Comparison of transvaginal natural orifice transluminal endoscopic surgery (NOTES®) and laparoscopy for elective bilateral ovariectomy in standing mares.
Authors: Pader Karine, Freeman Lynetta J, Constable Peter D, Wu Ching C, Snyder Paul W, Lescun Timothy B
Journal: Veterinary surgery : VS
Summary
# Editorial Summary Researchers compared transvaginal natural orifice transluminal endoscopic surgery (NOTES®) with conventional bilateral flank laparoscopy for standing ovariectomy in mares, evaluating surgical trauma, inflammation, operative time, and postoperative complications across both techniques. Twelve healthy mares underwent either transvaginal NOTES (n=6) or laparoscopic ovariectomy (n=6), with systematic monitoring of haematological markers (complete blood count, fibrinogen, serum amyloid A), peritoneal fluid analysis, vital parameters, and clinical recovery for 14 days, followed by necropsy examination at 3 weeks or 3 months. Both procedures proved equally effective and efficient: operative times were comparable (NOTES 100±40 minutes versus laparoscopy 107±47 minutes), and neither technique produced significant differences in inflammatory markers, tissue trauma indicators, or systemic response to surgery, with all mares maintaining normal appetite and demeanour except one laparoscopic case. For practitioners, these findings suggest transvaginal NOTES represents a viable alternative to laparoscopy for mare ovariectomy, potentially offering the advantage of avoiding flank incisions and associated scar tissue whilst maintaining equivalent safety profiles and recovery characteristics. Further investigation into mare owner preferences, long-term functional outcomes, and cost-effectiveness would help determine whether this minimally invasive approach justifies adoption in routine equine reproductive surgery.
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Practical Takeaways
- •Transvaginal NOTES is a viable alternative to flank laparoscopy for standing ovariectomy in mares, with equivalent surgical times and comparable trauma
- •NOTES may offer advantages of natural orifice access without flank incisions, potentially reducing recovery time and postoperative complications in clinical practice
- •Both techniques are suitable for elective bilateral ovariectomy; choice can be based on surgeon experience and available equipment rather than patient outcome concerns
Key Findings
- •Transvaginal NOTES and laparoscopic ovariectomy both completed successfully with similar surgical times (NOTES 100±40 min vs laparoscopy 107±47 min)
- •No significant differences in inflammatory markers (CBC, fibrinogen, serum amyloid A) or peritoneal parameters between NOTES and laparoscopy groups
- •Both procedures resulted in minimal surgical trauma and inflammation with comparable postoperative recovery profiles