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Laparoscopic Gastropexy Techniques

Gastropexy is a surgical procedure used to attach the stomach to the abdominal wall to prevent gastric dilatation-volvulus (GDV), commonly known as bloat. In pets, particularly dogs, several types of gastropexy are performed, each with its own specific techniques and purposes.

Here are the main types:

Procedure: A small incision is made in the stomach wall and a corresponding incision in the abdominal wall. These incisions are then sutured together.

Advantages: Relatively simple and quick, with a lower complication rate.

Disadvantages: Not as secure as some other methods.

Procedure: A strip of the stomach wall (a belt) is passed through a loop created in the abdominal wall and then sutured in place.

Advantages: Provides a secure attachment.

Disadvantages: More complex than incisional gastropexy.

Procedure: A flap of the stomach wall is wrapped around a rib and sutured.

Advantages: Very secure attachment.

Disadvantages: Technically challenging and carries a higher risk of complications.

Procedure: A tube is placed between the stomach and the abdominal wall, and sutured in place, often used as a temporary measure.

Advantages: Useful for temporary decompression and feeding access.

Disadvantages: The tube must be removed later, and it is not intended as a permanent solution.

Procedure:

  • Hybrid Approach: Combines laparoscopy and open surgery.
  • Port Placement: One or two small incisions for the laparoscope and instruments.
  • Visualisation: The laparoscope helps in visualising the stomach and abdominal wall.
  • Exteriorisation: A small incision is made in the abdominal wall, and the stomach is partially pulled through this incision.
  • Suturing: The stomach is sutured to the abdominal wall using traditional suturing techniques outside the body, then returned to the abdominal cavity.

Advantages:

  • Combination of Techniques: Utilises the benefits of both laparoscopic and open surgery.
  • Reduced Pain and Faster Recovery: Compared to fully open surgery, there is less postoperative pain and a quicker recovery.
  • Simpler Suturing: Easier to perform the suturing compared to intracorporeal suturing in full laparoscopic surgery.

Disadvantages:

  • Technical Expertise: Requires knowledge of both laparoscopic and open surgical techniques.
  • Equipment Cost: Similar to LG, it requires laparoscopic equipment.
Photo credit: VCA Hospitals

Procedure:

  • Full Laparoscopy: Entirely performed using laparoscopic instruments without any need to exteriorize the stomach.
  • Port Placement: Several small incisions (ports) are made for the insertion of the laparoscope and specialized instruments.
  • Visualisation: The laparoscope provides a detailed, magnified view of the abdominal cavity.
  • Suturing: The stomach is sutured to the abdominal wall using laparoscopic tools. Often, a specialised needle driver and suture material are used to perform an intracorporeal suturing technique

Advantages:

  • Minimally Invasive: Smaller incisions and less tissue disruption.
  • Reduced Pain and Faster Recovery: Due to the minimally invasive nature.
  • Improved Visualisation: The magnified view can help in precise suturing.

Disadvantages:

  • Technical Complexity: Requires significant expertise in laparoscopic techniques.
  • Equipment Cost: Requires specialised laparoscopic equipment

Our focus is on providing full Laparoscopic Gastropexy (LG) for pets, particularly those at risk for gastric dilatation-volvulus (GDV). We have the facilities, equipment, and expertise necessary to carry out this advanced procedure and prefer this method due to its numerous benefits.

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