Comparison of Transvaginal Natural Orifice Transluminal Endoscopic Surgery (NOTES®) and Laparoscopy for Elective Bilateral Ovariectomy in Standing Mares

Authors

  • Karine Pader DVM,

    1. Department of Veterinary Clinical Sciences, School of Veterinary Medicine, Purdue University, West Lafayette, IN
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  • Lynetta J. Freeman DVM, MS, Diplomate ACVS,

    1. Department of Veterinary Clinical Sciences, School of Veterinary Medicine, Purdue University, West Lafayette, IN
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  • Peter D. Constable BVSc, MS, PhD, Diplomate ACVIM,

    1. Department of Veterinary Clinical Sciences, School of Veterinary Medicine, Purdue University, West Lafayette, IN
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  • Ching C. Wu DVM, PhD,

    1. Department of Comparative Pathobiology, School of Veterinary Medicine, Purdue University, West Lafayette, IN
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  • Paul W. Snyder DVM, PhD, Diplomate ACVP,

    1. Department of Comparative Pathobiology, School of Veterinary Medicine, Purdue University, West Lafayette, IN
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  • Timothy B. Lescun BVSc, MS, Diplomate ACVS

    Corresponding author
    • Department of Veterinary Clinical Sciences, School of Veterinary Medicine, Purdue University, West Lafayette, IN
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  • This study was supported by the Minimally Invasive Surgery Grant from the American College of Veterinary Surgeons and Ethicon Endo-Surgery, and by the State of Indiana and the Purdue University School of Veterinary Medicine Research account funded by the total wager tax.

Corresponding Author

Timothy B. Lescun, BVSc, MS, Diplomate ACVS, Department of Veterinary Clinical Sciences, School of Veterinary Medicine, Purdue University, 625 Harrison Street, West Lafayette, IN 47907

E-mail: tlescun@purdue.edu

Abstract

Objective

To compare surgical trauma, perioperative pain, surgical time, and complication rate in mares undergoing standing bilateral ovariectomy by natural orifice transluminal endoscopic surgery (NOTES) or laparoscopy.

Study Design

Experimental study.

Animals

Healthy mares (n = 12).

Methods

Ovariectomy was performed with a vessel-sealing device by transvaginal NOTES (n = 6) using a flexible endoscope and specialized instruments or by bilateral flank laparoscopy (n = 6). Preoperative and postoperative complete blood count (CBC), plasma fibrinogen concentration, serum amyloid A concentration, peritoneal nucleated cell count, and total protein concentration were compared using repeated measures ANOVA. Surgical times were compared using an unpaired t-test. Mares were monitored for 2 weeks postoperatively and necropsy was performed at 3 weeks (n = 6) or 3 months (n = 6) to assess short- and medium-term effects of each procedure. Complication rate, necropsy, and bacteriology findings were compared using a Fishers exact test. Significance was set at P < .05.

Results

All surgical procedures were performed successfully and all but one laparoscopy mare were bright, alert, and maintained a good appetite until euthanasia. Mean ± SD surgical time was similar between groups (NOTES: 100 ± 40 minutes; laparoscopy: 107 ± 47 minutes). There were no significant temporal differences in vital parameters, CBC, plasma fibrinogen concentration, serum amyloid A concentration, peritoneal nucleated cell count, and total protein concentration between groups.

Conclusions

Bilateral ovariectomy by transvaginal NOTES or laparoscopy resulted in minimal inflammation and surgical trauma.

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