Clinical Techniques
A Review of Equine Standing Laparoscopic Ovariectomy

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Introduction

Equine ovariectomies are performed for various reasons. The most common indications are to prepare a mount mare for semen collection, eliminate estrus behavior and colic signs associated with estrus,1, 2 sterilize the mare for registration purposes, and to prepare recipient mares for embryo transfer.2 Other reasons are associated with removing pathologically abnormal ovaries in the form of granulosa−theca cell tumors.2 Regardless of the reasons for performing the surgery, it has developed into a regularly requested procedure.

Different surgical approaches and amputation techniques have been developed to remove equine ovaries. Horses can be operated on while in a standing or dorsally recumbent position. The standing technique can be performed using sedation and local anesthesia,3 whereas dorsally recumbent procedures require administration of general anesthesia.2 General anesthesia has been shown to cause hypoxemia and hypoventilation that may necessitate a ventilator.1 The surgery can be done as a ventral midline celiotomy, flank laparotomy, or colpotomy.1, 2 Colpotomy complications include unidentified and potentially fatal hemorrhage of the mesovarium caused by poor hemostasis, intestinal and mesenteric trauma, peritonitis, adhesions, and possibly death.2 The flank approach is favorable because visibility is improved, but it is still difficult to exteriorize the ovary without making large incisions.2 Consequently, standing laparoscopic ovariectomy has become a more common technique to remove ovaries in mares.

Advantages of laparoscopic techniques include the reduction of complications through full observation of the operative field, minimal invasiveness, a shortened convalescent time with fewer postsurgical complications,1, 2 and improved cosmetics after surgery.1 It also allows for tension-free ligation of vessels in the mesovarium.2 Concerns and limitations associated with laparoscopic techniques include the necessity and cost of specialized equipment, technical difficulty of the procedures and required training to conduct them, and the fact that a lack of familiarity with procedures can dramatically increase operating time.2, 3

Performing laparoscopy in standing horses adds the advantage of avoiding the risk and expense of general anesthesia while providing easier access to the ovaries because of the location of the reproductive anatomy.3 Limitations of standing procedures include horses with unsuitable temperaments for standing sedation surgery, the size of the horse, and the availability of appropriate facilities for restraint.3

Section snippets

Patient Preparation

Feed but not water is withheld from the horses for 18 to 24 hours to reduce bulk in the peritoneal cavity and improve the working space. The use of prophylactic antibiotics is left to the surgeon's discretion; however, at most only perioperative antibiotics should be used. Preoperative nonsteroidal anti-inflammatory drugs should be given to reduce pain and inflammation associated with surgery. The horses are sedated, a catheter is placed, and surgical sedation can be obtained with intravenous

Conclusions

The primary advantages of standing laparoscopic surgeries are excellent intraoperative visibility, secure hemostasis, reduced surgical and postoperative morbidity, decreased postoperative discomfort, rapid and uncomplicated healing, reduced quantity of medication needed, shorter postoperative management, and less expense than for ovariectomies performed under general anesthesia.3

There have been few reported significant complications associated with standing laparoscopic ovariectomy. Choosing

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