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Laparoscopic Surgery

The top seven most asked questions about the keyhole spay

The keyhole (laparoscopic) spay is a significant advancement in patient care and public and professional opinion is rapidly leaning towards the procedure.

But when we talk about the keyhole laparoscopic spay there are a number of questions that are regularly asked…

1. If you only remove the ovaries then is my dog at risk of uterine cancer?

No. There are now lifelong studies published in dogs spayed at six months old laparoscopically and followed throughout their entire lives. ZERO died from any uterine complications.

2.Can my dog still get a pyometra (womb infection)?

No. There has to be active ovarian tissue left behind for this to be a possibility.

3.So why is the uterus taken away in a traditional spay?

It’s not necessary. The uterus is removed, which is ‘what has always been done’ and taught. It doesn’t need to be. Many other countries now perform an open ovariectomy (removing the ovaries only).

4. What if you can see something wrong with the uterus?

We can remove it. The uterus can easily be removed laparoscopically too or we can easily swap to the traditional spay method.

5.What about urinary incontinence?

Undecided. The occurrence of SMI (Sphincter Mechanism Incompetence), a leaking bladder when at rest, occurs in older spayed female dogs. This is linked to the lack of oestrogen. There is some anecdotal evidence that keyhole spaying, by leaving the support structure of the uterus behind, improves the management of SMI when it happens. Research on this is ongoing.

6.To achieve keyhole surgery the abdomen is inflated with carbon dioxide – I have heard this causes pain in people?

It does not cause pain in dogs. Yes, activation of the phrenic nerve leaves shoulder pain in some people who have had keyhole surgery – but this does not happen in dogs.

7.But my vet already does ‘keyhole surgery’ open, through a tiny hole.

Whilst the small open surgical incisions experienced vets can achieve look impressive, the stretching and pulling needed to access all the anatomy through this small hole is arguably more. Studies in small dogs under 10kg, using pedometers, show significant improvement in post-operative movement in those spayed via the keyhole method.

https://msmvets.co.uk/most-asked-questions-keyhole-spay/

Keyhole (laparoscopic) surgery is developing and is offering huge post operative advantages for dogs such as less pain and quicker recovery time.

The traditional bitch spay is undergoing a change. Keyhole (laparoscopic) surgery is developing and is offering huge post operative advantages for dogs such as less pain and quicker recovery time, and owners are now seeking out this technique with increasing frequency.

Post operative pain is vastly reduced through this procedure, a fact that is backed up by studies that compared traditional, and keyhole spay post-operatively. They showed blood glucose and cortisol (indicators of stress) at significantly lower levels from 30 minutes to two days post operatively after the keyhole spay compared to the traditional spay.

Pedometers attached to dogs also show quicker return to higher movement levels, and usually we would only recommend 48 hours rest before returning to normal routine and exercise levels. In the traditional spay 14 days restricted exercise is recommended.

An ovariohysterectomy (removal of both the ovaries and uterus) is the traditional method for spaying. Within the last 15 to 20 years many researchers and practitioners have started to argue against the need for this.

A lifetime study of dogs spayed via keyhole technique has been published in the US and reveals 0% of the dogs involved had any uterine complications in their lifetime.  Without the influence of oestrogen (hormone produced by the ovaries) the uterus is dormant and does not need removing.

So what happens when your dog is admitted for a laparoscopic spay?

In many ways the process is similar to the traditional spay, all aspects of pre-surgical preparation are identical, and your pet will only need to be with us for the day.

 The main difference is the process once your pet is under anaesthetic. Two small wounds are made on the dog’s under-surface. A small amount of gas is introduced internally through the first wound, to lift the body wall away from the internal organs, creating an internal ‘tent’ effect.

 A small camera is then inserted into the patient through the same wound to see the ovaries. Surgical instruments are inserted through the second wound to remove the ovaries. In female dogs, we only remove the ovaries and leave the womb (uterus) inside.

The vessel-sealing technology used to dissect (cut) and seal the blood vessels means no internal sutures are needed and there is confidence that nothing is bleeding inside, making keyhole surgery a very safe procedure.

So is your dog a candidate for laparoscopic procedures?

Dogs undergoing a laparoscopic spay must be between 7-25kg. This is due to either the equipment we use being too big to use in dogs under 7kg or the ovaries of larger dogs being too big to remove laparoscopically.

Dogs should be of the correct body condition score, any scores over 5/9 and the surgery has increased risks (you can book in with one of our nurses to check this!)

The keyhole spay method is perfect for very active dogs who cannot keep still! Usually following the procedure, only two days restricted exercise is needed and then the dog can return to normal exercise levels. This also makes the keyhole spay perfect for working dogs that need to be back to normal as soon as possible

“Best vets in Wrexham. Always helpful and nothing is too much trouble. Friendly staff that go out of their way to not only care for your pet, but also to keep the pets carer fully informed every step of the way. They have always looked after and treated my 2 yorkies Lulu and Pebbles amazingly, they saved Lulu’s life, words can never describe how grateful I am to them. I Would recommend this veterinary practice to everyone and anyone.”

Sha Parry

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