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Percival A, Singh A, Gartley C, Balsa I, Case JB, Mayhew PD, Oblak M, Brisson BA, Runge JJ, Valverde A, Alex Zur Linden R, Gatineau M. Single-Port Laparoscopic Treatment and Outcome of Dogs with Ovarian Remnant Syndrome: 13 Cases (2010-2018). J Am Anim Hosp Assoc 2020; 56:114-119. [PMID: 31961214 DOI: 10.5326/jaaha-ms-6923] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Ovarian remnant syndrome (ORS) is a condition resulting from incomplete removal of ovarian tissue during ovariectomy and/or ovariohysterectomy. Single-port laparoscopy (SPL) is an alternative to ventral midline laparotomy for treatment of ORS. Medical records of 13 client-owned female dogs who underwent SPL for the treatment of ORS were retrospectively reviewed to evaluate surgical technique and outcome. Dogs who had undergone a previous attempt at open ovariectomy or ovariohysterectomy were included. Major intraoperative complications did not occur and conversion to open laparotomy was not required. In 1 dog, an SPL + 1 technique was used, in which an additional port was placed cranial to the single-port device to aid in dissection and tissue manipulation. Median surgical time was 45 min (range, 30-90 min). Clinical signs related to estrus had resolved in 11 of 13 dogs with a median follow-up time of 18 mo. Two of 13 dogs were lost to follow-up at 3 mo postoperatively; however, signs of estrus had resolved at time of last follow-up. SPL treatment for ORS was feasible and successful in this cohort of dogs. Reduced surgical time was found in this study compared with previous reports investigating multiple-port laparoscopic treatment of ORS.
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Affiliation(s)
- Aaron Percival
- From the Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Canada (A.P., A.S., C.G., M.O., B.A.B., A.V., R.A.zL.); Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California-Davis, Davis, California (I.B., P.D.M.); Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, Florida (J.B.C.); Centre Veterinaire DMV, Montreal, Canada (M.G.); and Department of Clinical Studies, Matthew J. Ryan Veterinary Hospital, University of Pennsylvania, Philadelphia, Pennsylvania (J.J.R.)
| | - Ameet Singh
- From the Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Canada (A.P., A.S., C.G., M.O., B.A.B., A.V., R.A.zL.); Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California-Davis, Davis, California (I.B., P.D.M.); Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, Florida (J.B.C.); Centre Veterinaire DMV, Montreal, Canada (M.G.); and Department of Clinical Studies, Matthew J. Ryan Veterinary Hospital, University of Pennsylvania, Philadelphia, Pennsylvania (J.J.R.)
| | - Cathy Gartley
- From the Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Canada (A.P., A.S., C.G., M.O., B.A.B., A.V., R.A.zL.); Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California-Davis, Davis, California (I.B., P.D.M.); Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, Florida (J.B.C.); Centre Veterinaire DMV, Montreal, Canada (M.G.); and Department of Clinical Studies, Matthew J. Ryan Veterinary Hospital, University of Pennsylvania, Philadelphia, Pennsylvania (J.J.R.)
| | - Ingrid Balsa
- From the Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Canada (A.P., A.S., C.G., M.O., B.A.B., A.V., R.A.zL.); Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California-Davis, Davis, California (I.B., P.D.M.); Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, Florida (J.B.C.); Centre Veterinaire DMV, Montreal, Canada (M.G.); and Department of Clinical Studies, Matthew J. Ryan Veterinary Hospital, University of Pennsylvania, Philadelphia, Pennsylvania (J.J.R.)
| | - J Brad Case
- From the Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Canada (A.P., A.S., C.G., M.O., B.A.B., A.V., R.A.zL.); Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California-Davis, Davis, California (I.B., P.D.M.); Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, Florida (J.B.C.); Centre Veterinaire DMV, Montreal, Canada (M.G.); and Department of Clinical Studies, Matthew J. Ryan Veterinary Hospital, University of Pennsylvania, Philadelphia, Pennsylvania (J.J.R.)
| | - Philipp D Mayhew
- From the Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Canada (A.P., A.S., C.G., M.O., B.A.B., A.V., R.A.zL.); Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California-Davis, Davis, California (I.B., P.D.M.); Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, Florida (J.B.C.); Centre Veterinaire DMV, Montreal, Canada (M.G.); and Department of Clinical Studies, Matthew J. Ryan Veterinary Hospital, University of Pennsylvania, Philadelphia, Pennsylvania (J.J.R.)
| | - Michelle Oblak
- From the Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Canada (A.P., A.S., C.G., M.O., B.A.B., A.V., R.A.zL.); Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California-Davis, Davis, California (I.B., P.D.M.); Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, Florida (J.B.C.); Centre Veterinaire DMV, Montreal, Canada (M.G.); and Department of Clinical Studies, Matthew J. Ryan Veterinary Hospital, University of Pennsylvania, Philadelphia, Pennsylvania (J.J.R.)
| | - Brigitte A Brisson
- From the Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Canada (A.P., A.S., C.G., M.O., B.A.B., A.V., R.A.zL.); Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California-Davis, Davis, California (I.B., P.D.M.); Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, Florida (J.B.C.); Centre Veterinaire DMV, Montreal, Canada (M.G.); and Department of Clinical Studies, Matthew J. Ryan Veterinary Hospital, University of Pennsylvania, Philadelphia, Pennsylvania (J.J.R.)
| | - Jeffrey J Runge
- From the Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Canada (A.P., A.S., C.G., M.O., B.A.B., A.V., R.A.zL.); Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California-Davis, Davis, California (I.B., P.D.M.); Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, Florida (J.B.C.); Centre Veterinaire DMV, Montreal, Canada (M.G.); and Department of Clinical Studies, Matthew J. Ryan Veterinary Hospital, University of Pennsylvania, Philadelphia, Pennsylvania (J.J.R.)
| | - Alexander Valverde
- From the Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Canada (A.P., A.S., C.G., M.O., B.A.B., A.V., R.A.zL.); Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California-Davis, Davis, California (I.B., P.D.M.); Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, Florida (J.B.C.); Centre Veterinaire DMV, Montreal, Canada (M.G.); and Department of Clinical Studies, Matthew J. Ryan Veterinary Hospital, University of Pennsylvania, Philadelphia, Pennsylvania (J.J.R.)
| | - R Alex Zur Linden
- From the Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Canada (A.P., A.S., C.G., M.O., B.A.B., A.V., R.A.zL.); Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California-Davis, Davis, California (I.B., P.D.M.); Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, Florida (J.B.C.); Centre Veterinaire DMV, Montreal, Canada (M.G.); and Department of Clinical Studies, Matthew J. Ryan Veterinary Hospital, University of Pennsylvania, Philadelphia, Pennsylvania (J.J.R.)
| | - Matthieu Gatineau
- From the Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Canada (A.P., A.S., C.G., M.O., B.A.B., A.V., R.A.zL.); Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California-Davis, Davis, California (I.B., P.D.M.); Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, Florida (J.B.C.); Centre Veterinaire DMV, Montreal, Canada (M.G.); and Department of Clinical Studies, Matthew J. Ryan Veterinary Hospital, University of Pennsylvania, Philadelphia, Pennsylvania (J.J.R.)
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van Nimwegen SA, Van Goethem B, de Gier J, Kirpensteijn J. A laparoscopic approach for removal of ovarian remnant tissue in 32 dogs. BMC Vet Res 2018; 14:333. [PMID: 30404648 PMCID: PMC6223097 DOI: 10.1186/s12917-018-1658-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2017] [Accepted: 10/19/2018] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Surgical treatment of ovarian remnant syndrome (ORS) in dogs usually necessitates large celiotomies and considerable manipulation of organs because of the relatively deep position of ovarian remnant tissue, large patient size, and often encountered adhesions. In women, laparoscopic treatment of ORS is successful and has significant advantages over laparotomy. Since laparoscopic ovariectomy has significant advantages over open ovariectomy in dogs, including reduced surgical stress and postoperative pain and shorter convalescence period, the rationale for a laparoscopic approach of canine ORS is evident. Feasibility and efficacy of a laparoscopic approach for treatment of ORS in dogs was prospectively evaluated using a standardized protocol for diagnosis, treatment, and follow-up. Treatment success was evaluated by histology of removed tissues, postoperative hormone testing, and long-term clinical follow-up. RESULTS Thirty-two client-owned predominantly medium and large breed dogs diagnosed with ORS underwent abdominal ultrasound for ovarian remnant localization prior to laparoscopic surgery for removal of ovarian remnants. Tissue dissection and excision was performed using a vessel sealing forceps. Laparoscopy subjectively enabled detailed visibility and facilitated detection and removal of suspected ovarian tissue in all cases. Histology confirmed ovarian origin of removed tissue in all dogs. Additionally, a GnRH stimulation test was performed in fourteen dogs after a median follow-up of 10.5 months, which verified absence of residual functional ovarian remnant tissue in all dogs. Median surgery duration was 97.5 min and mean total convalescence duration, subjectively scored by owners, was 1.5 ± 0.7 days. No major complications occurred. Adhesions were observed in 79% of the dogs, complicated the surgical approach, and significantly affected surgery duration (85 versus 109 min; p = 0.03). Minor hemorrhage occurred in 12% and significantly increased surgery duration (95.5 versus 128 min; p = 0.02). Trendelenburg position and lateral tilting of the patient were essential for proper access to ovarian remnants. GnRH stimulation test results and/or absence of clinical signs indicative of ORS after a median follow-up period of 22.5 months confirmed treatment efficacy in all dogs. CONCLUSION Laparoscopic surgery for ORS in dogs is effective with minimal complications and short convalescence and can successfully replace the conventional, more invasive open surgical procedure.
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Affiliation(s)
- Sebastiaan A van Nimwegen
- Department of Clinical Sciences of Companion Animals, Faculty of Veterinary Medicine, Utrecht University, Yalelaan 108, 3584CM, Utrecht, the Netherlands.
| | - Bart Van Goethem
- Department of Small Animal Medicine, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, 9820, Merelbeke, Belgium
| | - Jeffrey de Gier
- Department of Clinical Sciences of Companion Animals, Faculty of Veterinary Medicine, Utrecht University, Yalelaan 108, 3584CM, Utrecht, the Netherlands
| | - Jolle Kirpensteijn
- Department of Clinical Sciences of Companion Animals, Faculty of Veterinary Medicine, Utrecht University, Yalelaan 108, 3584CM, Utrecht, the Netherlands.,Hill's Pet Nutrition, 400 SW 8th Ave, Topeka, KS, 66603, USA
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