Comparison of the Effect of Laparoscopic and Conventional Pyloric Surgery on Gastric Emptying in Dogs

Abstract

The effect of a laparoscopic approach and pyloric surgery on canine gastrointestinal activity, particularly gastric emptying time, is not well understood. The purpose of this study was to compare the effect of laparoscopic and conventional pyloric surgery, in Ramstedt pyloromyotomy and Heineke-Mikulicz pyloroplasty, on complete gastric emptying time in 20 clinically normal dogs. Dogs were divided into four groups of five animals: dogs with laparoscopic Ramstedt pyloromyotomy, conventional Ramstedt pyloromyotomy, or laparoscopic Heineke-Mikulicz pyloroplasty, and the conventional Heineke-Mikulicz pyloroplasty group. Gastric emptying time using barium sulfate mixed with dry kibble dog food was measured fluoroscopically before and 1 month after surgery. Gastric emptying of solids was significantly enhanced in the pyloroplasty groups in the postoperative period compared with preoperative emptying. Just as after conventional pyloromyotomy, gastric emptying time after laparoscopic pyloromyotomy was not statistically different as compared with preoperative values. This study indicates that the fluoroscopic test meal is a valuable tool for defining complete gastric emptying time in normal dogs. We conclude that pyloromyotomy was less effective in decreasing complete gastric emptying time than Heineke-Mikulicz pyloroplasty in normal dogs. The possibility of decreasing complete gastric emptying time by laparoscopic surgery suggests a potential clinical application for this technique in small animals.

Technical feasibility of laparoscopic Finney pyloroplasty examined in a canine model

“…Future investigations should identify the ideal technique Our previous studies demonstrated that laparoscopic Finney pyloroplasty is technically more demanding than Heineke-Mikulicz pyloroplasty or Ramstedt pyloromyotomy [12,13], but allows for a greater increase in pyloric diameter [11]. As this report shows, mechanical suturing has markedly simplified the gastroduodenal anastomosis.…”

“…As in our previous studies [12,13], we performed fluoroscopic and ultrasonographic studies to determine the efficacy of the laparoscopic procedures. In both groups, the gastric emptying time was increased after surgery.…”

“…After the procedure, the permeability of the anastomoses was demonstrated by laparoscopic ultrasonography [12]. Gastroscopy with insufflation was used to confirm the absence of leak.…”

“…Fluoroscopic studies were performed 15 days and 1 month after surgery using the technique we previously described in dogs [12,13]. After 1 month, an endoscopic exploration and a postmortem laparotomy with intraoperative ultrasonography were performed to evaluate the results of the intervention.…”

Laparoscopic Finney pyloroplasty in the emergency setting: first case report in the literature and technical challenges

“…The posterior walls of the gastric and the duodenum portions were closed with a continuous seromuscular suture running through the inferior gastroduodenal angle to proceed onto the anterior wall of the gastroduodenostomy. Recent studies reported the feasibility of LFP in a canine model, which strongly suggests applicability to human gastrointestinal surgery since canine and human anatomy in this region is similar (17). Sánchez-Margallo et al evaluated the technical feasibility of LFP in six dogs and successfully completed all the operations laparoscopically and postoperative studies assessed the correct function of the anastomosis (18).…”