Abstract
Simple SummaryGastric dilatation and volvulus is a very severe condition that is most commonly seen in large and giant deep-chested dogs, although any dog may be affected. Recently, an increasing number of breeders and owners have become aware of the benefits of prophylactic gastropexy. Many techniques have been developed to perform gastropexy, but laparoscopic surgery, having very low levels of morbidity and invasiveness, fits well with the concept of prevention. The aim of this study is to validate a rapid, modified total laparoscopic prophylactic gastropexy technique with a low rate of complications. The results show that this procedure is safe and effective. Using this technique, it is possible to respect animal welfare and prevent the development of a life-threatening syndrome.Laparoscopic-assisted, laparoscopic, and endoscopic gastropexy techniques have been proven successful in recent years. Thanks to minimal invasiveness, low morbidity, and fast recovery, total laparoscopic gastropexy techniques have been gaining popularity. The objective of this study was to describe the use of a modified minimally invasive technique to perform prophylactic gastropexy in dogs. A case series study of 39 client-owned dogs was undertaken from June 2019 to August 2020. Each dog underwent total laparoscopic prophylactic gastropexy using a simple continuous barbed suture line and two laparoscopic needle holders without incising the seromuscular layer of the stomach and the abdominal wall. Surgical time, the number of stitches, and the length of suture were recorded. Telephone checks, owner questionnaires, and ultrasonographic exams were used to evaluate the effectiveness of the procedure after surgery. The median gastropexy surgical time was 12 min (range 4–30 min), and the median length of the suture line was 3 cm (range 2–4 cm). The last follow-up check was carried out 9 months (mean, range 3–14 months) after surgery, and all ultrasonographic exams (n = 29) showed an intact gastropexy. Intraoperative and postoperative complications were noted. This total laparoscopic gastropexy technique was found to be safe, fast, simple, and with a low morbidity rate. It appears to be a new alternative to other methods of prophylactic gastropexy; however, further research in this area is warranted.
Highlights
Gastropexy is a surgical procedure in which the stomach is permanently attached to the right internal abdominal wall
An incision or a partial thickness peritoneal abrasion has usually been performed before suturing to stimulate a tissue reaction that leads to the creation of permanent adhesion between the gastric seromuscular layer and the right transversus abdominis muscle
It has already been demonstrated that a knotless unidirectional barbed suture can form a pexy without creating intentional trauma to the gastric area or the abdominal wall [23]
Summary
Gastropexy is a surgical procedure in which the stomach is permanently attached to the right internal abdominal wall. In 1979, it was used for the first time to treat and prevent the recurrence of gastric dilatation-volvulus (GDV) [1]. Prophylactic gastropexy can be performed by laparotomy, laparoscopic- or endoscopic-assisted techniques, or full laparoscopy [1,2,3,5,7,8,9,10,11,12,14,15,16,17,18]. Thanks to their minimal invasiveness, low morbidity, and fast recovery rates, total laparoscopic gastropexy techniques have gained popularity. It has already been demonstrated that a knotless unidirectional barbed suture can form a pexy without creating intentional trauma to the gastric area or the abdominal wall [23]
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