Gastropexy is a surgical procedure in which the stomach is permanently adhered to the internal abdominal wall in order to prevent gastric torsion or gastric dilatation-volvulus (GDV). Gastropexy is performed at the same time as GDV surgery, or prophylactically on an elective basis in healthy dogs susceptible to developing GDV. Some veterinarians recommend prophylactic gastropexy for certain dog breeds at the time of neutering.
Elective gastropexy can be performed during an open abdominal surgical procedure, or laparoscopically for a more minimally invasive approach.
Gastropexy with Open Surgery
There are many surgical techniques available to perform a gastropexy from an open abdominal incision. All techniques are performed through a laparotomy, or a full abdominal incision. The most commonly utilized technique is called an incisional gastropexy. In this procedure, a small incision is made on the stomach wall, and a second small incision is made on the inner right abdominal wall. The two incisions are then sutured together to form a permanent adhesion between the stomach and the body wall.
Recovery from gastropexy after open abdominal surgery is no different than recovery from any other elective surgical procedure. Patients that undergo this surgery are typically rested with activity restriction for 2-3 weeks post-operatively. They are sent home with pain medications, and owners are instructed to feed frequent small meals throughout the day rather than 1 or 2 large meals daily for 1-2 weeks after surgery. After full recovery, the diet can return to normal. If the dog has a gastropexy at the same time that he or she is neutered or spayed, the recovery time is the same.
The use of laparoscopy to assist in gastropexy has become more popular in recent years because the surgery is less invasive. A rigid laparoscope is utilized to visualize and grasp the stomach, which is exteriorized through a small incision in the body wall. An incisional gastropexy is performed as described above through the small incision on the outside of the body. The gastropexy site is then visualized abdominally with the scope. (Figures 1-6 below)
Recovery from laparoscopic-assisted gastropexy is similar to recovery from open surgical gastropexy. The patient is rested, given pain medication, and fed small frequent meals for 2-3 weeks. Laparoscopic-assisted gastropexy is only an option for prophylactic surgery. Dogs that have GDV will require open abdominal surgery.
Figure 1. View through the laparoscope inside the abdomen. The stomach (bottom of the picture) and graspers are visible.
Figure 2. The stomach is grasped and pulled to the right body wall.
Figure 3. A small incision is made on the right body wall so that the stomach can be seen from the outside of the dog. An incisional gastropexy is performed.
Figure 4. The completed gastropexy, as seen by the laparoscope.
Figure 5. Image showing the two small incisions from a completed laparoscopic gastropexy.
View Gastric Dilatation and Volvulus
Author: Anna Dunlap, DVM