Female urogenital surgery

How to – Colpotomy

Indications

Colpotomy is useful for access to the peritoneal cavity for ovariectomy, mummy removal and cervicopexy.

Relevant anatomy

The peritoneal cavity is entered at 2:00 or 10:00 from the vaginal fornix. This avoids the rectum (12:00), bladder (6:00) and iliac arteries (3:00 and 9:00). The upper incisions also decrease the risk of evisceration.

Preoperative management

Food restrictions: Hold patients off feed for 24 hours to minimize abdominal fill.

NSAIDs/analgesics: Perioperative NSAIDs are recommended.

Antibiotics: Perioperative antibiotics are recommended as it is a contaminated procedure.

Local blocks: Epidural and splash block

Position/preparation: The patient is restrained standing. Sedation is recommended.

Surgery Supplies: 

  • Colpotomy spear – scissors, ovariectomy device, ring blade or scalpel

Surgical procedure

After the vaginal is cleansed, the surgeon punctures the wall of the vagina and the peritoneum. This should be done quickly and relatively forcefully or the peritoneum will be pushed away rather than punctured. As the peritoneum is hard to block, this portion of the procedure can be painful.

The incision is made at 2:00 or 10:00, above the cervix.

The incision is left open in most cases. Closure would require laparoscopic type instruments.

Postoperative care

  • Stall or pen rest for 3 days
  • Horses may be restrained in a standing position to minimize the risk of evisceration.

Complications

  • Peritonitis
  • Intestinal evisceration
  • Trauma to internal organs
  • Inability to puncture the peritoneum

Videos

Resources

License

Icon for the Creative Commons Attribution-NonCommercial 4.0 International License

Large Animal Surgery - Supplemental Notes by Erin Malone, DVM, PhD; Elaine Norton, DVM PhD; Erica Dobbs, DVM; and Ashley Ezzo, DVM is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License, except where otherwise noted.