title: Standing ovariectomy in mares using a transvaginal natural orifice transluminal endoscopic surgery (NOTES®) approach.
abstract: OBJECTIVE
  To develop and assess the feasibility of standing transvaginal Natural Orifice Transluminal Endoscopic Surgery (NOTES®) ovariectomy in the mare.
  
  
  METHODS
  Descriptive study.
  
  
  METHODS
  Mares (n=10).
  
  
  METHODS
  The technique was developed in 6 mares and then evaluated in a short-term study in 4 mares. Abdominal access was developed using controlled access vaginal cannula placement under endoscopic guidance. With viewing provided by a flexible endoscope, hemostasis, and transection of ovarian pedicles was performed using a customized bipolar vessel-sealing device. The ovaries were retrieved and the colpotomy was sutured. Surgical time, intra-, and postoperative complications were recorded. Necropsy was performed immediately after surgery in 6 mares and 15 days after surgery in 4 mares to assess short-term complications.
  
  
  RESULTS
  After the instruments and techniques were developed, transvaginal NOTES® ovariectomy was successfully performed. Analgesia during the procedure was adequate in all cases. The visual field provided by the endoscope was acceptable. The customized 60 cm vessel-sealing device provided good hemostasis and a comfortable working length. Intraoperative complications included difficult viewing that prolonged operative time and inability to remove the second ovary in 1 mare. Postoperative recovery was excellent. Postmortem findings of 1 true positive microbial culture, elevated cell counts in abdominal fluid, and adhesion formation raise questions that must be addressed in future studies.
  
  
  CONCLUSIONS
  Using specialized instruments, transvaginal NOTES® ovariectomy is technically feasible in mares.
authors: Department of Veterinary Clinical Sciences, School of Veterinary Medicine, Purdue University, West Lafayette, IN 47907, USA.
authors: Karine
authors: K
authors: Pader
authors: Timothy B
authors: TB
authors: Lescun
authors: Lynetta J
authors: LJ
authors: Freeman
mesh_terms: D000818:Animals; D017558:Elective Surgical Procedures / Q000379:methods / Q000662:veterinary; D005240:Feasibility Studies; D005260:Female; D006736:Horses / Q000601:surgery*; D007431:Intraoperative Complications / Q000662:veterinary; D057605:Natural Orifice Endoscopic Surgery / Q000379:methods / Q000662:veterinary*; D010052:Ovariectomy / Q000379:methods / Q000662:veterinary*; D011183:Postoperative Complications / Q000662:veterinary