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Effect of patient rotation on ovary observation during laparoscopic ovariectomy in dogs

OBJECTIVE
To describe the optimal recumbency for laparoscopic ovariectomy (LapOVE) in dogs.


STUDY DESIGN
Prospective clinical trial.


ANIMALS
Sixteen healthy client-owned female dogs undergoing routine single-port LapOVE.


METHODS
Anesthetized dogs were placed in dorsal recumbency on a tilting operation table. The operating laparoscope was introduced and, after inspection of abdominal organs, directed toward the randomly assigned ovary. Fifteen-second video recordings were taken at each table rotation of 0°, 22.5°, and 45°. LapOVE was performed using the single-port technique. The procedure was repeated on the contralateral side. Blinded observers (3 inexperienced [IO], 3 experienced [EO], 1 expert [EE]) evaluated the recordings postoperatively for visibility of ovary/ovarian bursa, ovario-uterine transition, and other organs.


RESULTS
In the 0° position, ovarian structures were rarely visualized (IO, 13/96 [13.5%]; EO, 7/96 [7.3%]; EE, 5/32 [15.6%]). In the 22.5° position, visualization improved significantly for EO (26/96 [27.1%], P < .001). There was a marked improvement in visualization for all groups when the positioning angle was altered to 45° (IO, 62/96 [64.6%]; EO, 67/96 [69.8%]; EE, 25/32 [78.1%]). The differences between 0° and 45° and between 22.5° and 45° were significant for all groups of observers (all P < .001). There was an advantage for ovary visualization when procedures were started with left ovariectomy.


CONCLUSION
The 45° table rotation provided the best ovary visualization, regardless of body side or observer experience. There is evidence that procedures should be started with the left ovary when body side declination is used for organ retraction from the ovaries.