New approach and sharp management of the suspensory ligament in canine ovariohysterectomy (Tunnel-Cut) to enhance bupivacaine blockage and reduce surgical complications

Abstract

Ovariohysterectomy is the most common elective surgical procedure performed by small animal practitioners. Suspensory ligament rupture permits retraction of the ovary and distal ovarian pedicle through a limited ventral midline incision. Breaking the suspensory ligament is often the most frightening part of ovariohysterectomy, especially for novel surgeons and it is usually avoided by widening the surgical incision and excessive traction of the ovarian pedicle. Objective: The objective of this study is to demonstrate a new approach of the suspensory ligament in a tunnel-cut technique to provide an easier bupivacaine blockage and its following sharp management in order to improve analgesia and reduce length of incision and surgical complications. Materials and Methods: This work describes step-by-step the tunnel-cut technique for the sharp management and the bupivacaine blockage of the suspensory ligament in 126 canine female patients undergoing ovariohysterectomy. All the animals were from the Insular Animal Shelter of Gran Canaria and presented a range of 6 months to 10 years and 3,5 to 36,4 kg. All the surgeries were performed by the same surgeon and always assisted by students of the Veterinary College of University of Las Palmas de Gran Canaria. We compare this method with a senior surgeon technique from the Insular Shelter of Gran Canaria undergoing 279 ovariohysterectomies during the same period of time of our study. Results: No complications were observed and all the procedures were performed successfully. The surgical technique was feasible in all different animal in age and sizes. The mean time of surgery was 74.99 ± 12.29 min. Surgery showed some difficulties when the females were in oestrus or presented advanced age. Conclusions: This new approach of the suspensory ligament provides an easy bupivacaine blockage showing and excellent analgesia and fast recovery in an opioid free anaesthesia protocol. Sharp management of the suspensory ligament it is also recommended through this new tunnel-cut technique as a controlled and easy method to reduce length of incision and avoid surgical complications.