This keyhole surgery operation is becoming more and more common in practices all over the UK. Also known as a keyhole spay or keyhole neutering, it has many advantages over the traditional spay procedure. This Pets4Homes article is going look at the operation and its pro’s and cons.
The traditional spay is also called an ovariohysterectomy and has been performed by vets for many years. With this operation, the anaesthetised bitch is positioned on her back, so the vet has access to her abdominal area. When she has been surgically prepared, usually by a veterinary nurse, the vet will make an incision along her midline. The length of the incision depends on the size of the animal but can be from around 8 to 20 centimetres.
With the bitch open, the vet can see inside and will then remove the uterus and both ovaries. They will use a variety of sterilised surgical instruments to complete the procedure along with different suture materials. The suture materials are used to tie off small veins and the ovarian stumps (containing bigger blood vessels). Doing this is the riskiest part of the operation as if the sutures slip off, the bitch can bleed profusely internally. Because of this, the traditional spay is possibly the most nerve-wracking operation for many vets, especially a new graduate, even though it’s a routine procedure.
Once everything is removed and the vet is happy, they will suture the incision opening closed, firstly the muscle layer and then finally the skin layer. It is common that the skin stitches are nylon, and therefore need removing in around 10 days from the procedure.
There are two really big differences between a lap spay and a traditional bitch spay. The first difference is the incision. Instead of being on the midline and a long opening, there are usually two (or if the dog is really large three) small incisions. These openings are only half to one centimetre long.
The first one is used for passing a tiny sterile camera through and into the cavity so the vet can see everything they are doing, via a television screen. The second incision is used for passing specialist laparoscopic instruments through. With these instruments, the vet will then remove both of the ovaries, however, they will leave the uterus fully in place. This is because, for keyhole surgery, the uterus is too large to remove safely, via the keyhole incisions.
Once the operation is complete, instead of a large scar as with the traditional approach, the vet will close the small lap spay incisions, commonly using only one or two internal stitches for each. Because the uterus is left in place, this operation is called an ovariectomy.
There are clear advantages in spaying via keyhole surgery, as opposed to traditional surgery. The three biggest examples of where a lap spay has the distinct edge, all have benefits to the bitch.
In the traditional spay, the bitch is in considerable discomfort for a good few days after the operation. Although this is reduced through the use of painkillers, having less discomfort overall would be much preferable. Because the lap spay surgery involves much smaller invasiveness, and the ovaries are removed with specialist equipment, the bitch will be in much less pain and therefore happier.
Like any wound, the smaller it is, the less chance there is of infection occurring. Because the lap spay wounds are so small, there is no need for external nylon skin stitches. Dissolvable internal stitches are used to close the hole and usually, only one to two stitches are needed. Of course, because they are dissolvable, they don’t even need removing 10 days later!
The recovery period after a traditional spay is considerably longer. Because traditional surgery involves the incision into a tendon – the midline is called the linear alba (which is Latin for white line), this can take a long time to heal fully. A lap spay, on the other hand, does not impact on the midline at all and leaves the body wall with only two (or three if a really large animal), small incisions. In a comparison a dog will return to their full fitness capacity a lot quicker as the rest period for a lap spay is only a couple of days, whereas traditional spaying the period is at least two weeks.
Research has also found that 50% of lap spays show fewer complications.
Whilst it is true to say every surgery has risks and disadvantages, in the case of spaying both are the same for either traditional spaying or lap spaying. Both operations need a general anesthetic, which is as safe as they can be with monitoring equipment, fluids, safer drugs, and expertise.
The disadvantages of both types of operation are still the same, for example, a spayed bitch can have the potential to put on more weight, or have an increased risk of cruciate injury. But there are no actual disadvantages to having your bitch spayed via keyhole surgery – it may be a little more expensive because of the extra training and equipment needed, but the expense is surely worth it for a happier dog that recovers quicker?
It is a common question, mainly because the uterus is left behind. The clear answer is no – there is no risk of pyometra. The condition can only happen when progesterone in the bitch makes fluid sit in the uterus, and this fluid becomes infected causing a pyometra. However, there is no progesterone in the body, because that is what the ovaries produce, and these are removed during the lap spay.
If you want to choose minimally invasive surgery for your bitch when it comes to neutering, then a lap spay is something to definitely consider. Of course, it depends on whether your own surgery uses laparotomy equipment for these procedures. It is always best to speak to your vet to discuss neutering. There are even some practices that have stopped doing the traditional spay, in favour of lap spays simply to benefit their patients and the recovery.