Laparoscopic surgery is performed using a camera and instruments placed through small incisions (ports) in the body wall. The patient is under anaesthesia and lying on the back. The incisions are between and the number varies according to the equipment and technique used. The surgeon watches on a screen during the operation. The first port is made just behind the umbilicus and the camera is inserted. The abdomen is inflated with carbon dioxide gas to create a space in which to operate. A second port is introduced a few centimeters in front of the navel and a long grasping instrument called a Babcock forceps is inserted. The surgeon finds the ovary with the instrument and uses it to suspend the ovary from a needle placed through the abdominal wall. This lifts the ovary and uterus safely away from other organs. The surgeon then removes the grasping instrument and replaces it with an instrument that cauterizes and cuts tissue. This instrument uses electricity to heat the blood vessels to seal them and to cut them. No sutures are placed inside. The ovary is separated from the uterus and round ligament. The cautery instrument is removed and replaced by the grasping instrument, which is used to pull the ovary out through the small abdominal incision (port). This is repeated on the other side and the small holes are closed with a few sutures. Another method uses ligatures and even the uterus is removed. In female dogs only removing the ovaries and not the uterus is not state of the art because this way the risk of pyometra persists.