Q: My veterinarian offers laparoscopic spays for dogs. It is more expensive, and I am wondering if it is worth the money to do that type of spay?
Let me answer your question by first giving you a little bit of history. Spaying a female dog traditionally involved removing the ovaries and uterus of the patient (an ovariohysterectomy or OHE). This procedure has been performed for decades, and it has been our primary means of population control in dogs.
In Europe, the traditional technique has been to remove just the ovaries alone and leave the uterus in place (an ovariectomy or OVE). This technique is becoming more popular in the United States, primarily because it can be performed using a laparoscope.
A laparoscope is an instrument that allows the surgeon to look inside of the abdomen. The surgeon can see the ovaries and then remove them through a small hole. In this technique two small, approximately 1 cm, incisions are made into the abdomen, in which two small ports are placed. The abdomen is inflated with carbon dioxide, allowing space to operate. Through one port, a fiber optic scope is placed through which the organs of the abdomen can be seen magnified on a video monitor. The second port is a working port, through which instruments can be placed to remove the ovaries. Electrocautery is used to close and cut the blood vessels leading to the ovaries and each ovary can be removed through the working port incision.
The primary benefit to this technique is that the recovery time and pain from surgery is a lot less. With a traditional spay (OHE), a relatively large incision is made into the abdomen to remove the ovaries and uterus. The recovery time to allow the muscle wall and tissue to heal is about 10–14 days. Because the incisions are so small with a laparoscopic spay, the recovery time is about 2 days, and the dog experiences less pain.
Many people wonder if there are any downsides to leaving the uterus in place. Typically the answer is no. Most of the diseases that can occur in the uterus occur because of hormonal changes from the ovaries secreting sex hormones. If the ovaries are removed, they are not present to exert influence over the uterus. Studies have shown that there is no increased risk of disease in the uterus, such as infection or cancer, when the ovaries are removed and the uterus left behind.
All dogs that have their ovaries removed, either with or without the removal of the uterus, are at increased risk of weight gain and urinary incontinence. These are the two most common side effects of spaying your dog. Fortunately, both of these conditions can be managed. Overweight dogs can be managed with dietary changes or restrictions, and patients that experience urinary incontinence after being spayed can take medication that typically resolves the problem.
The only downside to doing a laparoscopic spay is the cost. Because specialized instruments are needed to perform this technique, the cost of a laparoscopic spay is typically more expensive than a traditional spay.
In addition, not all dogs are candidates for a laparoscopic spay. Depending on the instruments available, very small dogs may not accommodate the size of the instruments used for the procedure. Also, dogs that have gone through many heats or have existing disease in the uterus should not have an OVE performed.
Because of the additional equipment needed, not all veterinarians perform laparoscopic spay procedures. If you have questions about this technique, your veterinarian is the best source of information. In Minnesota, laparoscopic spays are performed at a handful of private practices and several of the referral hospitals in our area. At Westgate Pet Clinic, three of the veterinarians, Dr. Melin, Dr. Perry, and Dr. Mirodone, are trained in this technique.