Two-step surgery combining standing laparoscopy with recumbent ventral median celiotomy for removal of enlarged pathologic ovaries in 20 mares.
Authors: Vitte Amélie, Rossignol Fabrice, Mespoulhes-Rivière Céline, Lechartier Antoine, Röecken Michael
Journal: Veterinary surgery : VS
Summary
# Editorial Summary Enlarged ovaries in mares present a significant clinical challenge, often requiring invasive surgical intervention to resolve behavioural problems or address pathology; this case series evaluated a hybrid surgical technique combining the advantages of standing laparoscopy with limited recumbent celiotomy to achieve safe removal of ovaries measuring 12–50 cm in 20 mares aged 3–22 years. The procedure involved three sequential steps: initial standing laparoscopic dissection of the mesovarial pedicle using vessel sealing under sedation, followed by general anaesthesia and dorsal recumbency for an 8 cm ventral median celiotomy to retrieve the freed ovary in a specimen bag. The two-step approach proved entirely successful in 17 mares and effectively resolved behavioural issues in a further 3, with zero operative or postoperative complications recorded and owner satisfaction rated as excellent. By combining laparoscopic precision for vascular dissection with minimal celiotomy for specimen retrieval, this technique circumvents many limitations of traditional flank ovariectomy—namely the large incision, significant postoperative complications, and cosmetic concerns—whilst avoiding the need for extended general anaesthesia during delicate mesovarial work. For practitioners managing mares with enlarged ovaries, this hybrid approach warrants consideration as a safe, effective alternative that reduces surgical morbidity and delivers superior cosmetic outcomes.
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Practical Takeaways
- •This two-step approach offers a minimally invasive alternative to traditional ovariectomy with superior cosmetic outcomes and no increased surgical risk
- •Standing laparoscopic dissection reduces hemorrhage risk and tissue trauma compared to standing flank procedures while allowing safe ovary removal through a small incision
- •Procedure is suitable for managing behavioral problems secondary to ovarian enlargement, with high owner satisfaction and rapid recovery
Key Findings
- •Two-step laparoscopic-celiotomy procedure successfully removed enlarged ovaries (12-50 cm) in 17 of 20 mares with no operative or postoperative complications
- •Technique achieved excellent owner satisfaction and cosmesis outcomes compared to traditional open celiotomy approaches
- •Standing laparoscopy dissection of the mesovarial pedicle followed by limited ventral median celiotomy (8 cm) eliminated complications associated with flank ovariectomy