Comparison of Surgical Time and Complications of the Pure-NOTES, Single-Port Laparoscopic-Assisted and Open Approaches for Ovariohysterectomy in Bitches
The development of new minimally invasive techniques of ovariohysterectomy (OVH) has been carried out with the purpose of optimizing its benefits and reducing risks to the patients.
The aim of the current study was to compare intraoperative aspects and complications of OVH performed by a recently developed pure transvaginal natural orifice transluminal endoscopic surgical approach (NOTES group), single-port laparoscopic-assisted technique (SPLA group) and traditional celiotomy approach (OPEN group).
Twelve mongrel bitches were operated on per group. NOTES-OVH was performed following the insertion of a single trocar into the abdominal cavity through a cul-de-sac vaginal incision. An operative laparoscope was used and a bipolar forceps was inserted through its working channel for both coagulation and resection of the ovarian pedicles. SPLA-OVH was achieved employing the same instruments used for NOTES-OVH, though through a prepubic mini-celiotomy. Mean surgical time and the rates of intra and postoperative complications were compared among groups.
Mean surgical time was shorter (p < 0.05) in NOTES (25.7' ± 6.8') and SPVA (23.1' ± 4.0') groups than in the OPEN group (34.0' ± 6.4'). The rate of intraoperative bleeding due to surgical access to the abdominal cavity was 75.0% in OPEN, 41.6% in NOTES and 25.0% in SPLA group. Five (41.6%) patients of OPEN group presented mild swelling of the surgical incision and two (16.6%) bitches of SPLA group presented seroma at the port site.
NOTES and SPLA approaches were faster and presented lower rates of intra- and postoperative complications than OPEN OVH in bitches.