What is laparoscopy?

Laparoscopy is a minimally invasive technique for performing certain types of abdominal surgery. Generally 2-3 small keyhole incisions are made into the abdomen and a specialized camera and instruments are used to visualize the organs and perform surgery. The advantages of laparoscopic surgery include: less pain for our patients, less bleeding, better visualization of the abdominal organs due to clear, bright, magnified images provided by the camera, and faster patient recovery.

What types of surgery can be performed laparoscopically at Arcata Animal Hospital?

At Arcata Animal Hospital, we currently offer canine L-OVE spays (laparoscopic ovariectomies), laparoscopic assisted gastropexies, laparoscopic liver and pancreatic biopsies, and laparoscopic surgery for intra-abdominal cryptorchid canine neuters.

Canine L-OVE Spay: Laparoscopic Ovariectomy

L-OVE stands for Laparoscopic Ovariectomy. This is a spay wherein the ovaries are removed laparoscopically. It is a less painful alternative to a traditional spay. This surgery is done through two keyhole incisions into the abdominal cavity and a specialized camera is used to magnify and clearly visualize the ovaries. With this precise visualization, the ovaries are then isolated and the ligament that attaches the ovary to the body wall along with the blood vessels supplying the ovary are sealed and cut with a highly specialized instrument. The attachments of the ovaries to the uterus are sealed and cut in the same manner. Due to less stretching and trauma to the supporting ligaments and vessels, there is less pain and less bleeding. Patients generally return to regular activities (except for swimming and bathing) in 2 days.

A traditional spay has a single, larger incision versus the two small incisions for a L-OVE spay. Regardless of the size of the incision, the incisions still take 10 -14 days to heal. However, a patient can return to regular activities (other than swimming or bathing) more quickly with a L-OVE spay compared to a traditional spay because the incisions are much smaller and do not carry the same risk of opening as does a traditional spay incision.

The other difference is the degree of pain felt by the patient. With a traditional spay, the ovaries are either stretched very tightly as they are pulled away from the body wall, or the attachment is broken and torn from the body as the ovaries are lifted out of the abdomen to where the surgeon can see them. The attachment is very close to the diaphragm and there a lot of nerves in this area, the resulting trauma creates a great deal of pain and increased risk of bleeding. A L-OVE spay does not require so much tension on the attachments to the body wall, the attachment is not manually broken. Sealing and cutting the vessels with the specialized vessel sealer is done quickly with minimal tension on the ligament and no trauma to the body wall attachments. Also, due to clear, magnified visualization of the ovaries with a L-OVE Spay, there is a significantly reduced chance of leaving any ovarian tissue behind compared to a traditional spay.

With a L-OVE Spay, the uterus is left intact, hence the name laparoscopic ovariectomy vs ovariohysterectomy. Ovariectomies are how dogs and cats are normally spayed in Europe and other countries. This is becoming more common in the United States. It is relatively common in animal shelters and is becoming more common in general practices. Technically, there is no medical reason to remove a healthy uterus in a dog. Even with traditional spays, a portion of the uterus is usually left behind, it is generally not completely removed. Most veterinarians were trained to remove the ovaries and uterus and have become accustomed to performing spays this way. It is fine to do, just not necessary. With time, most veterinarians become very skilled at quickly removing the uterus, and as it is what they are used to doing, they generally do not alter their way of doing traditional spays.

The actual skin incisions take 10-14 days to heal, the same as a traditional spay. For this reason, a patient should not go swimming or be bathed until after 10-14 days. However, because the incisions in the body wall are so small, most patients can resume other regular activities in 2-3 days.

Other than swimming and bathing, a dog can return to regular activities 2-3 days after surgery. This is one reason why L-OVE spays are preferred by people who have working dogs.

The uterus is left in place when a L-OVE Spay is performed because there is no medical reason to remove a healthy uterus. This is not a problem for a dog. A dog that has a L-OVE Spay or even a dog that has an ovariectomy performed as a traditional open abdominal surgery does not have an increased risk of pyometra compared to a dog spayed with a traditional spay. In order for a pyometra to develop, functioning ovarian tissue (ovarian tissue secreting hormones) must be present. If the ovaries are completely removed, there is no tissue to produce hormones, hence no risk of pyometra. Whether a dog has a L-OVE Spay or traditional spay, if the ovaries are not completely removed and any functioning ovarian tissue is left behind, there is a risk of developing a pyometra (L-OVE Spay) or stump pyometra (traditional spay). Due to the high magnification and better visualization of the ovaries with a L-OVE Spay, the risk of leaving any ovarian tissue behind is much less than with a traditional spay.

At Arcata Animal Hospital, patient safety before, during and after any anesthetic procedure is a critical priority. Anesthetic complications are rare, but not non-existent. In general, the anesthetic complications associated with a L-OVE spay are the same as with a traditional spay. A full medical history is obtained, a full physical exam is performed and a complete blood panel is done prior to a L-OVE Spay to ensure our patients are healthy surgical candidates and to further reduce the risk of an anesthetic complication.

However, insufflation of the abdomen with the CO2 gas to allow visualization of the abdominal organs has potential complications if a patient has a heart condition or an unknown diaphragmatic hernia. We diligently monitor our patient’s vital parameters during anesthesia to be alert to any possible complication in this area. Another possible complication would be unexpected bleeding, which is actually a much higher risk with a traditional spay vs a L-OVE Spay.

Cancer of the uterus is a rare cancer in dogs. The published rate of uterine cancer in dogs indicates that about 0.03% of all cancers seen in dogs are uterine cancer, most of these cancers are benign. The overall chance of developing a malignant uterine tumor is 0.003%. In general, it is thought that many uterine cancers are related to reproductive hormones, so if the spay is done at a younger age versus an older age, the risk is even less. Of course now we realize that these hormones also play an important role in canine development in other areas and we do recommend waiting until physical maturity if possible before having the spay done. The rates of uterine cancer in dogs in Europe where ovariectomy is standard have not been found to be any higher in dogs compared to other countries.

A conversion is when a laparoscopic spay has to be converted to a traditional open spay. This may happen in the event of visible uterine pathology, necessitating the removal of the uterus, or if a dog is found to be pregnant upon visualization of the uterus, encountering unexpected bleeding (very rare), or if abdominal adhesions from previous abdominal surgeries are noted and it is not possible to visualize the ovaries and uterus.

Canine L-OVE Spay: Laparoscopic Ovariectomy

L-OVE stands for Laparoscopic Ovariectomy. This is a spay wherein the ovaries are removed laparoscopically. It is a less painful alternative to a traditional spay. This surgery is done through two keyhole incisions into the abdominal cavity and a specialized camera is used to magnify and clearly visualize the ovaries. With this precise visualization, the ovaries are then isolated and the ligament that attaches the ovary to the body wall along with the blood vessels supplying the ovary are sealed and cut with a highly specialized instrument. The attachments of the ovaries to the uterus are sealed and cut in the same manner. Due to less stretching and trauma to the supporting ligaments and vessels, there is less pain and less bleeding. Patients generally return to regular activities (except for swimming and bathing) in 2 days.

A traditional spay has a single, larger incision versus the two small incisions for a L-OVE spay. Regardless of the size of the incision, the incisions still take 10 -14 days to heal. However, a patient can return to regular activities (other than swimming or bathing) more quickly with a L-OVE spay compared to a traditional spay because the incisions are much smaller and do not carry the same risk of opening as does a traditional spay incision.

The other difference is the degree of pain felt by the patient. With a traditional spay, the ovaries are either stretched very tightly as they are pulled away from the body wall, or the attachment is broken and torn from the body as the ovaries are lifted out of the abdomen to where the surgeon can see them. The attachment is very close to the diaphragm and there a lot of nerves in this area, the resulting trauma creates a great deal of pain and increased risk of bleeding. A L-OVE spay does not require so much tension on the attachments to the body wall, the attachment is not manually broken. Sealing and cutting the vessels with the specialized vessel sealer is done quickly with minimal tension on the ligament and no trauma to the body wall attachments. Also, due to clear, magnified visualization of the ovaries with a L-OVE Spay, there is a significantly reduced chance of leaving any ovarian tissue behind compared to a traditional spay.

With a L-OVE Spay, the uterus is left intact, hence the name laparoscopic ovariectomy vs ovariohysterectomy. Ovariectomies are how dogs and cats are normally spayed in Europe and other countries. This is becoming more common in the United States. It is relatively common in animal shelters and is becoming more common in general practices. Technically, there is no medical reason to remove a healthy uterus in a dog. Even with traditional spays, a portion of the uterus is usually left behind, it is generally not completely removed. Most veterinarians were trained to remove the ovaries and uterus and have become accustomed to performing spays this way. It is fine to do, just not necessary. With time, most veterinarians become very skilled at quickly removing the uterus, and as it is what they are used to doing, they generally do not alter their way of doing traditional spays.

The actual skin incisions take 10-14 days to heal, the same as a traditional spay. For this reason, a patient should not go swimming or be bathed until after 10-14 days. However, because the incisions in the body wall are so small, most patients can resume other regular activities in 2-3 days.

Other than swimming and bathing, a dog can return to regular activities 2-3 days after surgery. This is one reason why L-OVE spays are preferred by people who have working dogs.

The uterus is left in place when a L-OVE Spay is performed because there is no medical reason to remove a healthy uterus. This is not a problem for a dog. A dog that has a L-OVE Spay or even a dog that has an ovariectomy performed as a traditional open abdominal surgery does not have an increased risk of pyometra compared to a dog spayed with a traditional spay. In order for a pyometra to develop, functioning ovarian tissue (ovarian tissue secreting hormones) must be present. If the ovaries are completely removed, there is no tissue to produce hormones, hence no risk of pyometra. Whether a dog has a L-OVE Spay or traditional spay, if the ovaries are not completely removed and any functioning ovarian tissue is left behind, there is a risk of developing a pyometra (L-OVE Spay) or stump pyometra (traditional spay). Due to the high magnification and better visualization of the ovaries with a L-OVE Spay, the risk of leaving any ovarian tissue behind is much less than with a traditional spay.

At Arcata Animal Hospital, patient safety before, during and after any anesthetic procedure is a critical priority. Anesthetic complications are rare, but not non-existent. In general, the anesthetic complications associated with a L-OVE spay are the same as with a traditional spay. A full medical history is obtained, a full physical exam is performed and a complete blood panel is done prior to a L-OVE Spay to ensure our patients are healthy surgical candidates and to further reduce the risk of an anesthetic complication.

However, insufflation of the abdomen with the CO2 gas to allow visualization of the abdominal organs has potential complications if a patient has a heart condition or an unknown diaphragmatic hernia. We diligently monitor our patient’s vital parameters during anesthesia to be alert to any possible complication in this area. Another possible complication would be unexpected bleeding, which is actually a much higher risk with a traditional spay vs a L-OVE Spay.

Cancer of the uterus is a rare cancer in dogs. The published rate of uterine cancer in dogs indicates that about 0.03% of all cancers seen in dogs are uterine cancer, most of these cancers are benign. The overall chance of developing a malignant uterine tumor is 0.003%. In general, it is thought that many uterine cancers are related to reproductive hormones, so if the spay is done at a younger age versus an older age, the risk is even less. Of course now we realize that these hormones also play an important role in canine development in other areas and we do recommend waiting until physical maturity if possible before having the spay done. The rates of uterine cancer in dogs in Europe where ovariectomy is standard have not been found to be any higher in dogs compared to other countries.

A conversion is when a laparoscopic spay has to be converted to a traditional open spay. This may happen in the event of visible uterine pathology, necessitating the removal of the uterus, or if a dog is found to be pregnant upon visualization of the uterus, encountering unexpected bleeding (very rare), or if abdominal adhesions from previous abdominal surgeries are noted and it is not possible to visualize the ovaries and uterus.