Hand-assisted laparoscopic ovariohysterectomy in the mare.
Authors: Delling Uta, Howard Rick D, Pleasant R Scott, Lanz Otto I
Journal: Veterinary surgery : VS
Summary
# Hand-Assisted Laparoscopic Ovariohysterectomy in the Mare Ovariohysterectomy remains a significant surgical undertaking in equine practice, and this 2004 study explored whether hand-assisted laparoscopic surgery (HALS) could offer a minimally invasive alternative to conventional open approaches. Researchers developed the technique in two non-survival mares before progressing to six survival procedures; all animals underwent dorsal recumbency positioning with a hand access device (Omniport) combined with four laparoscopic portals, allowing vascular control of the ovarian pedicles and broad ligaments using laparoscopic stapling instruments, ultrasonic dissection, and endoscopic clips, with exteriorisation of the uterus through a small laparotomy for conventional transection and closure. Four mares recovered without complication; one sustained bilateral femoral fractures during anaesthetic recovery and required euthanasia, whilst another developed severe pleuropneumonia, though necropsy confirmed satisfactory healing of all vascular and uterine remnants in uncomplicated cases, with only one mare developing incisional abscessation and visceral adhesions. The findings demonstrate technical feasibility and suggest HALS-OHE could reduce surgical trauma and postoperative morbidity compared with conventional ovariohysterectomy, though careful case selection and perioperative management remain essential to minimise complications. This approach warrants further investigation in practice, particularly as the hand-assisted technique may also facilitate other equine laparoscopic procedures where intracorporeal suturing or complex dissection is required.
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Practical Takeaways
- •HALS ovariohysterectomy is technically feasible in mares and offers a minimally invasive alternative to conventional open approaches with reduced postoperative wound complications in selected cases
- •Careful patient selection, anesthetic management, and recovery protocols are critical—complications occurred in 3/8 mares, highlighting the importance of experience and appropriate facility support
- •This technique may have applications beyond ovariohysterectomy for other laparoscopic procedures in equine surgery, but requires specialized equipment and training
Key Findings
- •Hand-assisted laparoscopic ovariohysterectomy (HALS) technique was successfully developed and performed in 8 mares with 4 uncomplicated recoveries
- •Ovarian pedicles and broad ligaments were safely transected using laparoscopic stapling, ultrasonic activation, and endoscopic clips
- •Complications included 1 anesthetic recovery fracture, 1 severe pleuropneumonia, and 1 incisional abscess with visceral adhesions among 8 procedures
- •Transected mesovarial, mesometrial, and uterine remnants healed routinely without infection in successful cases