Ovariohisterectomia Videolaparoscópica em Cadela com Ovários Remanescentes e Piometra de Cornos Uterinos.

Background: The ovariosalpingohisterectomy (OSH) is the treatment of choice for the remaining ovary syndrome and canine pyometra, which can be performed by conventional or laparoscopic approach. In recent years, have developed new techniques for laparoscopic treatment of uterine and ovarian diseases in dogs. However, there are few reports of laparoscopic OSH for treatment of ovarian remnant syndrome and stump pyometra. Thus, the present report aims to describe the use of laparoscopy for the treatment of pyometra uterine horns and ovaries in a bitch remaining. Case: A bitch, mixed breed, with two years of age, was answered with a history of heat after being submitted to OSH was five months. Against clinical and ultrasonographic findings, the diagnosis was the remaining ovary syndrome pyometra and uterine horns, the animal being referred for laparoscopic surgery to remove the remaining uterine and ovarian tissue. After placing two laparoscopic portals, the animal was placed in right lateral recumbency. After the seizure of the ovarian ligament itself with the Kelly forceps, was held dual temporary transparietal suture for better exposure of the left arteriovenous ovarian complex. Was continued with bipolar cautery and Metzenbaum scissors with section. The animal was repositioned in the left lateral decubitus position, and the procedure was repeated on the right ovarian arterial-venous complex. The animal was positioned in dorsal recumbency again. Was held to apply temporary transparietal suture involving the urinary bladder for inspection of the uterine stump, without this change. There was exposure of the ovaries and uterine segments from the removal of the cannula and aspiration of uterine contents with the aid of a catheter 18. Verifying the absence of hemorrhage, the cavity was deflated, and the wounds sutured into muscle level access quilter cross pattern with 2-0 polyglactin 910. Subcutaneous suture was performed with the same wire a simple continuous pattern. The skin was occluded with a 3-0 monofilament nylon in standard default horizontal quilter stopped. Discussion: Patient in this report, when it was found the remaining ovaries and uterine horns increased in volume, remained the proposal OSH by laparoscopy, once the laparoscopic surgery is associated with better and faster postoperative recovery, as well as lower production of painful stimuli, magnification of images, the possibility of wide-ranging exploration of the peritoneal cavity, decreases the length of hospitalization and intensive care at that stage. Despite the success of previous reports of therapeutic video-assisted OSH in dogs and cats, the use of laparoscopic OSH with two portals for the treatment of ovarian remnant syndrome is still scarce in the small animal clinic. The minimally invasive procedure has disadvantages as a steep learning curve, with consequent initial prolonged surgical time and high operating costs. On the other hand, laparoscopy has less adhesion formation and better preservation of lung function. This may have contributed to the rapid postoperative recovery this dog. It is concluded therefore that laparoscopic OSH with two portals proved effective and beneficial in the treatment of ovarian remnant stump pyometra and uterine horn can be used in dogs as an alternative to conventional surgery. [ABSTRACT FROM AUTHOR]