Outcomes and Complications in a Case Series of 39 Total Laparoscopic Prophylactic Gastropexies Using a Modified Technique

Abstract

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.

Outcomes and complications of prophylactic incisional gastropexy in 766 dogs (2009-2019)

“…The surgical site infection rate for all abdominal surgeries in this population of dogs was 11.5%. The frequency of incision complications in this study was lower compared to a frequency of 15.5% in other studies evaluating prophylactic IG [37], LAIG [38], and TLIG [39]. This is the largest study to date reporting the outcomes and complications of prophylactic gastropexy.…”

“…More recently, studies by Gazzola et al and Coleman et al concluded that LAIG did not in uence GI motility based on data collected from a wireless motility device [48][49]. Three dogs (0.4%) in the present study had persistent GI signs and 11 dogs (1.4%) had transient GI signs that responded to medical therapy compared to 6.4% of dogs with GI signs reported in other studies [37][38][39]. A previous study reported the occurrence of GD in 3/27 dogs undergoing IG [37].…”

“…There are 3 recent studies that reported on the long-term outcomes and complications of prophylactic IG in 27 dogs in Benitez et al [37], LAIG in 44 dogs in Loy-Son et al [38], and TLIG in 39 dogs in Giaconella et al [39]. In the present study, only 3/766 dogs (0.4%) were found to have complications directly associated with the gastropexy that required surgical intervention compared to a frequency of 4.5% in the other studies evaluating prophylactic IG [37], LAIG [38], and TLIG [39]. Loy-Son et al reported gastropexy malpositioning that required immediate surgical revision in 2/44 dogs.…”

Outcomes and complications of prophylactic incisional gastropexy in 766 dogs (2009–2019).

“…There are 3 recent studies that reported on the long-term outcomes and complications of prophylactic IG in 27 dogs in Benitez et al [ 37 ], LAIG in 44 dogs in Loy-Son et al [ 38 ], and TLIG in 39 dogs in Giaconella et al [ 39 ]. In the present study, only 3/766 dogs (0.4%) were found to have complications directly associated with the gastropexy that required surgical intervention compared to a frequency of 0–5% in the other studies evaluating prophylactic IG [ 37 ], LAIG [ 38 ], and TLIG [ 39 ]. Loy-Son et al was the only study to report the need for immediate surgical revision in 2/44 dogs (5%) due to direct gastropexy complication (gastropexy malpositioning).…”

“…Great Danes) compared with dogs that did not get a gastropexy [ 19 ]. Gastropexy is a surgical procedure involving fixation of the pyloric antrum region of the stomach to the right body wall with several techniques described [ 18 – 39 ]. The incidence of gastric dilatation (GD) in patients who previously underwent prophylactic incisional gastropexy (IG) was 11.1% in one report [ 37 ].…”