Standing ovariectomy in mares using a transvaginal natural orifice transluminal endoscopic surgery (NOTES®) approach.
Authors: Pader Karine, Lescun Timothy B, Freeman Lynetta J
Journal: Veterinary surgery : VS
Summary
# Editorial Summary: Standing Transvaginal Ovariectomy Using NOTES in Mares Researchers developed and tested a minimally invasive standing ovariectomy technique in 10 mares, using transvaginal Natural Orifice Transluminal Endoscopic Surgery (NOTES) to access the abdomen through the vagina under endoscopic guidance, with a customized bipolar vessel-sealing device to control bleeding and remove ovarian tissue. After initial technique development in six animals, the procedure was formally evaluated in four mares with immediate and 15-day postoperative necropsies to assess complications. The surgery proved technically feasible with adequate intraoperative analgesia, acceptable endoscopic visualisation, and excellent postoperative recovery in all cases; however, operative time was occasionally prolonged by visualisation challenges, and one mare could not have the second ovary removed during the procedure. Post-mortem examination revealed concerning findings in some animals—including one confirmed intra-abdominal infection, elevated peritoneal fluid cell counts, and adhesion formation—that indicate the technique requires further refinement before clinical adoption. This approach offers genuine promise for reducing surgical trauma and recovery time compared to traditional standing ovariectomy, yet the infection and adhesion concerns must be systematically addressed through longer-term studies and protocol modifications before practitioners should consider offering this technique routinely to clients.
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Practical Takeaways
- •This standing transvaginal approach represents an alternative to traditional ovariectomy methods with good intraoperative analgesia and rapid recovery, but is currently an experimental technique requiring specialized equipment and training.
- •Although postoperative recovery appeared excellent clinically, postmortem findings suggest potential for abdominal complications and infection risk that need resolution before clinical adoption.
- •This technique is not yet ready for routine practice—further studies addressing sterility protocols, complication rates, and long-term outcomes are essential before considering clinical implementation.
Key Findings
- •Transvaginal NOTES ovariectomy was technically feasible in all 10 mares using a customized bipolar vessel-sealing device and endoscopic guidance.
- •Analgesia was adequate in all cases and postoperative recovery was excellent with no major complications observed.
- •Intraoperative challenges included difficult visualization in some cases and inability to remove the second ovary in 1 mare (10% failure rate).
- •Postmortem examination revealed concerns including microbial contamination, elevated abdominal fluid cell counts, and adhesion formation requiring further investigation.