyhole technique. This involves making two small 3-10mm long incisions depending on the size of the patient. The ovaries are cut and the vessels cauterized within the abdomen and removed avoiding the ligament tearing of the traditional technique, hence reducing pain and bruising.
Recent work in the USA has shown that removing only the ovaries (ovarectomy) has the same benefits as a full ovariohysterectomy. Therefore it is unnecessary to remove the uterus unless it is diseased and this saves on surgical time and further tissue trauma. Removing the ovaries alone still avoids the problem of pyometra (septic womb) later in life.
Advantages of keyhole ovariectomy vs. traditional spay:
- Less tissue removed, thus less trauma
- Reduced risk of adhesions
- Less pain
- Speedier recovery
- Very small wounds - few if any stitches and therefore less problems with licking and wound breakdown
- No long-term difference to outcome
- Possibly leaving the uterus alone reduces incidence of urinary incontinence later in life
Disadvantages of keyhole ovariectomy vs. traditional spay:
- In the event of complications e.g. previous scarring, abnormal anatomy, bleeding problems, it would be necessary to switch to the traditional technique with associated larger wound
- Cost of the equipment - it is extremely expensive
Keyhole surgery will become the technique of choice for many veterinary procedures in the years ahead due to its obvious benefits. Aniwell Veterinary Clinic is pleased to be at the forefront of this advance.