Comparison of Transvaginal Natural Orifice Transluminal Endoscopic Surgery (NOTES®) and Laparoscopy for Elective Bilateral Ovariectomy in Standing Mares

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Abstract

Objective:

To compare surgical trauma, perioperative pain, surgical time, and complication rate in mares undergoing standing bilateral ovariectomy by natural orifice transluminal endoscopic surgery (NOTES) or laparoscopy.

Study Design:

Experimental study.

Animals:

Healthy mares (n = 12).

Methods:

Ovariectomy was performed with a vessel-sealing device by transvaginal NOTES (n = 6) using a flexible endoscope and specialized instruments or by bilateral flank laparoscopy (n = 6). Preoperative and postoperative complete blood count (CBC), plasma fibrinogen concentration, serum amyloid A concentration, peritoneal nucleated cell count, and total protein concentration were compared using repeated measures ANOVA. Surgical times were compared using an unpaired t-test. Mares were monitored for 2 weeks postoperatively and necropsy was performed at 3 weeks (n = 6) or 3 months (n = 6) to assess short- and medium-term effects of each procedure. Complication rate, necropsy, and bacteriology findings were compared using a Fishers exact test. Significance was set at P < .05.

Results:

All surgical procedures were performed successfully and all but one laparoscopy mare were bright, alert, and maintained a good appetite until euthanasia. Mean ± SD surgical time was similar between groups (NOTES: 100 ± 40 minutes; laparoscopy: 107 ± 47 minutes). There were no significant temporal differences in vital parameters, CBC, plasma fibrinogen concentration, serum amyloid A concentration, peritoneal nucleated cell count, and total protein concentration between groups.

Conclusions:

Bilateral ovariectomy by transvaginal NOTES or laparoscopy resulted in minimal inflammation and surgical trauma.

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