Comparison of three techniques for ovarian pedicle hemostasis during laparoscopic-assisted ovariohysterectomy

Philipp Mayhew, Dorothy Cimino Brown

Research output: Contribution to journalArticle

106 Scopus citations

Abstract

Objective To describe the safety, surgical time, and complications associated with 3 techniques for achieving hemostasis during laparoscopic-assisted ovariohysterectomy (LAOVH). Study Design Prospective, randomized clinical trial. Animals Female dogs (n=30). Methods Dogs were randomly assigned to 1 of 3 methods for achieving ovarian pedicle hemostasis during LAOVH: extracorporeal modified Roeder knot application (suture group), metal clip application using a multifire 10 mm laparoscopic clip applier (clip group), or use of a novel 5 mm bipolar vessel-sealing device (vessel-sealing group). In all dogs a 3 median portal technique was used. Results Controlling for the dogs' bodyweights, there was a significant association between surgical time and which method for hemostasis was used. This association was different when comparing the first 5 procedures using each method to the second 5. For a 20 kg dog, the surgical time (95% CI) for the first 5 procedures was 80 (69-91), 68 (57-79), and 33 (21-45) minutes for the suture, clip, and vessel-sealing groups, respectively. For the second 5 procedures surgical time was 71 (60-81), 50 (39-60), and 40 (29-51) minutes. Pedicle hemorrhage occurred in all dogs in the clip group, 3 dogs in the suture group, and none of the dogs in the vessel-sealing group although in all cases was considered hemodynamically inconsequential. All dogs recovered uneventfully. Conclusions All methods of hemostasis were safe for pedicle sectioning. A learning curve exists for clip and suture methods. Clinical Relevance Use of a vessel-sealing device significantly shortens surgical time and provides excellent hemostasis during LAOVH.

Original languageEnglish (US)
Pages (from-to)541-547
Number of pages7
JournalVeterinary Surgery
Volume36
Issue number6
DOIs
StatePublished - Aug 2007
Externally publishedYes

ASJC Scopus subject areas

  • veterinary(all)

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