Giuseppe Catone. Italia.

 

Istituto di Ostetricia e Ginecologia Veterinaria, Via S. Cecilia 30, 98123-Messina

Email: gcatone@www.unime.it

 

SUMMARY

The Authors describe a laparoscopic ovariohysterectomy method in the cat which allows the genital system to be left in situ. The procedure involves application of pneumoperitoneum, insertion of one trocar and use of a laparoscope equipped with an operating telescope, a grasping forceps and scissors. Once the uterine horns and ovaries are "mobilised" by electro-coagulation, they are left in situ. In the follow-up check at 12 months after surgery, using both laparotomy and laparoscopy, the Authors noticed the complete "disappearance" of the organ previously left in situ. This fact must be considered important as it could open up new horizons for the concept of miniinvasiveness.

Key words: Laparoscopy – ovariohysterectomy – cat.

 

RESUMEN

Los autores describen un metodo de ovario-isterectomia por vía laparoscópica en la gata , que permite que el aparato genital permanezca "in situ".

El procedimiento incluye la aplicación del neumoperitoneo , la introducción de un trocar y

el empleo de un laparoscópio equipado de un telescópio operativo, de una pinza de aprehensión y de una tijera.

Una vez conseguida la movilisación del utero y de los ovarios , por medio de la electro-coagulación, estos permanecen "in situ".

En las prueba siguiente, doce meses después de la intervención quirúrgica , utilizando a la vez laparotomía y laparoscopia, los Autores notan la completa desaparición del organo, que antes había permanecido in situ.

El hecho puede considerarse muy importante porqué puede abrir nuevos horizontes para el concepto de miniinvasividad .

Palabras clave: laparoscópia - ovario-isterectomia - gata

 

INTRODUCTION

In recent years, laparoscopic surgery has become so widespread as to be one of the most popular methods among surgeons for birth-control in the bitch and cat and several new methods have been proposed by different authors. Among these are: electrocoagulation of the cat oviduct (Wildt e Lawder, 1985; Moriconi et al, 1989; Catone e Zanghì, 1990) which is a simple technique, but not routinely usable because owners are ever more frequently requesting the interruption of manifestations of oestrus; ovariohysterectomy, used only in the bitch (Remedios, 1997; Freeman and Hendrickson, 1999) and ovariectomy (Usòn et al., 1992; Thiele et al., 1993; Guevar, 1997; Quaranta et al., 1997; Muttini et al., 1997). The latter, a rather invasive and destructive technique does not unfortunately eliminate the risk of uterine infections (Arthur et al., 1996), although this risk seems restricted only to animals treated with progestins (Okkens et al., 1997).

With the aim of finding methods which offer less invasive and more reliable contraception, the Authors developed a laparoscopic ovariohysterectomy method in the cat which allows the genital system to be left in situ.

This technique originated from similar methods used in the horse (Hendrickson e Wilson, 1996; Wiemer, 1998) and in the dog (Nudelmann et al., 1998).

 

MATERIALS AN METHODS

The operation was performed on ten cats aged between 6 months and 3 years. After general anaesthesia the animals were placed in dorsal recumbency.

After preparing the surgery field and inflating the abdomen, a 10mm trocar was inserted through a small incision in the skin and subcutis between the xiphoid and the umbilical scar.

For a better view of the ovary and uterine horn it is better to turn the animal to dorsal-lateral recumbency.

After inserting the operative laparoscope with its 4mm forceps, the surgeon will localise the right ovary with its vein and artery, which will be clamped, raised and electrocoagulated (Fig. 2,3). The thermic diffusion will also involve the ovary. The cauterised segment will be slightly distended so as to detach it.

 

Then, the suspensory ligament of the ovary and the large ligament of the right uterine horn will be coagulated and resected (Fig. 4,5). Once the uterine horn has been "mobilised", the uterine body will be electrocoagulated, taking care not to involve the colon or the urinary bladder, which must always be empty. Because of the thickness of the wall, the uterine body will at first, be gradually coagulated with the forceps until the typical white colour, which confirms that coagulation has taken place, appears.

The uterine body will be now cut using scissors (fig. 6,7). The same method will be applied to the left ovary and uterine horn. The genital tract will be left in situ.

After pulling out the Verres’ needle and verifying the absence of severe haemorrhages, the abdominal inflation will be gradually reduced and thr trocar will be pulled out. The abdominal wall and the skin will be closed with a single "X" knot.

Total surgery time is about 30 minutes.

 

RESULTS AND CONCLUSIONS

On the basis of the follow-up checks the technique described seemed to be simple and risk-free when following the indications of Usòn et al. (1996), its application needed considerable training time, with practice of the technique on cadavers.

In the follow-up check 12 months after surgery, using both laparotomy and laparoscopy, the authors noticed the complete "disappearance" of the organ previously left in situ (Fig. 8,9). This fact must be considered important as it could open up new horizons for the concept of miniinvasiveness.

In our opinion, this technique is really miniinvasive considering that during a laparoscopic ovariectomy, two or more trocars will be used (Thiele et al., 1992; Usòn, 1992; Quaranta et al., 1997).

Despite the technological efforts and the enthusiasm aroused, we must not forget that laparoscopic surgery is used with the intention of reducing invasiveness on the patient and so must be seen not as an end but as a means. This must always be borne in mind.

 

BIBLIOGRAPHY

• Arthur GH, Noakes DE, Pearson H, Parkinson TJ. In: Veterinary Reproduction and obstetrics" Saunders Company, London, 1996.

• Catone G, Zanghì A. La elettrocoagulazione laparoscopica della salpinge della gatta a fini aniconcezionali: studio delle lesioni procurate. Atti SISvet 1990; 44: 557-560.

• Freeman LJ, Hendrickson DA. Minimally invasive surgery of the reproductive system. In: Freeman LJ: Veterinay endosurgery. Mosby, St. Louis, 205-207; 1999.

• Guevar P. Technique d’ovariectomie chez la chienne par utilization de clips metalliquès. Pract Med Chir Anim Comp 1997; 32: 503-506.

• Hendrickson DA, Wilson DG. Instrumentation and techniques for laparoscopic and thoracoscopic surgery in the horse. Vet Clin North Am Equine Pract 1996; 12: 235-259.

• Moriconi F, Di Meo A, Bellezze E, Bellucci M. Sterilizzazione per via laparoscopica nel cane e nel gatto. ODV 1989; 10: 13-16.
• Muttini A, Petrizzi L, Carluccio A, Bucci Sabattini G. Ovariectomia laparoscopica nella cavalla. Atti SISvet 1997; 51: 191-192.

• Nudelmann N, Boulouha l, Rousseau A, Siliart B. Testicular degeneration by devascularization: practical surgical application in the dog. Rec Méd Vet 1998; 174: 133-139.

• Okkens AC, Kooistra HS, Nickel RF. J Reprod Fert Suppl 1997; 51: 251-257.

• Quaranta G, Bianco S, Vincenti L, Starvaggi Cucuzza A. Ovariectomia nella gatta con tecnica di videolaparochirurgica. Atti SISvet 1997; 51: 197-198.

• Remedios AM. Laparoscopic versus open ovariohysterectomy in dogs: a comparasion of postoperative pain and morbidity. Vet Surg 1997; 26: 425.

• Thiele S, Kelch G, Gerlach K. Kastration der hundin durch laparoskopische ovarektomie. Kleintierpraxis 1993; 38: 463-466.

• Usòn J, Tejedo V, Vives MA, Ezquera LJ, Uson JM. Therapeutique laparoscopique: l’ovariectomie et la legature des cornes uterines chez la chienne. Rec Méd Vet 1992; 168: 237-241.

• Usòn J, Rioja C, Climent S. In: Formaciòn en cirugía laparoscópica" Ed. Centro de Cirugía de minima invasiòn. Madrid, 33-43; 1996.

• Wiemer P. Evaluation of the spermatic cord ligation as castration technique in the horse – Surgical castration by which testicle left in-place. Tijdschrift Voor Diergeneeskunde, 1998; 123: 432-434.

• Wildt DE, Lawder DF. Laparoscopic sterilization of the bitch and queen by uterine horn occlusion. Am J Vet Res 1985; 46: 864-869.

 

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