Vessel sealing versus suture ligation for canine ovarian pedicle haemostasis: a randomised clinical trial

Abstract

Vessel sealing (VS) is well established in laparoscopic ovariectomy (OVE) in dogs. The objectives of this study were to evaluate the efficacy of ovarian pedicle haemostasis by VS using a commercially available VS tool in open OVE and compare it with suture ligation (SL). A prospective, randomised clinical trial including 20 female dogs was designed. Open OVE was performed via a standard mid-line celiotomy by a single surgeon using a standardised protocol. At random, the right ovarian pedicle was sealed (VS) or ligated (SL) whereas the left pedicle was treated by the alternative technique. Surgical times for procedural stages and intra-operative complications were recorded and statistically evaluated. Total surgical time was 29.28±11.13 minutes (range 12.50-62.13 minutes) and time from identification to removal of the ovary was significantly less when sealing (VS 2.22±0.58 minutes) than when ligating (SL 4.10±1.13 minutes P=0.0001). Intra-operative complications were rare for both techniques (failure of the electrode of the VS device (n=3); ovarian pedicle haemorrhage due to ligature slippage (n=1)). The results of the current study indicate that ovarian pedicle haemostasis achieved by VS is significantly faster than by placement of ligatures without appearing to compromise safety.

Cordless ultrasonic dissector versus advanced bipolar vessel sealing device for laparoscopic ovariectomy in dogs*

“…Ultrasonic devices and advanced vessel sealing devices have been evaluated in clinical settings and both significantly reduce surgical duration and intraoperative hemorrhage compared to mechanical surgical hemostasis (suture ligation or vascular clips) . Sonosurg ultrasonic shears has been compared to LigaSure in Lap OVE in dogs, showing comparable efficacy …”

“…Ultrasonic devices and advanced vessel sealing devices have been evaluated in clinical settings and both significantly reduce surgical duration and intraoperative hemorrhage compared to mechanical surgical hemostasis (suture ligation or vascular clips). [17][18][19] Sonosurg ultrasonic shears has been compared to LigaSure in Lap OVE in dogs, showing comparable efficacy. 2 Most advanced energy-based hemostatic devices are relatively expensive to purchase and require ongoing costs with replacement of disposable hand pieces, thereby limiting their use in veterinary private practice.…”

The use of bipolar electrosurgical forceps for haemostasis in open surgical ovariectomy of bitches and queens and castration of dogs

“…The time saving has similarities with a study that used a vessel‐sealing device and found a reduction in time to achieve haemostasis compared with ligation with suture (Schwarzkopf et al . ). As inexperienced surgeons often take the longest amount of time to perform surgeries, it is likely that improved methods of haemostasis would reduce their surgical time more than for an experienced surgeon.…”

“…Two studies have used commercially available vessel‐sealing devices with feedback control to limit possible thermal tissue damage in ovariectomy in groups of 20 bitches (Schwarzkopf et al . , Devriendt et al . ).…”

“…The use of a commercially available bipolar vessel‐sealing device did reduce surgical time compared with ligation with suture (Schwarzkopf et al . ), but their disadvantage is that they can be expensive to purchase, and some or all of the components are usually designed for single use.…”