Comparison of incisional gastropexy with and without addition of two full-thickness stomach to body wall sutures

F. A. Mann Department of Veterinary Medicine and Surgery, College of Veterinary Medicine, University of Missouri, Columbia, MO

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Yi Pan Department of Veterinary Medicine and Surgery, College of Veterinary Medicine, University of Missouri, Columbia, MO

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John R. Middleton Department of Veterinary Medicine and Surgery, College of Veterinary Medicine, University of Missouri, Columbia, MO

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Candida K. Chairez Department of Veterinary Medicine and Surgery, College of Veterinary Medicine, University of Missouri, Columbia, MO

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Connor Pyne Department of Veterinary Medicine and Surgery, College of Veterinary Medicine, University of Missouri, Columbia, MO

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Abstract

OBJECTIVE

To compare complications between a modified incisional gastropexy (MIG) technique and standard incisional gastropexy (SIG).

ANIMALS

347 client-owned dogs.

PROCEDURES

Dogs that had undergone SIG or MIG from March 2005 through April 2019 were identified through a medical record search of the University of Missouri Veterinary Health Center. The MIG technique is identical to SIG except 2 additional simple interrupted sutures are added, 1 cranial and 1 caudal to the continuous suture line, going full thickness into the stomach to ensure engagement of submucosa. Medical record information was used to identify intraoperative, postoperative, and short-term complications, and telephone or email communication to pet owners and/or referring veterinarians was used to identify complications (short-term and long-term) after discontinuance of care at the University of Missouri Veterinary Health Center. Intraoperative, postoperative, short-term, and long-term complications were analyzed in aggregate within 6 matched groupings: (1) gastropexy for gastric dilatation-volvulus, (2) prophylactic gastropexy without other procedures, (3) gastropexy with ovariohysterectomy, (4) gastropexy with castration, (5) gastropexy with splenectomy, and (6) gastropexy with celiotomy other than splenectomy. Overall rates of complications potentially attributed to gastropexy were compared between SIG and MIG using the Fisher exact test. Overall rates of complications not attributed to gastropexy were compared between SIG and MIG using the χ2 test.

RESULTS

There were no significant differences in overall complication rates between SIG and MIG.

CLINICAL RELEVANCE

Surgeons who feel that engagement of gastric submucosa is important for gastropexy success may use the MIG technique with minimal fear of complications. However, superiority of one technique over the other cannot be determined on the basis of this study.

Abstract

OBJECTIVE

To compare complications between a modified incisional gastropexy (MIG) technique and standard incisional gastropexy (SIG).

ANIMALS

347 client-owned dogs.

PROCEDURES

Dogs that had undergone SIG or MIG from March 2005 through April 2019 were identified through a medical record search of the University of Missouri Veterinary Health Center. The MIG technique is identical to SIG except 2 additional simple interrupted sutures are added, 1 cranial and 1 caudal to the continuous suture line, going full thickness into the stomach to ensure engagement of submucosa. Medical record information was used to identify intraoperative, postoperative, and short-term complications, and telephone or email communication to pet owners and/or referring veterinarians was used to identify complications (short-term and long-term) after discontinuance of care at the University of Missouri Veterinary Health Center. Intraoperative, postoperative, short-term, and long-term complications were analyzed in aggregate within 6 matched groupings: (1) gastropexy for gastric dilatation-volvulus, (2) prophylactic gastropexy without other procedures, (3) gastropexy with ovariohysterectomy, (4) gastropexy with castration, (5) gastropexy with splenectomy, and (6) gastropexy with celiotomy other than splenectomy. Overall rates of complications potentially attributed to gastropexy were compared between SIG and MIG using the Fisher exact test. Overall rates of complications not attributed to gastropexy were compared between SIG and MIG using the χ2 test.

RESULTS

There were no significant differences in overall complication rates between SIG and MIG.

CLINICAL RELEVANCE

Surgeons who feel that engagement of gastric submucosa is important for gastropexy success may use the MIG technique with minimal fear of complications. However, superiority of one technique over the other cannot be determined on the basis of this study.

Supplementary Materials

    • Supplementary Table S1 (PDF 169 KB)
    • Supplementary Table S2 (PDF 171 KB)
    • Supplementary Table S3 (PDF 172 KB)
    • Supplementary Table S4 (PDF 171 KB)

Contributor Notes

Corresponding author: Dr. Mann (mannf@missouri.edu)
  • 1.

    Levine SH, Caywood DD. Biomechanical evaluation of gastropexy techniques in the dog. Vet Surg. 1983;12(3):166-169. doi:10.1111/j.1532-950X.1983.tb00733.x

    • Search Google Scholar
    • Export Citation
  • 2.

    Leib MS, Konde LJ, Wingfield WE, Twedt DC. Circumcostal gastropexy for preventing recurrence of gastric dilatation-volvulus in the dog: an evaluation of 30 cases. J Am Vet Med Assoc. 1985;187(3):245-248.

    • Search Google Scholar
    • Export Citation
  • 3.

    Whitney WO. Belt-loop gastropexy: technique and results of surgery in 20 dogs. J Am Anim Hosp Assoc. 1989;25:75-83.

  • 4.

    Fox SM, Ellison GW, Miller GJ, Howells D. Observations on the mechanical failure of three gastropexy techniques. J Am Anim Hosp Assoc. 1985;21(6):729-734.

    • Search Google Scholar
    • Export Citation
  • 5.

    Smeak DD. Gastropexy. In: Monnet E, Smeak DD, eds. Gastrointestinal Surgical Techniques in Small Animals. John Wiley & Sons Inc; 2020:165-178. doi:10.1002/9781119369257.ch23

    • Search Google Scholar
    • Export Citation
  • 6.

    Allen P, Paul A. Gastropexy for prevention of gastric dilatation-volvulus in dogs: history and techniques. Top Companion Anim Med. 2014;29(3):77-80. doi:10.1053/j.tcam.2014.09.001

    • Search Google Scholar
    • Export Citation
  • 7.

    Benitez ME, Schmiedt CW, Radlinsky MG, Cornell KK. Efficacy of incisional gastropexy for prevention of GDV in dogs. J Am Anim Hosp Assoc. 2013;49(3):185-189. doi:10.5326/JAAHA-MS-5849

    • Search Google Scholar
    • Export Citation
  • 8.

    Glickman LT, Lantz GC, Schellenberg DB, Glickman NW. A prospective study of survival and recurrence following the acute gastric dilatation-volvulus syndrome in 136 dogs. J Am Anim Hosp Assoc. 1998;34(3):253-259. doi:10.5326/15473317-34-3-253

    • Search Google Scholar
    • Export Citation
  • 9.

    Hammel SP, Novo RE. Recurrence of gastric dilatation-volvulus after incisional gastropexy in a Rottweiler. J Am Anim Hosp Assoc. 2006;42(2):147-150. doi:10.5326/0420147

    • Search Google Scholar
    • Export Citation
  • 10.

    Theisens L. Long Term Follow Up After Incisional Gastropexy. Master’s thesis. Utrecht University; 2017.

  • 11.

    Hoogzan JT. A Retrospective Study of the Recurrence Rate of Gastric-Dilatation Volvulus After Incisional Gastropexy in Dogs. Master’s thesis. Utrecht University; 2016.

    • Search Google Scholar
    • Export Citation
  • 12.

    Cornell K. Stomach. In: Johnston SA, Tobias KM, eds. Veterinary Surgery Small Animal. 2nd ed. Elsevier; 2018:1700-1730.

  • 13.

    Degna MT, Formaggini L, Fondati A, Assin R. Using a modified gastropexy technique to prevent recurrence of gastric dilatation-volvulus in dogs. Vet Med. 2001;96(1):39-50.

    • Search Google Scholar
    • Export Citation
  • 14.

    Ward MP, Patronek GJ, Glickman LT. Benefits of prophylactic gastropexy for dogs at risk of gastric dilatation-volvulus. Prev Vet Med. 2003;60(4):319-329. doi:10.1016/s0167-5877(03)00142-9

    • Search Google Scholar
    • Export Citation
  • 15.

    Yoon HY, Mann FA. Clinical evaluation of three different colopexy techniques in dogs. Indian Vet J. 2009;36:1129-1131.

  • 16.

    Henderson RA. Controlling peritoneal adhesions. Vet Surg. 1982;11(1):30-33. doi:10.1111/j.1532-950X.1982.tb00662.x

  • 17.

    MacPhail C, Fossum TW. Biomaterials, suturing, and hemostasis. In: Fossum TW, ed. Small Animal Surgery. 5th ed. Elsevier; 2019:60-78.

  • 18.

    Byrne M, Aly A. The surgical suture. Aesthet Surg J. 2019;39(suppl 2):S67-S72. doi:10.1093/asj/sjz036

  • 19.

    Souza CHM, Mann FA. Basic wound healing and wound closure. In: Mann FA, Constaninescu GM, Yoon H, eds. Fundamental of Small Animal Surgery. Wiley Blackwell; 2011:176-186.

    • Search Google Scholar
    • Export Citation
  • 20.

    Deroy C, Hahn H, Bismuth C, Ragetly G, Gomes E, Poncet C. Simplified minimally invasive surgical approach for prophylactic laparoscopic gastropexy in 21 cases. J Am Anim Hosp Assoc. 2019;55(3):152-159. doi:10.5326/JAAHA-MS-6879

    • Search Google Scholar
    • Export Citation
  • 21.

    Takacs JD, Singh A, Case JB, et al. Total laparoscopic gastropexy using 1 simple continuous barbed suture line in 63 dogs. Vet Surg. 2017;46(2):233-241. doi:10.1111/vsu.12601

    • Search Google Scholar
    • Export Citation
  • 22.

    Balsa IM, Culp WTN, Johnson EG, et al. Efficacy of two radiologic-assisted prophylactic gastropexy techniques. Vet Surg. 2016;45(4):464-470. doi:10.1111/vsu.12457

    • Search Google Scholar
    • Export Citation

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