Laparoscopic ( Key Hole ) Surgery
Laparoscopy is the term given to the endoscopic examination of the abdominal cavity either for diagnostic or treatment purposes. In certain circumstances this ‘key-hole’ surgical technique can provide a number of advantages over conventional surgery. Laparoscopic (keyhole) surgery has become commonplace in human surgery and it is well established that it creates less trauma, less pain and allows for a much faster recovery for the patient.
Where its use is appropriate, the key-hole technique usually involves three small incisions (cuts) rather than the single large incision associated with conventional surgery. These holes then facilitate the insertion of a laparoscope and instrument ports. The abdomen is distended with carbon dioxide gas and the laparoscope is introduced to visualise the structures. Instruments are used to grasp and manipulate the tissue through the instrument ports. Blood vessels can then be ligated with a vessel-sealing device.
In general, the advantages of laparoscopic over conventional surgery include:
- Reduced pain from the surgical wounds – the pet is likely to be more comfortable post-operatively
- 3 smaller surgical wounds rather than one large one.
- Fewer stitches
- A faster return to normal activity, due to improved patient comfort and reduced scar tissue formation
Whilst we can use this type of surgery on a number of different abdominal surgical procedures, by far the most commonly performed laparoscopic surgery is the neutering of female dogs.
Laparoscopic Spaying of Pets
We are very pleased to be able to offer ’key-hole’ neutering surgery at our Sutterton Hospital site. Like conventional spays, the operation is performed on a day-patient basis. Most pets do not need to stay in overnight and are re-united with their owners later the same day.
During the procedure, we remove both ovaries. This will mean that your pet will no longer have seasons, cannot become pregnant and it will reduce the risk of other diseases such as uterine infections and mammary cancer. Laparoscopic spaying is different in that it means leaving the uterus (the womb) in place. Conventional open surgical spaying (neutering) of cats and bitches (female dogs) usually involves removal of the ovaries and uterus together (ovario-hysterectomy). The key-hole ovariectomy operation is quicker, less involved and less painful than the conventional spay procedure. Diseases of the womb in dogs, including infection and cancer, are mainly due to the female hormone, oestrogen. Oestrogen is produced by the ovaries, so as long as these are removed, the risk of diseases of the womb are very small. There is no evidence that leaving a healthy uterus behind results in any increased risk of incontinence or womb infection in the future when compared to conventional surgery.
Can every dog have a keyhole surgery?
Whilst we can do laparoscopic neutering on small dogs and cats, the relative size of the abdomen means that traditional surgery is probably still the best option. As a result we would suggest that dogs over 7-8kg benefit most from laparoscopic neutering.
For older dogs, who may already have early stages of disease in their womb or for dogs with confirmed disease of their womb, traditional open surgery to allow easy removal of their womb is advised.
We would also recommend the traditional surgery technique in patients that are markedly overweight, although as with all our surgeries, a pre-surgical weight loss programmes to reduce overall increased risk would be recommended.
As with humans undergoing laparoscopic surgery, we do ask that we are given permission to convert to a more conventional approach during the procedure if necessary. This is only required in the unlikely event that unforeseen circumstances arise which result in the risks to your pet being reduced by converting to conventional surgery. In addition we would point out that this form of surgery involves a larger clipped area of fur on your pets abdomen than with a traditional technique.
Will It Cost More?
Yes, but not as much as you may think. The equipment and training required to provide this service is very expensive and we must cover these costs. We are confident that the benefits to you and your pet are far outweighed by the additional costs that are involved. We have done everything we can to ensure that this service is an affordable option for our clients. For routine bitch spaying of dogs that do not have any of the issues listed above, the additional costs will equate to £150 more than our conventional spays.
Why don’t all vets offer laparoscopic Surgery as an option?
Due to the additional training required and cost of the specialised equipment, many small practices cannot yet offer these services. Keyhole surgery in veterinary practice is still many years behind the human field, but in the future, it is likely that many more practices will start to offer this service.