Why Laparoscopic Desexing in Dogs Is About More Than a Smaller Incision
Written by Dr Andrew Nicholls DVM
Dr Andrew Nicholls DVM recently completed extensive training in laparoscopic surgery in London. Here, he shares why minimally invasive surgery has captured his interest, and why the real story behind laparoscopic desexing happens inside the abdomen.
There is something slightly misleading about the term “keyhole surgery”.
It makes you think about the holes.
Small incisions. Small wounds. A smaller scar.
Those things are certainly part of laparoscopic surgery, but they aren't what interests me most.
What interests me is what happens inside those small incisions.
Laparoscopic surgery changes the way we see and access the structures we're operating on.
Rather than simply making a smaller opening, it gives us a different way to work inside the abdomen.
To understand why that matters, it helps to look at one of the key differences between
conventional and laparoscopic desexing, which is how we access the ovaries.
Working directly around the ovary
A conventional spay is a well-established procedure. The surgeon locates each ovary, safely controls its blood supply and removes it through an abdominal incision.
To do this, the ovary needs to be brought towards the incision so the surgeon can see and safely access the structures around it. This can involve some pulling and manipulation of the tissues that support the ovary, including the suspensory ligament.
Laparoscopy allows us to take a different approach.
A small camera provides a magnified view of the ovary inside the abdomen. Specialised instruments can then be used to identify, seal and divide the relevant structures while working directly around the ovary.
The difference isn't simply the size of the incision. It's how we access the ovary and what that means for the tissues around it.
That is what I find most interesting about laparoscopic surgery.
The incision doesn't tell the whole story
It is easy to look at a conventional spay incision and a laparoscopic incision and assume that the smaller one must automatically be the less invasive operation.
But surgery isn't just about what we can see from the outside. A conventional spay can be performed through a relatively small incision and can heal extremely well.
What matters is also what happens to the tissues underneath it.
With laparoscopic surgery, the camera provides a magnified view inside the abdomen, allowing the surgeon to see and work around the ovary without needing to bring it towards the incision.
For me, that is what makes laparoscopic surgery genuinely interesting.
Why tissue manipulation matters to recovery
Every surgical procedure creates some degree of tissue trauma. The body responds to that trauma, and the dog experiences some discomfort as part of the healing process.
How much tissue is manipulated is one part of that equation.
Research comparing laparoscopic and conventional surgical techniques in dogs¹ has found lower postoperative pain in a number of studies, along with differences in the physiological stress response associated with surgery.
There are also studies reporting other potential advantages, including reduced anaesthetic requirements¹ and fewer surgical site infections².
These findings don't mean that every dog will have a dramatically different recovery, or that conventional desexing is somehow inadequate. Every dog is different, and recovery can vary depending on the individual dog, the surgeon, anaesthetic protocol and circumstances of the procedure.
But the research does support an important point. If we can perform the same essential operation while manipulating less tissue, could that make the recovery more comfortable?
It's not about doing the operation faster
Keyhole surgery isn't necessarily quicker. A laparoscopic procedure can take as long as, or sometimes longer than, a conventional spey.
That's because the goal isn't speed. It's about how the surgery is performed, using direct visualisation and specialised instruments to minimise unnecessary tissue manipulation.
For me, that's the more important part of the technique.
So, is laparoscopic desexing better?
Conventional desexing is a safe, well-established procedure and remains the right choice for many dogs. Laparoscopy simply gives us another option.
Not every dog is suitable. Factors such as size, body condition, reproductive status and underlying disease all play a role.
Laparoscopic surgery in Melbourne
I'm excited to announce that laparoscopic desexing is now available at Tooronga Veterinary Hospital.
Laparoscopic desexing isn't just about smaller incisions. It's about finding a different way to perform the surgery that may offer meaningful benefits for suitable dogs.
If you'd like to find out whether laparoscopic desexing is right for your dog, get in touch with our team today.
Sources
Hancock RB, Lanz OI, Waldron DR, Duncan RB, Broadstone RV, Hendrix PK. ‘Comparison of postoperative pain after ovariohysterectomy by harmonic scalpel-assisted laparoscopy compared with median celiotomy and ligation in dogs.’ Veterinary Surgery. 2005;34(3):273–282. doi:10.1111/j.1532-950X.2005.00041.x.
Devitt CM, Cox RE, Hailey JJ. ‘Duration, complications, stress, and pain of open ovariohysterectomy versus a simple method of laparoscopic-assisted ovariohysterectomy in dogs.’ Journal of the American Veterinary Medical Association. 2005;227(6):921–927. doi:10.2460/javma.2005.227.921.Mayhew PD, Freeman L, Kwan T, Brown DC. ‘Comparison of surgical site infection rates in clean and clean-contaminated wounds in dogs and cats after minimally invasive versus open surgery: 179 cases (2007–2008).’ Journal of the American Veterinary Medical Association. 2012;240(2):193–198. doi:10.2460/javma.240.2.193.