In bitches, is ovariectomy/ovariohysterectomy by laparoscopy less painful postoperatively than by midline open laparotomy?



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PICO question

In bitches, is an ovariectomy/ovariohysterectomy by laparoscopy superior to an ovariectomy/ovariohysterectomy by a midline surgical laparotomy in causing less postoperative pain?


Clinical bottom line

Category of research question


The number and type of study designs reviewed

Seven papers were critically appraised. They comprised of three blinded randomised controlled trials, two non-blinded randomised controlled trials and two non-blinded non-randomised controlled trials

Strength of evidence


Outcomes reported

In bitches, ovariectomy/ovariohysterectomy by laparoscopy is superior to ovariectomy/ovariohysterectomy by a midline laparotomy in causing less postoperative pain


Despite the widely held belief that laparoscopic surgery is associated with less postoperative pain, the available veterinary literature only provides weak evidence to support this in bitches undergoing ovariectomy/ovariohysterectomy. There are many uncontrolled variables to consider across these underpowered studies including surgeon number (and experience), the choice of perioperative analgesia, method of pain scoring and the laparoscopic technique. It is therefore clear that laparoscopic procedures cannot be viewed equally and the strength of the answer to the clinical question may change based upon these variables. It is also important to note that the incidence of complications or the effect of the above variables on postoperative pain have not been critically reviewed and warrant careful consideration when deciding on a laparoscopic approach


How to apply this evidence in practice

The application of evidence into practice should take into account multiple factors, not limited to: individual clinical expertise, patient’s circumstances and owners’ values, country, location or clinic where you work, the individual case in front of you, the availability of therapies and resources.

Knowledge Summaries are a resource to help reinforce or inform decision making. They do not override the responsibility or judgement of the practitioner to do what is best for the animal in their care.


Open Access Peer Reviewed


Charlesworth, T. M. & Sanchez, F. T. (2019). A comparison of the rates of postoperative complications between dogs undergoing laproscopic and open ovariectomy. Journal of Small Animal Practice. 60(4), 218–222. DOI:

Coutinho, A. J., Gasser, B., Rodriguez, M. G. K., Uscategui, A. A. R., Santos, V. J. C., Tiosso, C. de F., Barros, F. F. P. da C. & Toniollo, G. H. (2018). Comparison between single port videolaparoscopy and miniceliotomy with snook hot ovariohysterectomy techniques in bitches. Ciênca Rural. 48(10), e20180345. DOI:

Dalmolin, F., Oliveira, M. T., Filho, S. T. L. P., Vaz, M. A. B., de Cecco, B. S., Feranti, J. P. S., Carvalho, E. R., Silva, M. A. M. & Brun, M. V. (2020). Dipyrone, Scopolamine, and meloxicam for conventional or two-port laparoscopic assisted ovariohysterectomy in female dogs. Semina: Ciências Agrárias (Londrina). 41(3), 887–896. DOI:

Davidson, E. B., Moll, H. D. & Payton, M. E. (2004). Comparison of Laparoscopic Ovariohysterectomy and Ovariohysterectomy in Dogs. Veterinary Surgery. 33(1), 62–69. DOI:

Devitt, C. M., Cox, R. E. & Hailey, J. J. (2005). 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. 227(6), 921–927. DOI:

Freeman, L. J., Rahmani, E. Y., Al-Haddad, M., Sherman, S., Chiorean, M. V., Selzer, D. J., Snyder, P. W. & Constable, P. D. (2010). Comparison of pain and postoperative stress in dogs undergoing natural orifice transluminal endoscopic surgery, laparoscopic, and open oophorectomy. Gastrointestinal Endoscopy. 72(2), 373–380. DOI:

Hancock, R. B., Lanz, O. I., Waldron, D. R., Duncan, R. B., Broadstone, R. V. & Hendrix, P. K. (2005). Comparison of postoperative pain after ovariohysterectomy by harmonic scalpel-assisted laparoscopy compared with median celiotomy and ligation in dogs. Veterinary Surgery. 34(3), 273–282. DOI:

Khasriya, R., Vashisht, A. & Cutner, A. (2018). Laparoscopy in urogynaecology. The Obstetrician and Gynaecologist. 20(2), 101–108. DOI:

Mouton, W. G., Bessell, J. R., Otten, K. T. & Maddern G. J. (1999). Pain after laparoscopy. Surgical Endoscopy. 13(5), 445–448. DOI:

Pelligand, L. & Mora, S. S. (2016). Pain assessment methods. In: Duke-Novakovski T., de Vries M. & Seymour C. (Eds.) BSAVA Manual of Canine an Feline Anaesthesia and Analgesia, Third Edition. Gloucester, UK. British Small Animal Veterinary Association, pp113–123.

Pope, J. F. A. & Knowles, T. G. (2014). Retrospecitve Analysis of the Learning Curve Associated With Laparoscopic Ovariectomy in Dogs and Associated Perioperative Complication Rates. Veterinary Surgery. 43, 668–677. DOI:

Sarrau, S., Jourdan, J., Dupuis-Soyris, F. & Verwaerde, P. (2007). Effects of postoperative ketamine infusion on pain control and feeding behaviour in bitches undergoing mastectomy. Journal of Small Animal Practice. 48(12), 670–676. DOI:

Slingsby, L. S. & Waterman‐Pearson, A. E. (2000). The postoperative analgesic effects of ketamine after canine ovariohysterectomy—a comparison between pre and postoperative administration. Research in Veterinary Science. 69(2), 147–152. DOI:

Vasiljević, M., Ristanović, D., Jovanović M., Davitkov, D., Bošnjak, I., Krstić, V. & Stanimirović, Z. (2015) Comparative analysis of parameters of intraoperative and postoperative pain in bitches undergoing laparoscopic or conventional ovariectomy. Acta Veterinaria-Beograd. 65(4), 488–495. DOI:

Walsh, P. J., Remedios, A. M., Ferguson, J. F., Walker, D. D., Cantwell, S. & Duke, T. (1999). Thoracoscopic versus open partial pericardectomy in dogs: Comparison of postoperative pain and morbidity. Veterinary Surgery. 28(6), 472–479. DOI:

Vol. 6 No. 1 (2021): The first issue of 2021

Section: Knowledge Summaries

Categories :  Small Animal  /  Dogs  /  Cats  /  Rabbits  /  Production Animal  /  Cattle  /  Sheep  /  Pig  /  Equine  /  Exotics  /