Laparoscopy, or minimally-invasive surgery, is a way to explore the organs of your pet’s abdomen using only tiny key-hole incisions. Using these incisions (generally 3/16”), we can insert a camera and our surgical instruments to perform surgery. Laparoscopy is a safer method of surgery because everything that is done is under direct magnified visualization. Organs, such as your pet’s ovaries, do not need to be pulled out of the body to allow the surgery to be performed so there is less trauma to the internal structures of your pet’s abdomen. Recent studies have shown the use of laparoscopy to be a less traumatic and less painful alternative to traditional procedures, such as a spay.
With traditional spays, a 1-4” incision is made in the abdominal wall. The ovaries are then blindly hooked and the ovarian ligament is torn from the body wall. This tearing causes pain and can cause bruising. In traditional spays, most vets also unnecessarily remove the uterus. Due to the location of the uterus and the attempt to minimize the surgical incision, significant tension is placed on the body of the uterus which may cause trauma and bleeding.
A LOVE spay is short for a Laparoscopic OVE (ovariectomy). This is a minimally-invasive spay that removes the ovaries from healthy dogs and has been shown to be a less painful alternative to traditional spays. With this technique, 2 small keyhole incisions are made in to the abdomen and our laparoscopic equipment is used to perform the surgery. The ovarian ligament is not torn from the body, but carefully cut and cauterized with virtually no bleeding or pain. No tension is placed on the uterus (which is not removed). Because of the enhanced visualization, there is less of a chance of leaving ovarian tissue behind. Laparoscopic spays have been shown to offer 65% less pain than traditional spays which means a faster recovery and less trauma to their body. Activity restriction is only recommended for the first 2-3 days after a LOVE spay versus 7-14 days for a traditional spay.
Laparoscopy is also a less invasive alternative for a preventative gastropexy. This surgery is the only proven method for preventing Gastric Dilatation-Volvulus, or GDV, which is common in deep chested dogs such as Great Danes, German Shephards, Irish Setters, Bernese Mountain Dogs, Saint Bernards, Weimaraners, and Boxers, to name a few. This is a rapidly fatal condition where the stomach flips over on itself and compromises the blood flow to the stomach and heart. If not corrected quickly, your pet can die within a few hours. A preventative gastropexy anchors the stomach to the body wall which will prevent the torsion. Normally this surgery requires a long incision of at least 8-12 inches but with the laparoscope-assisted surgery the incision is less than 2 inches.
Laparoscopy is also a less invasive alternative for a cryptorchid neuter. A cryptorchid male is an animal whose testicles (one or both) have not descended in to the scrotum. Watch our blog post on the subject to see what this looks like internally. Finding these testicles in the abdomen can be difficult and requires a large incision to safely perform the incision. Laparoscopy is an ideal manner to find these “hidden” testicles because it affords great visualization and magnification of the internal organs without the need for a large incision.
Coastal Animal Hospital is one of the few hospitals in San Diego and Southern California area to offer laparoscopic surgery. Minimally invasive surgery techniques results in safer, visual surgery, with less pain, and excellent outcomes.
Q: Will my pet need a Elizabethan collar (E-collar, cone of shame, lampshade, etc) after the procedure?
A: Yes, even though the incisions are tiny, it is still an incision. If your pet licks at this small incision it could still become infected and require at minimum antibiotics and at worst a second surgery. However, we find that pets are generally less interested in these incisions (most likely due to the reduced pain) than the larger incisions from traditional spays. All incisions – regardless of their size, require a minimum of 7 days to heal, so plan on having your pet wear the cone for a minimum of 7 days.
Q: How long do I need to keep my crazy dog confined after surgery??
A: This is one of the biggest benefits of a LOVE spay. We only recommend 2-3 days of activity restriction after a LOVE spay versus 7-14 days with a traditional spay. The risk of a complication such as a hernia is very low and if it does occur, would not be a life threatening emergency like a hernia could be with a traditional spay. NOTE: Your pet cannot go swimming for 7-14 days. The skin needs to heal to prevent the surgical site from getting infected from potentially contaminated water.
Q: Is it dangerous to not remove the uterus? Why does my vet remove the uterus?
A: Traditionally in the United States, veterinarians have removed both the ovaries and the uterus when performing a spay. However, there is no real benefit in removing the uterus of a young, otherwise healthy animal. The initial justification came from a belief that it would prevent gynecological problems later in the dog’s life. Many papers have since been published debunking this rationale backed up by data from our European counterparts who only remove the ovaries. We are hoping that even if your veterinarian doesn’t perform laparoscopic spays, that they will start at the very least to perform ovariectomies which are associated with less pain, less complications, and is a faster surgery. See the following article for more details: VAN GOETHEM, B., SCHAEFERS-OKKENS, A. and KIRPENSTEIJN, J. (2006), Making a Rational Choice Between Ovariectomy and Ovariohysterectomy in the Dog: A Discussion of the Benefits of Either Technique. Veterinary Surgery, 35: 136–143.
Q: Can my dog develop pyometra (uterine infection) if you don’t remove the uterus?
A: Pyometra is a hormonally driven process and is an abnormal uterine response to repeated exposure of the hormone called progesterone. If the ovaries of your dog are removed, then pyometra is highly unlikely because the source of progesterone has been removed.
Q: Can my dog develop uterine cancer?
A: Uterine cancer in dogs is not common. The incidence of uterine cancer is 0.03% of all cancers found in dogs. However, most of these uterine cancers are benign tumors and only 10% of these tumors are malignant (spread to other organs). So overall, your dog has a 0.003% chance of developing a malignant uterine tumor. To look at the equation on the other side, there is a much higher rate of complications, including fatal complications, from the process of removing the uterus during a spay (see the paper cited above). Also, these cancers are thought to be hormonally-driven, so by removing the ovaries at a young age, the likelihood of developing uterine cancer is even more remote.
Q: Do you perform laparoscopic spays on cats?
A: While it is possible to perform laparoscopic spays on cats, we do not recommend it. We are still technically performing a “minimally-invasive” surgery on cats – we just don’t need the fancy camera equipment to do it. The incision we normally make to spay a cat is the same size as 1 of the 2 incisions needed for a laparoscopic approach. The ligaments of the cat ovaries are also under a lot less tension, so we don’t have to stretch and tear as much as we do with dogs, and thus the pain is less with cats. We still only remove the ovaries (ovariectomy) as removing the ovaries and uterus (ovarihysterectomy) of a young, otherwise healthy animal has not shown to provide any benefit. So, by making 1 tiny keyhole incision and removing only the ovaries, our spay procedure for cats is “minimally-invasive”.
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