title: Effect of portal access system and surgery type on surgery times during laparoscopic ovariectomy and salpingectomy in captive African lions and cheetahs.
abstract: BACKGROUND
  A prospective randomized study was used to compare surgery times for laparoscopic ovariectomy and salpingectomy in female African lion (Panthera leo) (n = 14) and cheetah (Acinonyx jubatus) (n = 20) and to compare the use of a multiple portal access system (MPAS) and single portal access system (SPAS) between groups. Two different portal techniques were used, namely MPAS (three separate ports) in lions and SPAS (SILS™ port) in cheetahs, using standard straight laparoscopic instruments. Portal access system and first ovary was not randomized. Five different surgery times were compared for the two different procedures as well as evaluating the use and application of MPAS and SPAS. Carbon dioxide volumes for lions were recorded.
  
  
  RESULTS
  In adult lionesses operative time (OPT) (P = 0.016) and total surgical time (TST) (P = 0.032) were significantly shorter for salpingectomy compared to ovariectomy. Similarly in cheetahs OPT (P = 0.001) and TST (P = 0.005) were also shorter for salpingectomy compared to ovariectomy. In contrast, in lion cubs no difference was found in surgery times for ovariectomy and salpingectomy. Total unilateral procedure time was shorter than the respective bilateral time for both procedures (P = 0.019 and P = 0.001) respectively and unilateral salpingectomy was also faster than unilateral ovariectomy (P = 0.035) in cheetahs. Port placement time, suturing time and TST were significantly shorter for SPAS compared to MPAS (P = 0.008). There was, however, no difference in OPT between SPAS and MPAS. Instrument cluttering with SPAS was found to be negligible. There was no difference in mean volume CO2 required to complete ovariectomy in lions but the correlation between bodyweight and total volume of CO2 in lions was significant (rs = 0.867; P = 0.002).
  
  
  CONCLUSIONS
  Laparoscopic salpingectomy was faster than ovariectomy in both adult lions and cheetahs. Using SPAS, both unilateral procedures were faster than bilateral procedures in cheetahs. Placement and suturing of SPAS in cheetahs was easier and faster compared to three separate ports in lions and lion cubs. The use of standard straight instruments during SPAS did not prolong surgery. Surgery was faster in cubs and CO2 required for laparoscopic sterilization in lions could be determined. Predictable surgery times and CO2 volumes will facilitate the accurate planning and execution of surgery in lions and cheetahs.
authors.affiliation: Department of Companion Animal Clinical Studies, Faculty of Veterinary Science, University of Pretoria, Private Bag X04, Onderstepoort, Pretoria, South Africa. marthinus.hartman@up.ac.za.
authors.forename: Marthinus Jacobus
authors.initials: MJ
authors.lastname: Hartman
authors.affiliation: Department of Clinical Sciences, Colorado State University, Fort Collins, CO, USA. emonnet@me.com.
authors.forename: Eric
authors.initials: E
authors.lastname: Monnet
authors.affiliation: Department of Companion Animal Clinical Studies, Faculty of Veterinary Science, University of Pretoria, Private Bag X04, Onderstepoort, Pretoria, South Africa. robert.kirberger@up.ac.za.
authors.forename: Robert Murco
authors.initials: RM
authors.lastname: Kirberger
authors.affiliation: Department of Companion Animal Clinical Studies, Faculty of Veterinary Science, University of Pretoria, Private Bag X04, Onderstepoort, Pretoria, South Africa. johan.schoeman@up.ac.za.
authors.forename: Johan Petrus
authors.initials: JP
authors.lastname: Schoeman
mesh_terms: D002612:Acinonyx / Q000601:surgery*; D000818:Animals; D000836:Animals, Zoo / Q000601:surgery*; D005260:Female; D010535:Laparoscopy / Q000592:standards / Q000662:veterinary*; D008045:Lions / Q000601:surgery*; D010052:Ovariectomy / Q000662:veterinary*; D011446:Prospective Studies; D058994:Salpingectomy / Q000662:veterinary*; D013995:Time