TITLE:
Simplified Laparoscopic-Assisted Prophylactic Gastropexy in 40 Client-Owned Dogs
AUTHORS:
Luca Formaggini, Mariangela De Franco, Daniela Nulty, Giulia Boi
KEYWORDS:
Canine Gastric Dilatation/Volvulus, Gastric Disease, Gastric Obstruction, Prophylactic Gastropexy, Video-Assisted Gastropexy, Laparoscopy, Surgery
JOURNAL NAME:
Open Journal of Veterinary Medicine,
Vol.15 No.2,
February
28,
2025
ABSTRACT: Background: Gastric dilatation-volvulus (GDV) syndrome in dogs is a potentially fatal condition that can currently only be prevented surgically. The goal of prophylactic gastropexy is to secure the pyloric antrum to the right abdominal wall, preventing cranial and leftward displacement of the pylorus. Among the various surgical techniques described, minimally invasive approaches are currently preferred. This study presents a simplified technique for laparoscopic-assisted prophylactic gastropexy (LAG). Methods: A case series study was conducted on 40 client-owned dogs to assess the feasibility (i.e., the likelihood of successful completion) and efficacy of a modified laparoscopic-assisted prophylactic gastropexy (LAG). The original Rawlings video-assisted technique (2001) involves an incisional gastropexy with laparoscopic assistance, requiring exteriorization of part of the antral gastric wall, incision of the stomach to expose the gastric mucosa, and subsequent suturing seromuscular layers of the stomach to the transversus abdominis muscle. Additionally, the abdominal musculature encountered during the surgical approach—caudal to the last rib and lateral to the rectus abdominis muscle—is incised. In the modified technique described herein, a more delicate grid approach was used for muscle dissection, and both stomach exteriorization and gastric wall incision have been avoided. This modification aimed to reduce invasiveness and potentially minimize postoperative pain. The efficacy of this modified gastropexy in preventing GDV was assessed based on the presence of adhesions between the transversus abdominis muscle and the pyloric antrum. Adhesion formation was evaluated via ultrasound at 1, 3, and 6 months postoperatively. The technique was considered effective if ultrasound confirmed adhesion formation and if no cases of GDV occurred throughout the study period. Intraoperative and postoperative complications, as well as any occurrence of GDV, were also recorded and analyzed. Results: At the scheduled follow-up evaluations at 1 and 3 months, all dogs (n = 40; 100%) examined via ultrasound demonstrated adhesion formation at the gastropexy site. At the 6-month ultrasound follow-up, 32 dogs (80%) were re-evaluated, and all exhibited persistent adhesions. The owners of the eight dogs that missed the 6-month ultrasound check were contacted by telephone to gather follow-up information. None of these dogs exhibited any signs suggestive of GDV or other postoperative complications, further supporting the short-term efficacy and safety of the procedure. No intraoperative complications occurred, and no cases required conversion to open surgery, confirming the feasibility of the procedure. Minor and self-limiting skin wound inflammation was observed in seven dogs (17.5%) within the first 5 to 10 days postoperatively. Conclusion: Based on the obtained results, the modified laparoscopic-assisted gastropexy appears to be effective in creating adhesions between the abdominal and gastric walls, with no higher complication rate than other described laparoscopic-assisted gastropexy techniques and with reduced soft tissue manipulation. Furthermore, during the telephone follow-up, none of the dogs exhibited signs of GDV one year post-surgery. Given these findings, this technique may be considered a viable alternative to both video-assisted and the more technically demanding fully laparoscopic gastropexies.