Electrosurgery as the sole means of haemostasis during the laparoscopic removal of pathologically enlarged ovaries in mares: a report of 55 cases.
BACKGROUND
There is little published clinical evidence on the use of a laparoscopic approach for the removal of pathologically enlarged ovaries in standing mares.


OBJECTIVE
To show the orders of success and complication rates that can be expected if pathologically enlarged ovaries are removed from standing, sedated mares under laparoscopic guidance using only electrosurgical means of haemostasis.


METHODS
A retrospective analysis was made of 55 mares in which the removal of an enlarged ovary was attempted by applying a standard laparoscopic procedure for routine ovariectomy in standing mares including a reliance solely on one of 2 types of electrosurgical bipolar forceps with an integrated guillotine for haemostasis and transection of the ovarian pedicle. The outcomes and complications encountered were recorded. Logistic regression analysis was performed to identify the risk of any complications associated with the size of the ovary removed and the instrument used.


RESULTS
In 54 of the 55 mares, the surgery was successfully accomplished by the planned approach. In one mare there was significant intraoperative haemorrhage and this necessitated the additional use of a prosthetic haemostatic device. The only other complications encountered were post operative abdominal discomfort (n = 9), delayed incisional wound healing (n = 6) and iatrogenic uterine puncture (n = 2). One mare developed a rectal tear, but not as a direct complication of the surgical procedure. None of these prevented a long-term successful outcome.


CONCLUSIONS
The removal of pathologically enlarged ovaries (up to 30 cm diameter) from mares under standing sedation can be accomplished predictably and safely by applying the standard laparoscopic approach that is established for routine laparoscopic ovariectomy, including a reliance solely on endoscopic electrosurgery instruments for haemostasis of the ovarian pedicle.


CONCLUSIONS
This study shows that the simple standing laparoscopic technique now favoured for routine ovariectomy can be used safely and reliably for the removal of pathologically enlarged ovaries. This promises to be of significant clinical advantage to mares so affected.
Lloyd
D
D
The Liphook Equine Hospital, Forest Mere, Liphook, Hampshire GU30 7JG.
Walmsley
J P
JP
Greet
T R C
TR
Payne
R J
RJ
Newton
J R
JR
Phillips
T J
TJ
D000818:Animals; D016292:Procedural Sedation / Q000379:methods / Q000662:veterinary*; D004598:Electrosurgery / Q000379:methods / Q000662:veterinary*; D005260:Female; D006706:Homeostasis / Q000502:physiology*; D006736:Horses / Q000601:surgery*; D007431:Intraoperative Complications / Q000453:epidemiology / Q000662:veterinary; D016015:Logistic Models; D010052:Ovariectomy / Q000379:methods / Q000662:veterinary*; D010053:Ovary / Q000473:pathology / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology / Q000662:veterinary; D012189:Retrospective Studies; D016896:Treatment Outcome