New Ovariohysterectomy Technique

The standard approach to ovariohysterectomy (OVH) involves double ligation of the ovarian pedicle (PDL) and uterine body with suture before removal of reproductive tissue. A newer technique, the pedicle tie (PT), involves tying the ovarian pedicle onto itself, similar to feline castration. Potential benefits include decreased operative time and cost and less foreign material left within the abdomen. Despite its growing popularity, particularly in shelter medicine, no studies have reported outcomes using this technique.

This prospective study evaluated hemorrhage-related complications and compared surgical times in 2136 kittens and cats undergoing OVH using the PT technique vs PDL. Three experienced spay/neuter veterinarians performed all surgeries. Six of the cats (0.281%) experienced a hemorrhage-related complication. Five were identified intraoperatively and resolved with suture ligation; 1 was suspected postoperatively and a bleeding pedicle was ligated with suture on surgical revision. The time to complete an OVH using PT in kittens (4.7 ± 0.1 mins) was significantly shorter when using PDL (6.7 ± 0.1 mins). A significant time reduction was also reported for adult cats using PT (5.0+ 0.2 mins) vs PDL (7.0 + 0.2 mins). The authors conclude that PTs are safe and significantly faster than the traditional method of ovarian pedicle ligation in cats.

Commentary

High-volume spay-neuter clinics have a central role in controlling pet overpopulation. In this environment, efficiency of patient processing is extremely important; however, it must not compromise patient safety. The pedicle tie technique is a fast, safe, effective method for OVH in cats when performed by experienced veterinarians. This was clearly evident in this study, as operating time for the entire OVH procedure was 5-7 minutes regardless of technique. It is important to first consider the learning curve, the application to individual patients, and the environment when interpreting data from this type of study. For the purposes of training veterinary students, the PT procedure does not replace the fundamental surgical skills gained by learning and practicing the traditional surgical procedure.—Jason Bleedorn, DVM, DACVS