a video
The key components to this procedure are as follows;
1 - Make usual celiotomy approach, but extend incision almost all the way to the pubis caudally
2 - Perform right ovariectomy as per normal ovariohysterectomy, ensuring you take the entire ovary
3 - The left ovary is slightly easier to access in it's more caudal location. Therefore, it may be preferable to spare this ovary, in case it needs retrieval at a later point in time. Expose the left ovary. The suspensory ligament can still be stretched or torn to enable this
4 - Make usual window in the mesosalpinx to allow for forcep placement
5 - Place two forceps across the mesosalpinx very close to the ovary. Uterine horn cannot be left in this location near the ovary. A ligature can be placed in front of, or within the proximal (nearest ovary) crush mark. A transfixation ligature is recommended. A second ligature is also placed next to this transfixation ligature.
6 - If not already performed, express or drain urinary bladder and tuck caudally, prior to ligatures being placed in the vagina. This is very important, as the ureters are in close proximity to the uterus is if the bladder is full.
7 - Identify the cervix, which is paler and thicker. Place forceps just caudal to the cervix and ligate in the crush mark. A transfixation suture is recommended. Uterine arteries can be ligated separately.
The two key things to remember for this procedure, are that the entire uterus needs to be removed ie ligatures need to be placed at or proximal to the salpinx, and then just caudal to the cervix.
The second thing is to ensure that when you place your forceps in the vagina caudally, you ensure the ureters are well out of the way. The best way to ensure this, is to palpate the bladder, ensure it is empty, and then tuck it caudally under the pelvis.
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