Retrospective Analysis of the Learning Curve Associated With Laparoscopic Ovariectomy in Dogs and Associated Perioperative Complication Rates

Objective: To assess the learning curve associated with laparoscopic ovariectomy (LOE) in 618 dogs and to report perioperative complication rates. Study Design: Case series. Animals: Dogs (n=618). Methods: Data retrieved from the medical records of bitches admitted for LOE over 42 months included date of surgery, breed, weight (kg), age (months), surgeon, suture material used, intraoperative complications and postoperative complications. Each LOE was defined as "successful" or "unsuccessful" by the absence or presence of an intraoperative complication and "failure" rate described using a CUSUM technique. Results: Follow-up time ranged from 152 to 1,435 days (median, 737 days). Intraoperative complications occurred in 10 dogs (1.6%) and included: splenic laceration (6 dogs; 1%), urinary bladder perforation (3 dogs; 0.5%), and subcutaneous emphysema (1 dog; 0.2%). Postoperative complications occurred in 99 dogs (16%) and included: incisional inflammation treated with antibiotics (87 dogs [14%]; 96/1,854 incisions; 5.1%), incisional seroma (5 dogs [0.8%]; 5/1,854 incisions, 0.3%), incisional hernia (4 dogs [0.6%]; 4/1,854 incisions, 0.2%), and ovarian remnant syndrome (3 dogs; 0.5%). CUSUM charts indicated an initial "learning curve" of ~80 LOE. Conclusions: LOE is a technique with an initial learning curve but once surgical proficiency is reached after ~80 procedures then intraoperative complication rates associated with the procedure can be low.