OVARIOHYSTERECTOMY BY MEANS OF ENDOVIDEOLAPAROSCOPY IN LARGE WHITE GILTS. REPRODUCTION IN DOMESTIC ANIMALS

To the Authors knowledge this technique has not been previously reported. The aim of this study was to develop a laparoscopic technique for ovariohysterectomy (OHE) in pig for reproductive practical reasons and as a model for human and veterinary clinical use. Five gilts 4 months old weighing 25-35 kg were considered. All procedures were performed under general anaesthesia in dorsal recumbency and a neuromuscular block was induced. Traction was placed in order to lift the body wall about 4 cm away from the viscera, a Veress insufflation needle was inserted over the umbilicus and pneumoperitoneum was induced by CO2 insufflation to a pressure of 15 mmHg. In the same place a 10 mm trocar was positioned and a 10 mm laparoscope (angle 0°) connected to a 3 CCD video camera with light source was passed through (Karl Storz Endoscope® equipment). The patient was placed in Trendelenburg position. The laparoscope was used to guide the entrance of 2 trocars away from viscera, one (10 mm) paramedian to the midline on the left and one on the right (5 mm), to provide two operating channels. A grasping forceps, passed through the right cannula, was then used to lift the uterine horn and visualized ovarian vasculature. Ovarian vascular pedicle with broad uterine ligament was cauterized with a bipolar electrocautery (BEC) and transected using a hook shaped monopolar electrocautery (MEC) away from abdominal organs to prevent collateral thermal injuries. The procedure was repeated for the same left structures. The uterine body was grasped, coagulated and transected using BEC and MEC 1 cm proximal to the cervix. The “reproductive system” was then withdrawn through the left cannula. The laparoscope and the cannulas were also withdrawn and CO2 was allowed to escape. The stab incisions were sutured with Vicryl® EP 3.5. All the patients were awake and standing in half an hour. There was no need to convert to the open surgical approach in any case. The mean surgical time was 56±4 minutes. The BEC effectively sealed all vessels and tissues. No postoperative complications were observed. Three trocars allowed all procedures. This paper shows that laparoscopic OHE in the pig is feasible, safe and advisable because does not require an enlarged skin incision or extracorporeal ligation.