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Updated: Jul 9, 2026

Surgical Techniques to Optimize Ovarian Reserve during Laparoscopic Cystectomy for Ovarian Endometrioma
Published on: January 22, 2022
Standing hand-assisted laparoscopic ovariohysterectomy to treat chronic pyometra in a mare
Catherine C Thurston1,2, Patricia L Sertich1, Sue M McDonnell1
11Department of Clinical Studies, New Bolton Center, School of Veterinary Medicine, University of Pennsylvania, Kennett Square, PA.
Objective:
To describe a standing hand-assisted laparoscopic ovariohysterectomy in a mare.
Animal:
A 15-year-old maiden Oldenburg mare.
Clinical Presentation, Progression, And Procedures:
The mare was presented for evaluation of bucking under saddle and uncharacteristic aggressive behavior. Evaluation of a 24-hour video of the mare in a stall showed behavior consistent with caudal visceral abdominal discomfort. Reproductive evaluation revealed a pyometra secondary to complete transluminal cervical adhesions. The mare was initially managed medically with disruption of the adhesions and uterine lavage, but the adhesions reformed within 6 weeks and could not be manually disrupted.
Treatment And Outcome:
To eliminate the recurrence of pyometra, the mare underwent standing hand-assisted laparoscopic ovariohysterectomy through bilateral flank incisions. The only complication was a seroma at 1 flank incision that resolved after drainage.
Clinical Relevance:
Complete ovariohysterectomy in the mare is a challenging procedure and has previously been performed under general anesthesia. This is the first report of the procedure being performed completely in the standing mare without inversion of the uterus through the cervix.
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