What is a Gastropexy

by Dr. T. A. Nathan BVSc & AH, PG Dip (Ortho)
Senior Veterinary Surgeon, Animal Medical Centre
A gastropexy is a surgical procedure designed to permanently adhere the stomach to the body wall that is sometimes performed in large breed dogs to prevent gastric dilatation and volvulus (GDV), also known as bloat. A gastropexy may be performed prophylactically (as a preventive measure in a healthy dog predisposed to this condition) or may be done as part of the surgical management of GDV ( Gastric Dilatation and Volvulus) whereby the pyloric antrum is attached to the right body wall to prevent recurrence after the stomach has been returned to its normal position) and also for a condition called Hiatal Hernia (protrusions of the abdominal esophagus, gastroesophageal junction, and sometimes a portion of the gastric fundus through the oesophageal hiatus into the caudal mediastinum cranial to the diaphragm) where the fundus of the stomach is attached to the left body wall.

Gastropexy Techniques

Numerous Gastropexy techniques have been described, namely:
  1. Tube Gastropexy
  2. Circumcostal Gastropexy
  3. Incisional Gastropexy
  4. Belt – Loop Gastropexy
  5. Laparoscopic Gastropexy
  6. Fundic Gastropexy
Although the strength and extent of adhesions created by these techniques differ, all of them prevent movement of the stomach.

How does Gastropexy prevent GDV

In a gastropexy, your veterinarian will surgically ‘tack’ the stomach to the right side of the body wall. This will hold the stomach into place, preventing it from making the twist that results in a GDV.

Gastropexies performed on an emergency basis, when a dog has already developed GDV, often require more involved post-operative care, depending on the severity of stomach damage noted during surgery. Most dogs will remain hospitalized for several days post-operatively, before being sent home for the remainder of their recovery period. In addition to the activity restriction required with a prophylactic gastropexy, your dog may require a prescription diet and/or medications to protect the gastrointestinal tract.

What is Gastric Dilatation and Volvulus

Gastric dilatation and volvulus (GDV) are life-threatening conditions that is most commonly observed in deep-chested, large-breed dogs (for further information on this condition. Commonly affected breeds include Great Danes, German Shepherds, Standard Poodles, Basset Hounds, Weimaraners and Irish Setters.

In GDV, the stomach becomes dilated with gas and/or fluid and also becomes twisted on itself, in such a manner that the gas/fluid cannot escape. This leads to rising pressure levels within the stomach, decreasing blood flow to the stomach tissues. In some cases, the spleen can also get twisted with the stomach, having its blood supply compromised as well. Disruptions in blood supply can lead to death (necrosis) of the gastrointestinal tract and spleen, while also having significant effects on blood pressure and overall health status. Without treatment, GDV is fatal.

Prevention of GDV Recurrence

There is a recurrence rate of 70 – 80 % if a Gastropexy is not performed.

Prophylactic Gastropexy

This is a gastropexy performed to prevent GDV. This surgery is often performed in high-risk young dogs, frequently at the time that they are spayed or neutered. Prophylactic gastropexy is most frequently recommended in Great Danes, though it may be considered in any high-risk breed including large deep chested breeds. It is estimated that 40% of Great Danes will develop GDV at some point during their lifespan, GSD -27%, Boxers -10%, prophylactic GDV significantly reduces this likelihood.

When is a Prophylactic Gastropexy performed?

Prophylactic gastropexies are often performed in association with spay or neuter surgery. In these cases, there is no specific post-operative care beyond that required for a routine spay or neuter. Patients should be kept calm for approximately 7 days post-operatively to allow healing. Running and jumping should be prevented during this time, and pets should avoid swimming or bathing so that the incision can be kept clean and dry. Your dog will likely be sent home with pain medications and it is important to use these medications as directed.

Recommendations for Clients to prevent GDV

  • Feed several small meals a day rather than one large meal
  • Avoid stress during feeding (if necessary separate dogs in a multiple – dog households during feeding
  • Eating from a raised feed bowl 20% large dogs and 52 % giant breed dogs) increases risk of GDV
  • Other dietary – related risks factors include faster speed of eating and dry food only diets
  • Restrict exercise before and after meals
  • For high – risk dogs consider prophylactic Gastropexy

References

  1. Gastropexy by Catherine Barnette, DVM
  2. Gastrointestinal Tract Surgery by Philip Anthony Moses
  3. Surgery of the Alimentary Tract by Glenn Edwards (CVE)
  4. Small Animal Surgery by Theresa Welch Fossum