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

ObjectiveTo describe the optimal recumbency for laparoscopic ovariectomy (LapOVE) in dogs. Study DesignProspective clinical trial. AnimalsSixteen healthy client-owned female dogs undergoing routine single-port LapOVE. MethodsAnesthetized 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 degrees, 22.5 degrees, and 45 degrees. 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. ResultsIn the 0 degrees 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 degrees 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 degrees (IO, 62/96 [64.6%]; EO, 67/96 [69.8%]; EE, 25/32 [78.1%]). The differences between 0 degrees and 45 degrees and between 22.5 degrees and 45 degrees were significant for all groups of observers (all P < .001). There was an advantage for ovary visualization when procedures were started with left ovariectomy. ConclusionThe 45 degrees 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.