Ovarian Pedicle Research Articles

Spectrum of magnetic resonance imaging findings in ovarian torsion.

PurposeOvarian torsion is the twisting of the ovary on its vascular pedicle resulting in vascular compromise. Diagnosis of ovarian torsion is challenging in patients who have atypical clinical or ultrasound (US) findings. The objective of our study was to demonstrate the magnetic resonance imaging (MRI) features of ovarian torsion to help radiologists make a conclusive diagnosis when the clinical and US findings are unclear.Material and methodsWe retrospectively reviewed the clinical and MRI features in 10 females with surgically proven ovarian torsion, who had inconclusive clinical, US, or computed tomography findings.ResultsAll patients showed a significantly enlarged ovary with size ranging from 5 to 18 cm. ‘Twisted ovarian pedicle’ sign was seen in seven patients. Eight cases showed areas of haemorrhage within the ovarian stroma. Non-enhancement of ovarian stroma was observed in six patients. Seven patients showed an ipsilateral deviation of the uterus.ConclusionsMRI features of ovarian torsion include ovarian enlargement, twisted ovarian pedicle, ovarian haemorrhage, abnormal ovarian enhancement, and ipsilateral deviation of the uterus. Awareness of these imaging features will enable the radiologist to recognise ovarian torsion and differentiate it reliably from other benign or malignant ovarian lesions.

Repeating torsion of the ovarian pedicle complicated by inguinal hernia treated with laparoscopic oophoropexy and repair of inguinal hernia in a pediatric patient

Repeating torsion of the ovarian pedicle complicated by inguinal hernia treated with laparoscopic oophoropexy and repair of inguinal hernia in a pediatric patient

LESS ovariohysterectomy in cats using a new homemade multiport

ABSTRACT: The purpose of this study was to assess the use of a homemade multiport for LESS (laparoendoscopic single-site surgery) ovariohysterectomy (OVH) in cats. Intra and postoperative variables of the surgery steps, technical challenges, complications and evolution of surgical time by a surgeon in training were evaluated. Twenty queens were selected for LESS OVH. The multiport device was manufactured of a conical-shaped ethylene polytereftalate (PET) bottle, urethral catheter no. 8, latex balloon no. 11, a 3.5mm and a 6mm laparoscopic trocars. Hemostasis was carried out using bipolar diathermy. Mean total surgical time was 14.54±5.12 minutes. Approach to right and left ovarian pedicles and abdominal access for insertion of the multiport device were the most time consuming surgical steps. LESS ovariohysterectomy using a new homemade multiport device is feasible and safe. Thus, the proposed technique may be considered as a minimally invasive alternative to ovariohysterectomy in the feline specie.

543 - Laparoscopic Uterine Retrieval with Preservation of Uterine and Ovarian Vascular Pedicles: Promising Application for Human Uterine Transplants

543 - Laparoscopic Uterine Retrieval with Preservation of Uterine and Ovarian Vascular Pedicles: Promising Application for Human Uterine Transplants

Unusual case of utero-ovarian prolapse concurrent with cystocele in a queen.

Case Description- A 1-year-old female Domestic Shorthair cat weighing 2.5 kg with one week history of protruding mass from the vulva was admitted. Clinical Findings- The prolapse was complete involving both horns protruding from the vulva and a soft bulging mass was palpable inside the prolapsed uterus. Treatment and Outcome- The prolapsed organ was irrigated with warm saline solution and the debris was cleaned. A ventral midline celiotomy was performed for reduction of the mass and sterilization of the cat. The urinary bladder was incarcerated in the right horn of the uterus. The left ovary was inside the mass beside the bladder. Ovarian pedicles were intact but broad ligament was torn. An ovariohysterectomy was performed. Clinical Relevance- Complete uterine prolapse is an emergency case of surgery. If the prolapse includes abdominal contents, amputation of the mass may be avoided and reduction of the uterus and abdominal contents through celiotomy should be prioritized. It seems that this case is the first report of an ovarian prolapse coincident with retroversion of the uterus. The prognosis following ovariohysterectomy is excellent if shock and hemorrhage are treated appropriately.

Uterine auto-transplantation in the non-human primate with preservation of the uterine and ovarian vascular pedicles: modified surgical approach

Uterine auto-transplantation in the non-human primate with preservation of the uterine and ovarian vascular pedicles: modified surgical approach

Rates of intraoperative complications and conversion to laparotomy during laparoscopic ovariectomy performed by veterinary students: 161 cases (2010-2014).

OBJECTIVE To assess rates of intraoperative complications and conversion to laparotomy associated with supervised veterinary students performing laparoscopic ovariectomy in dogs. DESIGN Retrospective case series. ANIMALS 161 female shelter dogs for which elective laparoscopic ovariectomy had been performed by supervised senior (fourth-year) veterinary students from 2010 through 2014. PROCEDURES Medical records of all dogs were reviewed and data collected regarding duration of surgery, surgical complications and other characteristics, and whether conversion to laparotomy was required. RESULTS Laparoscopic ovariectomy was performed with a 2-cannula technique and a 10-mm vessel-sealing device for hemostasis in all dogs. A Veress needle was used for initial insufflation in 144 (89.4%) dogs; method of insufflation was not reported for the remaining 17 (10.6%) dogs. Mean ± SD duration of surgery was 114.90 ± 33.40 minutes. Surgical complications, all classified as minor blood loss, occurred in 24 (14.9%) dogs. These included splenic puncture during insertion of the Veress needle (n = 20 [12.4%]) and minor bleeding from the ovarian pedicle (4 [2.5%]). Splenic puncture required no intervention, and ovarian pedicle bleeding required application of the vessel-sealing device an additional time to control the bleeding. Two ovaries were dropped in the abdominal cavity at the time of removal. Both were retrieved without complication. Conversion to laparotomy was not required for any dog. All dogs were discharged from the hospital within 24 hours after surgery. CONCLUSIONS AND CLINICAL RELEVANCE Laparoscopic ovariectomy in dogs was performed safely by closely supervised novice surgeons, with only minor intraoperative complications encountered and no need for conversion to laparotomy.

CT features in surgically proven cases of ovarian torsion-a pictorial review.

Ovarian torsion is a surgical emergency characterized by a partial or complete rotation of the ovarian vascular pedicle, causing obstruction to venous outflow followed by arterial inflow. Clinically, ovarian torsion frequently mimics other causes of acute pelvic pain such as appendicitis, diverticulitis, renal colic etc. Ultrasonography is the first-line imaging modality of choice for evaluation of ovarian torsion. MRI is useful as a problem-solving tool in patients with equivocal or non-diagnostic ultrasonography studies. CT is ordinarily not utilized in a young female with suspected ovarian torsion due to the radiation dose. However, the significant expansion in use of CT imaging in emergency departments for female patients presenting with acute abdominal pain has increased the likelihood that ovarian torsion may be first seen on CT. In addition, a non-specific clinical presentation may lead to an initial imaging with CT rather than ultrasonography. Ultrasound features of the ovarian torsion are well known and sufficiently described across literature as compared with the CT scan findings. In view of the increasing usage of CT as the modality of choice in emergency settings, it is imperative for the radiologist to familiarize with the CT features of ovarian torsion. An early correct diagnosis by the radiologist in clinically unsuspected cases, facilitating a prompt surgery to restore the ovarian blood flow can prevent permanent irreversible damage. There is limited published data available on the CT features of ovarian torsion. This pictorial essay illustrates CT findings with histological correlation of surgically proven ovarian torsion in our institution. These patients were primarily investigated with CT scan for acute pelvic pain ascribed to non-gynaecological causes such as bowel or urinary tract lesions.

Preoperative epidural administration of lidocaine-methadone or lidocaine-fentanyl in female dogs undergoing elective ovariohysterectomy

We compared the analgesia and cardiopulmonary changes induced by epidural methadone or fentanyl in combination with lidocaine in female dogs undergoing elective ovariohysterectomy and anesthetized with propofol. Eighteen female dogs were randomly assigned to two groups and given either methadone (0.3 mg kg?¹) + 2% lidocaine without vasoconstrictor (LM) or fentanyl (5 µg kg?¹) + 2% lidocaine without vasoconstrictor (LF). The drugs were administered epidurally in a volume of 0.25 ml kg?¹. Heart rate (HR), respiratory rate (RR), rectal temperature (RT), systolic blood pressure (SBP), and blood glucose levels were recorded before and 15 minutes after premedication (T0 and T1); 15 minutes after epidural administration (T2); five minutes after dermotomy (T3); five minutes after clamping of the ovarian pedicle (T4); five minutes and 1, 3, 6, 12, 18, and 24 hours (T5, T6, T7, T8, T9, T10, and T11, respectively) after surgery. The number of additional propofol injections and total propofol dose (mg kg?¹) were recorded. Analgesia was assessed using a numerical descriptive scale. SBP and HR were similar in both groups, but hypotension was detected in animals from both groups at different times. Respiratory rate decreased significantly at T6 in the LF group and was lower than in the LM group. Hypothermia was observed in animals from both groups, but RT was significantly lower than baseline values only at T4 in the LM group. Blood glucose levels increased significantly only in the LF group at T4, T7, and T8. All animals in the LF group and eight animals in the LM group required additional propofol injections at T4, but no significant differences were detected in the number of propofol injections and total propofol dose between the LF (3 ± 1 injections, 7.5 ± 4.5 mg kg?¹) and LM (2 ± 2 injections, 4.5 ± 3.4 mg kg?¹) groups. The latency period, anesthetic period, and the duration of surgery were similar in both groups. No animals required rescue analgesia. The lidocaine-methadone and lidocaine-fentanyl combinations caused minimal cardiorespiratory changes, but did not abolish pain at the time of handling of the ovarian pedicle.

The effect of maropitant on intraoperative isoflurane requirements and postoperative nausea and vomiting in dogs: a randomized clinical trial

ObjectiveTo establish if preoperative maropitant significantly reduced intraoperative isoflurane requirements and reduced clinical signs associated with postoperative nausea and vomiting (PONV) in dogs. Study designRandomized clinical trial. AnimalsTwenty-four healthy, client-owned dogs undergoing routine ovariohysterectomy. MethodsPremedication involved acepromazine (0.03 mg kg−1) combined with methadone (0.3 mg kg−1) intramuscularly 45 minutes before anaesthetic induction with intravenous (IV) propofol, dosed to effect. Meloxicam (0.2 mg kg−1) was administered intravenously. Dogs were randomly assigned to administration of saline (group S; 0.1 mL kg−1, n=12) or maropitant (group M; 1 mg kg−1, n=12) subcutaneously at time of premedication. Methadone (0.1 mg kg−1 IV) was repeated 4 hours later. Anaesthesia was maintained with isoflurane in oxygen, dosed to effect by an observer unaware of group allocation. The dogs were assessed hourly, starting 1 hour postoperatively, using the short form of the Glasgow Composite Pain Score (GCPS), and for ptyalism and signs attributable to PONV [score from 0 (none) to 3 (severe)] by blinded observers. Owners completed a questionnaire at the postoperative recheck. ResultsOverall mean±standard deviation end-tidal isoflurane percentage was lower in group M (1.19±0.26%) than group S (1.44±0.23%) (p=0.022), but was not significantly different between groups at specific noxious events (skin incision, ovarian pedicle clamp application, cervical clamp application, wound closure). Cardiorespiratory variables and postoperative GCPS were not significantly different between groups. Overall, 50% of dogs displayed signs attributable to PONV, with no difference in PONV scores between groups (p=0.198). No difference in anaesthetic recovery was noted by owners between groups. ConclusionsMaropitant reduced overall intraoperative isoflurane requirements but did not affect the incidence of PONV. Clinical relevanceMaropitant provided no significant benefits to dogs undergoing ovariohysterectomy with this anaesthetic and analgesic protocol, although clinically significant reductions in isoflurane requirements were noted.

Follicular dynamics, ovarian vascularity and luteal development in mares with early or late postpartum ovulation

Follicular development and deviation processes during the postpartum period are not completely known in horses. Thus, we aimed to study the characteristics of follicular dynamics and ovarian vascular perfusion during the postpartum period in mares that demonstrated estrous behavior and had early (<10 days) or late (≥10 days) postpartum ovulation. Ten mares were scanned daily by transrectal ultrasonography from the first day postpartum (d1) to the sixteenth day after the first postpartum ovulation (D0 = ovulation). The animals were split in the early (n = 3) and late (n = 7) ovulation groups (average interval between parturition and ovulation: 8.0 ± 0.0 and 14.7 ± 1.2 days, respectively). For the follicular growth, no difference (P > 0.1) was detected between the groups when the data were normalized for the days preceding the first postpartum ovulation (from D−7 to D−1). However, when the data were normalized to days postpartum, the dominant follicle was larger (P < 0.05) in the early-ovulated group in all days during this period (d1 to d7). The number of follicles >25 mm diameter was greater (P < 0.05) in the early-ovulated group during the first 3 days postpartum, and the late-ovulated mares showed greater number of follicles with 20–25 mm during d4 to d7. For blood flow characteristics, no difference (P > 0.1) was detected between groups in vascular perfusion of the dominant follicle or in the ovarian pedicle ipsilateral to the largest follicle. Similarly, no difference (P > 0.1) was detected in progesterone concentrations, corpus luteum (CL) area and vascular perfusion of the CL. Pregnancy rate did not differ (P > 0.1) between the early (3/3; 100%) and late (5/7; 71.4%) groups. Therefore, the characteristics of the follicle growth on the preceding days of ovulation were similar between the early- and late-ovulated mares and were consistent with the follicular dynamics expected in non-pregnant and non-lactating mares. However, when the data were analyzed for the days relative to parturition, greater follicle development was present in mares that ovulate earlier during the postpartum period (<10 days). The results suggest that important events may occur before parturition, resulting in early follicle development, mainly in those mares that show estrus and ovulate within 10 days postpartum.

Effects of LPA2R, LPA3R, or EP4R agonists on luteal or endometrial function in vivo or in vitro and sirtuin or EP1R, EP2R, EP3R or EP4R agonists on endometrial secretion of PGE and PGF2αin vitro

In previous work, an EP2 prostanoid receptor (EP2R) agonist in vivo increased mRNA expression of luteal LH receptors (LHR), unoccupied and occupied luteal; LHR, and circulating progesterone, while an EP3R or FPR agonist decreased; mRNA expression of luteal LHR, unoccupied and occupied luteal LHR, and; circulating progesterone. An EP4R and lysophosphatidic acid (LPA) LPA2R and LPA3R agonists were reported to inhibit luteal function and sirtuins have been proposed to increase prostaglandin synthesis. The objectives were to determine; whether an EP4R, LPA2R, or LPA3R agonist affect ovine luteal function in vivo or; in vitro. In addition, whether sirtuin (SIRT)-1, 2, or 3; LPA2R or LPA3R; or EP1R, EP2R, EP3R, or EP4R agonists affect caruncular endometrial PGF2α or PGE (PGE1+PGE2) secretion in vitro. Day-10 nonpregnant ewes received a single injection of Vehicle (N = 5); an LPA2R (N = 5); LPA3R (N = 6); or EP4R (N = 5) agonist given into the interstitial tissue of the ovarian vascular pedicle adjacent to the luteal-containing ovary to determine effects on circulating progesterone, mRNA expression of luteal LHR, and luteal unoccupied and occupied LHR. In addition, agonists for LPA2R, LPA3R, EP1R, EP2R, EP3R, or EP4R or SIRT-1, SIRT-2, or SIRT-3 activators were incubated with caruncular endometrial slices in vitro to determine their effect on caruncular endometrial PGF2α, or PGE secretion. LPA2R, LPA3R, or an EP4R agonist in vivo did not affect (P ≥ 0.05) luteal weight, circulating progesterone, or occupied luteal LHR. However, an LPA2R or EP4R agonist, but; not LPA3R agonist, in vivo increased (P ≤ 0.05) mRNA expression of luteal LHR. An; LPA2R, LPA3R, or EP4R agonist increased (P ≤ 0.05) luteal unoccupied LHR, but; not occupied LHR. An LPA2R, LPA3R, or an EP4R agonist did not affect (P ≥ 0.05); luteal progesterone secretion in vitro. An LPA2R or LPA3R agonist did not affect (P ≥ 0.05) luteal PGF2α, or PGE secretion in vitro. However, an EP4R agonist tended to decrease (P < 0.066) luteal PGF2α secretion and increased (P ≤ 0.05) luteal PGE; secretion in vitro. EP1R, EP2R, EP3R, or an EP4R agonist did not affect (P ≥ 0.05); caruncular endometrial PGF2α secretion in vitro. However, EP1R, EP3R, or an EP4R agonist increased caruncular endometrial PGE secretion in vitro, while two different EP2R agonists did not affect (P ≥ 0.05) caruncular endometrial PGE; secretion. A SIRT-1 activator, but not SIRT-2 or SIRT-3 activators, increased (P ≤ 0.05) caruncular endometrial PGE secretion, while sirtuin 1, 2, or 3 activators did not affect (P ≥ 0.05) caruncular endometrial PGF2α secretion. In conclusion, receptors for EP4, LPA2, and LPA3 do not appear to be involved; in luteolysis, but EP4R and LPA2R might participate in preventing luteolysis by maintaining luteal mRNA expression for LHR and preventing loss of unoccupied luteal LHR. In addition, SIRT-1, EP1R, EP3R, and EP4R might be involved in; regulating caruncular endometrial PGE secretion, but not PGF2α secretion.

Pharmacokinetics of buprenorphine following constant rate infusion for postoperative analgesia in dogs undergoing ovariectomy

ObjectiveTo investigate the pharmacokinetics of buprenorphine and its main active metabolite, norbuprenorphine, after administration of an intravenous loading dose followed by constant rate infusion (CRI) in dogs. Study designProspective, clinical study. AnimalsA total of seven healthy dogs undergoing elective ovariectomy. MethodsBuprenorphine was administered as a loading dose (intravenous bolus of 15 μg kg−1) followed by CRI (2.5 μg kg−1 hour−1 for 6 hours). Moreover, intraoperative analgesia was supplemented by an intramuscular carprofen (4 mg kg−1) injection, administered prior to surgery, and by lidocaine, administrated through subcutaneous infiltration and through a splash on the ovarian vascular pedicle during surgery. Pain and sedation were scored for all animals throughout the 24-hour study period and rescue analgesia was administered when a visual analogue scale score was > 40 mm. Blood samples were collected from a jugular catheter at regular intervals, and plasma concentrations of buprenorphine and norbuprenorphine were determined by a validated liquid chromatography–tandem mass spectrometry method. ResultsBuprenorphine showed a two-compartment kinetic profile. Maximum concentration was 23.92 ± 8.64 ng mL−1 at 1 minute (maximum time); elimination half-life was 41.87 ± 17.35 minutes; area under the curve was 486.68 ± 125.66 minutes ng−1 mL−1; clearance was 33.61 ± 13.01 mL minute−1 kg−1, and volume of distribution at steady state was 1.77 ± 0.50 L kg−1. In no case was rescue analgesia required. Norbuprenorphine resulted below the lower limit of quantification in almost all samples. Conclusions and clinical relevanceThe results suggest that a buprenorphine CRI can be a useful tool for providing analgesia in postoperative patients, considering its minor side effects and the advantages of a CRI compared to frequent boluses. The negligible contribution of norbuprenorphine to the therapeutic effect was confirmed.

Evaluation of electrosurgery and titanium clips for ovarian pedicle haemostasis in video-assisted ovariohysterectomy with two portals in bitches

ABSTRACT: This study evaluated the use of bipolar electrosurgery and laparoscopic clipping, and their effects on blood loss and the inflammatory response, during a two portal video-assisted ovariohysterectomy technique (two groups with 10 animals each). Surgical time and blood loss volume were significantly lower in the electrosurgery group. There were no significant changes in haematocrit between groups; however, haematocrit did differ between evaluated times, and decreased 10% from the initial measurement to four hours after the procedure. The inflammatory response was significantly higher throughout the post-surgical period, but without any different clinical signs between the two groups. Both techniques had good application for the two portal video-assisted procedure; however, the bipolar electrosurgery allowed for shorter surgical times, reduced blood loss and a minimal learning curve for the surgeon.

Preoperative epidural administration of morphine or methadone for analgesia in female dogs undergoing to ovariohysterectomy*

The analgesia and cardiopulmonary changes provided by methadone or morphine, by epidural route, were compared in female dogs undergoing to ovariohysterectomy. Sixteen female dogs were distributed into two groups, which received 0.3 mg/kg of methadone (MET group) or 0.1 mg/kg of morphine (MORPH group), both by lumbosacral epidural route. The anesthesia was maintained with isoflurane. Heart and respiratory rates, body temperature, systolic, mean and diastolic arterial pressure, cortisol and analgesia were evaluated. The analgesia was measured by numerical descriptive scale which has as a maximum score 25 points. In case a score superior to 16 was detected, morphine was administered (0.5 mg/kg, IM). The following moments were considered: before and 15 minutes after the pre-anesthetic medication (M0 e M1); 15, 50, 55, 65 and 95 minutes after the&nbsp; epidural puncture (M2, M3, M4, M5 and M6, respectively); 2, 4, 7, 13, 19 and 25 hours (M7, M8, M9, M10, M11 and M12, respectively) after the epidural puncture. The cortisol was measured before the measurement of the physiological parameters, in the moments M0, M3, M4, M8, M10 and M12. A reduction in the respiratory rate and decrease of body temperature occurred in both groups. Cortisol increased in the MORPH group at the clamping of the ovarian pedicles (6.10 ± 1.85 μg/dL) and in the MET group, four hours after the epidural puncture (9.05 ± 7.77 mg/dL), but none of the animals needed rescue analgesia and the analgesia was intense in both groups. Morphine and methadone have similar analgesic efficacy, and do not cause significant cardiopulmonary changes

Bilateral ovarian pedicle ligation as an alternative to ovariectomy and ovarian response to eCG treatment

Ovariectomy (OVE) is a standard technique used for dog spaying. If blood circulation to the ovaries is blocked, ovarian tissue is destroyed without being removed from the body. In this study, 12 adult female dogs were selected. Dogs were assigned to treatment (N = 7) and control (N = 5) groups. Blood samples and vaginal cytology were taken and checked for estrus cycle for 3 weeks. After that, both ovarian pedicles of dogs in the treatment group were ligated and in the control group, laparotomy was performed only. Blood sampling and vaginal cytology smears were taken from both groups once a week for the next 8 weeks. All dogs received eCG (20 IU/kg, IM) 1 month post surgery for 5 consecutive days. On the 5th day after eCG treatment, they received a single dose of hCG (500 IU/cases IM). After 8 weeks, ovariohysterectomy was performed and the ovaries of all dogs were sent to the pathology laboratory for pathological examination. In serum samples, estrogen and progesterone were assayed with ELISA kits. Based on the results, five dogs were in the anestrous from the beginning to the end of study. Other dogs were cyclic. Estrogen and progesterone levels were not significantly changed due to ovarian activity (P > 0.05). There was a significant difference between blood levels of estrogen after eCG induction. The difference in progesterone between ligated and sham operated group was significant (P = 0.01). Ultrasonographical evaluation showed excessive fluid accumulation in ovarian bursa and giant follicles on ovaries of the ligated groups 1 month post ligation. Histopathological findings showed hemorrhage and necrosis in ovarian tissues. However, developing follicles and corpus luteums were seen too. In conclusion, the results of the present study showed that despite the severe changes in ovarian tissue following ovarian pedicle ligation, minor perfusions still exist and supply the ovaries so that hormone response and follicular development can occur.

Should we Refrain from Performing Oophorectomy in Conjunction with Radical Cystectomy for Bladder Cancer?

Radical cystectomy with neoadjuvant chemotherapy is the gold standard for treating muscle-invasive bladder cancer. Women subjected to radical cystectomy are frequently postmenopausal, and the median age for bladder cancer diagnosis in women in Sweden is currently 73 yr (Swedish National Bladder Cancer Register). Traditionally, most women treated with radical cystectomy have undergone simultaneous bilateral oophorectomy and hysterosalpingectomy to diminish the risk of later ovarian disease and ovarian bladder cancer recurrence, but also the belief that there is no impact on health or health-related quality of life associated with oophorectomy and the fact that it might be easier surgery to take the ovarian pedicles, rather than sparing the ovaries. However, pelvic organ preservation is considered in some younger women to diminish postoperative functional impairment. Based on recent literature in several areas related to oophorectomy, we question the rationale and arguments for performing oophorectomy in women in conjunction with radical cystectomy for bladder cancer.

Comparison of ultrasound interventional and laparoscopic surgeries for ovarian cyst pediculotorsion

ObjectiveTo study the wound degree and ovarian function of ultrasound interventional and laparoscopic surgeries for ovarian cyst pediculotorsion. MethodsPatients with ovarian cyst pediculotorsion admitted to Affiliated Hospital of Hebei University from May 2012 to August 2015 were selected. Patients underwent emergency ultrasound interventional operation were allocated into ultrasound intervention group and patients underwent laparoscopic surgery were allocated into laparoscopic group. The patients' conditions of two groups in perioperative period were compared. Before and after operation, the serum contents of total bilirubin, albumin, creatinine, blood urea nitrogen, tumor necrosis factor-alpha (TNF-α), interleukin-1β (IL-1β) and IL-6 were measured respectively. Serum contents of follicle-stimulating hormone, luteinizing hormone and estradiol were measured at 3 months, 6 months and 12 months after operation. ResultsThe operation time of ultrasound intervention group was shorter (P < 0.05) and the medical fees of it was lower than laparoscopic group (P < 0.05), while the serum contents of total bilirubin, albumin, creatinine and blood urea nitrogen during the perioperative period of two groups had no obvious changes and differences (P > 0.05). There was no significant difference in the recurrence rate after operation (P > 0.05). There was no significant difference in the serum contents of TNF-α, IL-1β, and IL-6 before and after operation in ultrasound intervention group (P > 0.05). While in laparoscopic group, serum contents of TNF-α, IL-1β and IL-6 after operation were significantly higher than those before operation (P < 0.05). And the serum contents of TNF-α, IL-1β and IL-6 after operation in ultrasound intervention group were significantly lower than those in laparoscopic group before operation (P < 0.05). The serum contents of follicle-stimulating hormone, luteinizing hormone and estradiol between two groups were not significantly different at 3 months, 6 months and 12 months after operation (P > 0.05). ConclusionsUltrasound interventional surgery has quite the same curative effect as laparoscopic surgery in ovarian cyst pedicle pediculotorsion, which also can reduce the surgical trauma, shorten the operation time and lower the operation cost.

Magnetic resonance imaging features of massive ovarian edema in pregnancy: utility for decisions in expectant management.

IntroductionMassive ovarian edema (MOE) is a rare disease and few reports have described the magnetic resonance (MR) imaging manifestations in pregnancy.Case descriptionWe report here a case of MOE in a patient at 12 weeks’ gestation. Abdominal T2-weighted MR images showed asymmetric ovarian enlargement in a teardrop configuration, hyperintense peripherally displaced follicles, and twisting of the vascular pedicle between the enlarged ovary and uterus. The diagnosis of MOE due to ovarian torsion was confirmed by exploratory laparotomy. Preoperative imaging, especially the MR imaging could distinguish MOE from other conditions and demonstrate the relations of adjunct organ, and allowed for untwisting during laparotomy with successful preservation of the ovary.Discussion and evaluationUltrasonography is important in detecting, evaluating, and determining the malignant potential of adnexal masses in pregnancy, but its findings may be nonspecific and then MR may assist characterization. This case was tentatively diagnosed as typical MOE by preoperative imaging, but the shape and location of the hugely enlarged ovarian mass suggested torsion of the ovarian pedicle. In our case, the diagnosis was confirmed by exploratory laparotomy and the pedicle was successfully untwisted.ConclusionMR imaging proved useful for decisions on expectant management of MOE in pregnancy, and the patient’s affected ovary could be preserved.

Veterinary Student Confidence after Practicing with a New Surgical Training Model for Feline Ovariohysterectomy.

Lack of confidence and self-efficacy are the main causes of negative emotions experienced by veterinary students when performing surgery. A surgical training model (STM) was developed to test the hypothesis that practical training on an STM before performing live surgery would enhance the students' confidence. In addition, low-cost and easily accessible materials were used for the construction. In the STM, neodymium magnets that were detached if too much traction was applied were used to ensure careful tissue handling during ligation of the ovarian pedicles and cervix. A pilot study was performed to evaluate veterinary undergraduate students' confidence when using the STM before performing their first live feline ovariohysterectomy (OHE) as lead surgeon. The results showed that the students rated their confidence level higher after performing feline OHE if they had practiced with the STM before surgery. Voluntary written comments revealed that live surgery as a learning situation could have a very negative emotional impact on some students.