Surgery Overview

OVARIOHYSTERECTOMY (OHE)

GENERAL INFORMATION

In dogs, the incision should be made just caudal to the umbilicus to maximize ability to ligate the ovarian pedicle.
In cats, the incision should be made more caudal to allow for ligation of the uterine body.

MOST COMMON COMPLICATIONS AND DIFFICULTY

Failure to remove the entire ovary.
Hemorrhage from the uterine artery when ligation is a single circumferential ligature. A uterus that is gravid or enlarged due to estrus or pyometra will rapidly involute. A circumferential ligature will become loose with this involution. Uterine arteries should be individually ligated in patients with a large uterus, those in estrus or with a pyometra or gravid uterus.
The ureter may be inadvertently ligated, particularly if a pedicle is dropped and exposure is inadequate.
Fistulation may occur with some non-absorbable materials when used for pedicle ligation. Use absorbable suture materials.

Separate the broad ligament from the uterine horn. Clamp and ligate the broad ligament (dashed line) if it appears vascular.

"EXPERTS' ADVICE"

Make incision of adequate length. Take time to place ligatures accurately.
The uterus can be easily located by looking for it adjacent to the dorsal bladder wall. The duodenum acts as a natural retractor for the right abdominal “trough” (where the ovarian pedicle lives) and can be recognized by the adjacent pancreas. The colon is the natural retractor on the left, and can be identified by its linear striations.
"Flash" clamps when tying ligatures to ensure the ligature tightly constricts the tissue. Avoid clamping the uterus in cats, particularly if they are in heat, as the uterus is friable and may tear.
Open ovarian bursa to examine ovarian tissue removed.

The ovariohysterectomy requires very secure mass ligatures of the ovarian pedicles with a suture of high tensile strength and good knot security. Since animals have a tendency to lick the wound postoperatively, an intradermal closure is preferable to a skin closure.

OVARIOHYSTERCTOMY (OHE):
SUTURE AND NEEDLE OPTIONS

Brand

Needle Type

Needle Reference

Main Choice

Also Possible

Main Choice

Also Possible

PEDICLES

Taper Point

Reverse Cut

SH, CT-2, CT-1

FS-2, FS-1, FS

LINEA ALBA

MONOCRYL* (young)

PDS* II (adult)

VICRYL* PLUS

Taper Point

Reverse Cut

SH-1, SH, CT-2, CT-1

RB-1, CT-3

FS-2, FS-1, FS, FSL, X-1, CP-2, CP-1

SUBCUTANEOUS

Taper Point

RB-1, SH, CT-2, CT-1

SKIN CLOSURE

ETHILON*

PROLENE*

Silk

Reverse Cut

FS-2, FS-1, FS

FSL, CP-2, CP-1, KS

Blue type indicates Reverse Cut

	Cat/Small Dog (20 lbs or less)	Medium Dog (20-45 lbs or less)	Large Dogs (50 to 75 lbs)	Giant Dog (75 lbs +)
PEDICLES	3-0	3-0 or 2-0	0 or 1	1
LINEA ALBA	3-0	3-0 or 2-0 or 0	2-0 or 0	0 or 1
SUBCUTANEOUS	4-0	4-0 or 3-0	3-0 or 2-0	2-0
SKIN CLOSURE	4-0	4-0 or 3-0 or 2-0	3-0 or 2-0	2-0

	Use the suture selection tool for specific product code recommendations.

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