I performed my first incisional gastropexy last week. This surgical procedure is incredibly important for deep-chested dogs as they are more susceptible to gastric dilatation-volvulus (GDV) which is nearly always a life-threatening emergency. In larger, deep-chested breeds like German Shepherds, Dobermans, Great Danes, Boxers or Weimaraners, the stomach can twist on itself and cause gas and food material to become trapped and result in a bloated stomach. This compromises blood supply to parts of the stomach, and if not corrected quickly, can result in death.
In order to reduce the chances of an emergency GDV, a surgical gastropexy can be performed. In female dogs, it is relatively easy to combine this with a spay surgery as there is already an abdominal incision, but it can also be performed in male dogs as well. The goal of the surgery is to prevent the stomach from being able to twist or flip within the abdomen by creating an adhesion between the stomach and the body wall.
The dog that I performed a gastropexy on is a German Shepherd and she was being spayed on the same day. After the spay, I was able to extend the abdominal incision toward her head. Once I located her stomach, I examined the body wall along her right side to locate the diaphragm. It is important to avoid disrupting the diaphragm as we do not want to enter the thoracic cavity with our incision. Once I found her diaphragm, I located a rather distinct “river of fat” which can serve as a landmark between the diaphragm and the body wall. Once I located a spot on the body wall where I felt comfortable creating the pexy I made a 3-cm incision. I made a matching incision through the top two layers of the stomach (serosa and muscularis). I then sutured the ventral incision of the stomach to the ventral body wall incision and the dorsal stomach to the dorsal body wall incision. When these incisions heal, they will create a scar that will fix the stomach to the body wall and make it a lot harder for the stomach to flip or twist in an inappropriate direction.
This little procedure could save a life and I encourage owners of larger dogs to ask for this procedure and will definitely promote it to my future clients. Anything that we do to prevent an emergency is a good thing to do in my book.
