title: Comparison of transvaginal natural orifice transluminal endoscopic surgery (NOTES®) and laparoscopy for elective bilateral ovariectomy in standing mares.
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.
  
  
  METHODS
  Experimental study.
  
  
  METHODS
  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.
authors.affiliation: Department of Veterinary Clinical Sciences, School of Veterinary Medicine, Purdue University, West Lafayette, IN 47907, USA.
authors.forename: Karine
authors.initials: K
authors.lastname: Pader
authors.forename: Lynetta J
authors.initials: LJ
authors.lastname: Freeman
authors.forename: Peter D
authors.initials: PD
authors.lastname: Constable
authors.forename: Ching C
authors.initials: CC
authors.lastname: Wu
authors.forename: Paul W
authors.initials: PW
authors.lastname: Snyder
authors.forename: Timothy B
authors.initials: TB
authors.lastname: Lescun
mesh_terms: D000818:Animals; D017558:Elective Surgical Procedures / Q000379:methods / Q000662:veterinary*; D005260:Female; D006736:Horses / Q000601:surgery*; D007249:Inflammation / Q000209:etiology / Q000662:veterinary; D010535:Laparoscopy / Q000379:methods / Q000662:veterinary*; D057605:Natural Orifice Endoscopic Surgery / Q000379:methods / Q000662:veterinary*; D010052:Ovariectomy / Q000379:methods / Q000662:veterinary*; D010149:Postoperative Pain / Q000662:veterinary; D011183:Postoperative Complications / Q000662:veterinary; D013997:Time Factors