Surgeon's Corner: Ovarian Remnant
Presentation
This 3-year-old spayed cat presented with a history of periodic estrus. The most likely diagnosis was ovarian remnant.
It is typically easier to surgically locate a remnant when the cat is exhibiting signs of estrus, so the patient was admitted for exploratory laparotomy while exhibiting signs.
Surgery
The patient was prepared for ventral midline celiotomy. It is important to perform a complete exploratory of both ovarian pedicles, so make your incision much longer than you would when performing a routine spay. In this patient, you can see evidence of a right ovarian remnant—there appears to be a cystic structure in the ovary. It appears that the original spay surgeon did not remove the entire right ovary. The left ovarian pedicle is identified and carefully examined; there is no evidence of a remnant. Right-sided remnants are generally more common than left-sided remnants because the right ovary is located more cranially in the abdomen than the left ovary.
Some adhesions from the previous surgery can be seen; these are carefully resected using cautery. The ovarian remnant is elevated with Debakey forceps. Care is taken to identify all vessels associated with the ovarian remnant and to completely excise the remnant without leaving any ovarian tissue. The suspensory ligament is cut, ensuring that the entire ovary is completely excised. You can see the advantage of using cautery in this case. Finally, the suture is cut and the ovarian remnant is amputated, double-ligated, and removed from the abdominal cavity. The surgeon has maintained plenty of distance between the ovarian remnant and the ligature, and the ovarian remnant is completely removed.
The abdominal incision is closed routinely. Sutures are placed in the intradermal layer (so that the patient does not have to return for suture removal), and the patient is recovered from anesthesia.
Outcome
The patient was discharged one day after surgery and no longer exhibits signs of estrus.
This video was authored by Howard B. Seim III, DVM, DACVS. Other surgical videos are available through VideoVet.
Surgeon’s Corner is intended as a forum for those with specialized expertise to share their approaches to various techniques and procedures. As such, the content reflects one expert’s approach and is not subject to peer review.
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