Laparoscopic Surgery

Doncaster Veterinary Hospital has extensive experience with Larparoscopic surgeries including ovariectomies (spay) of females, cryptorchid castrations in males, prophylactic gastropexies, vasectomies and exploratory laparoscopies. Compared to traditional open surgical techniques, laparoscopic surgery utilises 2 (sometimes 3) keyhole (5mm) incisions to allow for the surgery to be performed with minimal trauma to the patient. This means that recovery is much faster than open surgical techniques and due to the instrumentation used, the risk of post operative bleeding is reduced dramatically.

Laparoscopic desexing

Laparoscopic surgeyr is done with the use of endoscopes. The abdomen is inflated with medical grade carbone dioxide to allow visualisation of the internal organs.

Desexing procedures performed:

  1. Ovariectomies (removal of the ovaries only).  This procedure has been done in Europe for many decades.  Removal of the ovaries results in regression of the size of the uterus as there are no longer any reproductive hormones left to affect the uterus.  Leaving the uterus in situ is no problem as uterine tumours are extremely rare in dogs and cats.  Any uterine disease present can be treated by our residence small animal reproduction specialist, Dr Stuart Mason, before the ovariectomy.

  2. Cryptorchid castration. Following abdominal ultrasound examination, the retained teste(s) are identified to their approximate location. The exact location is found using the laparoscope and then a small incision is made over the retained teste(s) and the abdominal teste(s) removed. This is done through a small 5-7 mm hole, compared to traditional open surgery which involves an incision through the muscle next to the penis of male dogs which is extremely painful.

  3. Vasectomy.

Benefits of laparoscopic desexing:

  1. Quicker recovery time.

  2. Small incisions which require 1 stitch in the muscle and one buried knot in the skin.

  3. No risk of herniation of the surgery site.

  4. Less internal bleeding as a special device is used to cauterize and seal blood vessels rather than tied sutures.

  5. Less pain than open surgery.

  6. No need to keep quiet for as long as after open surgery (2-3 days compared to 10-14 days).

  7. Better visualisation of the internal organs of the abdomen to detect disease conditions more easily.

Risks of laparoscopic desexing:

  1. The tissue under the skin can sometimes blow up if there is difficulty placing the needle which introduces carbon dioxide into the abdomen.  If this occurs the animal will get puffy under the skin, however it is completely harmless and will disappear after a couple of days. (Risk: less than 1%)

  2. Gas emboli can sometimes be created, although the risk of this is less than 0.1% through the use of medical grade carbon dioxide.  Emboli (if they occur) can lodge in tissues like the spleen causing disease.  

  3. Foreign reactions to tissue glue in the skin. At Doncaster Veterinary Hospital we don’t use tissue glue to hold the skin together like some surgeons will so this reaction is averted.

Prophylactic laparoscopic-assisted gastropexy

This is a surgical procedure that is performed to prevent gastric dilatation and volvulus (GDV), a potentially fatal condition that is also known as bloat. In GDV, the stomach bloats with gas and becomes twisted.

GDV most commonly occurs in large breed dogs that are deep-chested e.g. Great Dane, German Shepherd Dog, Standard Poodle, Basset Hound, Irish Wolfhounds, Weimaraner, and Irish Setters. It is also high risk in dogs that have a parent or sibling with GDV. Middle-aged to older dogs are more likely to develop it than younger dogs (2 - 4 years).

Dogs that demonstrate these following behaviors are also at risk of GDV:

  • Gulping of dry food

  • Drinking large amounts of water at a time

  • Drinking a large amount after eating

  • Vigorous exercise after eating

The procedure

A gastropexy can be performed to surgically attach the stomach wall to the inner abdominal wall. This helps to hold the stomach in place to prevent it from twisting, reducing the chances of a twisted stomach to less than 3% from 20-40%.

Performing this procedure laposcopically means there are only two small incisions made in your dogs stomach. A small 5mm hole for the camera and endoscope and a 3-5cm incision to suture the stomach to the abdominal wall. By doing a gastropexy laparoscopically then it can be ensured that the correct part of the stomach is attached to the abdominal wall and the stomach sits in a natural position which the dog stands (this is done with much less certainty by open surgery).

Post-surgery

As with any abdominal surgery, pets should be rested for 10-14 days with restrictions from rubbing and jumping. Pain management should be given as per the label to help manage the pet’s pain at home.

Abdominal ultrasonography may be recommended 6- 12 months after surgery to assess the extent of the stomach wall adhesions to the body wall.

Potential surgical complications

  • Incision site swelling that resolves within a few days

  • Wound breakdown

  • Infection

Prognosis

Most pets recover well from the gastropexy with a reduced risk of GDV that carries a high mortality rate. 

It is important to note that the surgery will not prevent dilatation but will help prevent volvulus (twisting). If your pet experiences bloat, veterinary treatment is still important to reduce the pet’s discomfort.