Obstetrics and Gynecology International the latter are situated in the costolumbar angle, one or two centimetres from the bisection and buried in a fatty ovarian sac, which opens medially [7, 8]. The uterus receives its blood supply from the right and left uterine arteries (Figures 1 and 2). The body of the uterus that lies closest to the oviduct is irrigated by the uterine branch of the ovarian artery, whilst the neck and remainder of the body are supplied by the uterine branch of the vaginal artery. The uterine artery provides the majority of the organ’s blood supply and serves no other organs; it originates from the internal iliac artery along with the umbilical artery. 2.2. Surgical Approaches. Easy access to the genital apparatus is gained via the linea alba; the incision starts at the umbilicus and ends 2 to 3 cm cranial to the anterior border of the pubis. This approach provides direct access to the uterine horns and facilitates prehension of the ovaries. 2.3. Surgical Technique 2.3.1. Surgical Equipment (a) Preparation of the Animal. Ensure that the bitch has been fasted since the previous day especially in the context of elective surgery: however, in an emergency situation, after induction of anaesthesia rapid intubation with a cuﬀed endotracheal tube should prevent aspiration of stomach contents due to gastric reﬂux. In the event of pyometria or metritis, the bitch’s organism has to eliminate the toxins produced during the infection, it is therefore essential for the success of the procedure to choose anaesthetic agents with minimal toxicity. Various protocols are available, these include: IV premedication with valium and morphine at 0.25 mg/kg and 0.1 mg/kg, respec- tively, followed by induction of anaesthesia with propofol at a dose of 5 mg/kg, the volume is increased slowly until the animal is suﬃciently well anaesthetised to enable intubation. Isoﬂurane gas is then used to maintain anaesthesia; a ﬂow rate of 2% is normally suﬃcient to maintain a good level of anaesthesia until the end of the procedure. To control perioperative pain, morphine can be administered at the same dose as for premedication, to a maximum of 10 injections/hour to avoid exceeding the threshold of toxicity. Once anaesthetised, the bitch is positioned in dorsal recumbency with her front legs pulled forward and tied to the table, and the back legs tied back; the bitch is then put on a drip with previously warmed normal saline (0.9%) with glucose. (b) Preparation of the Surgeon. The surgeon should wear a clean and sterile gown, scrub their hands thoroughly using surgical scrub solution, and wear sterile gloves. (c) Preparation of the Material. In addition to the standard laparotomy kit, the surgeon requires the following instru- ments: 3 (i) 2 babcock forceps, (ii) 4 artery forceps, (iii) 4 doyen bowel clamps, (iv) resorbable multiﬁlament suture material, VICRYL, dec. 3. And ﬁnally material for the septic phase of the surgery: scalpel, mayo scissors, and resorbable VICRYL Dec 3.5 or 4 for closure of the abdominal wall. 2.3.2. Surgery. The surgical zone should be carefully scrubbed using the same type of surgical scrub solution as used by the surgeon, and disinfected using alcohol and surgical antiseptic solution several times over. (a) Principal Phases Laparotomy. The skin is incised along the linea alba, that is, the sheath of the rectus abdominus, starting from the umbilicus and ending a few centimetres in front of the pubis. Using a pair of scissors, the subcutaneous connective tissue, which may contain a substantial amount of fatty tissue, is bluntly dissected to visualise the linea alba. Haemostasis is performed before opening the abdominal cavity. If simple swabbing proves insuﬃcient, any bleeders should be ligated or twisted to obtain a very clean surgical ﬁeld. Using rat-tooth forceps, the linea alba is grasped in the middle and tented up before being incised with a pair of scissors. The peritoneum is then punctured using a cannula that is slid towards the umbilicus to enable incision of the linea alba without damaging the abdominal contents, with the cutting edge of the blade turned uppermost. The same procedure is then performed in the opposite direction towards the pubis. If the uterine horns are voluminous they will be seen in the bottom of the surgical ﬁeld following incision of the peritoneum; normal-sized horns will not be visible, for example, following recovery from postoestral metritis or during routine spaying. To ﬁnd the uterine horns easily, the operating table is tilted so that the animal’s head is below its feet, to move the abdominal organs towards the diaphragm; this is known as the TRENDELENBURG position. To locate the genital apparatus with ease, the bladder is retracted laterally; cranial to the bladder, the body of the uterus and bifurcation of the horns are easily locatable. One of the horns is then followed cranially up to the ovary, which is hidden in the fat-ﬁlled ovarian bursa. The ovary is not visible but can be felt through this ovarian bursa. It is a 1- 2 cm long mass, which is exposed after incision of the bursa. Sectioning the Ovarian Pedicle and Broad Ligament − Ovarian Pedicle. The ovary is grasped and babcock forceps placed. The latter are handed to an assistant who holds the ovarian pedicle taught out of the abdomen to facilitate placement of a ligature as close