Sometimes, it is enough to make an incision on one side of the body and remove the ovaries and the uterus through a single opening. However, Dr. Zoltan finds it easier to open the belly on the right side first to ligate and transect the ovarian vessels, and then he put everything back and closed the wound. In the next step, switch sides to open the abdomen from the left and pull out both uterine horns and the previously ligated right ovary. After both ovaries were exposed, the final steps of the surgery are the same as a midline spay: ligating and transecting the left ovarian vessels and then the uterus.

The advantage of the flank approach compared to the midline one is that the wound is smaller, the intestines are left undisturbed, the stretching of the wound is less, and consequently, it is less painful, and therefore the recovery is faster.

(To fit into the video limit, we cut out most of the scrubbing and prepping of the skin and the suturing of the second wound.)