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

Philipp Mayhew, Dorothy Cimino Brown

Research output: Contribution to journalArticle

103 Citations (Scopus)

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

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hemostasis
spaying
Hemostasis
Dogs
Surgical Instruments
Operative Time
dogs
sutures
Sutures
methodology
Equipment and Supplies
Learning Curve
randomized clinical trials
knots
hemorrhage
learning
Randomized Controlled Trials
surgery
experimental design
Metals

ASJC Scopus subject areas

  • veterinary(all)

Cite this

Comparison of three techniques for ovarian pedicle hemostasis during laparoscopic-assisted ovariohysterectomy. / Mayhew, Philipp; Brown, Dorothy Cimino.

In: Veterinary Surgery, Vol. 36, No. 6, 08.2007, p. 541-547.

Research output: Contribution to journalArticle

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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.",
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