Gastric torsion is a life-threatening condition in large and deep-chested dog breeds where the stomach twists on its axis and has prompted the investigation of surgical interventions to prevent this condition. One of these interventions included performing gastropexies on patients which are deemed to be at risk, however performing laparoscopic gastropexies has become increasingly more common.
Factors Leading to Gastric Torsion:
Large and deep-chested dog breeds, such as Great Danes, German Shepherds, and Basset Hounds, are predisposed to gastric torsion, leading to life-threatening complications if not corrected immediately. Factors such as age, genetics, diet, and individual anatomy may also contribute and all breeds may be at risk. The risk is then further increased if the animal is fed large meals once a day, eats rapidly, or exercises immediately before or after eating. Due to these contributing factors, it is not possible to provide a percentage of incidence, meaning individual risk factors should be considered.
The Beginning of Laparoscopic Gastropexies:
A gastropexy involves surgically attaching the stomach to the abdominal wall to prevent abnormal movement. The first gastropexies were performed through traditional open surgeries with the first being reported to have taken place in 1971 for management of acid reflux, being shortly followed suit in 1979 as treatment and prevention of gastric dilation and volvulus (GDV). However, the desire to minimise invasiveness and improve recovery times prompted veterinary surgeons (VS) to explore laparoscopic techniques. Often gastropexies are carried out as a preventative measure during routine neutering or just as a general preventative on their own, but they are also performed if gastric torsion/GDV has already occurred as a treatment though this is usually done via the open technique as the surgery needs to be fast in order to reduce mortality.
In the early 2000s, VSs began adapting laparoscopic techniques to perform gastropexies in a more minimally invasive way. Dr Daniel Smeak and others began performing laparoscopic gastropexies as an effective preventive measure against gastric torsion which gave way for the method to become more popular and widespread through the veterinary world.
Advantages Over Open Gastropexies:
Like with other laparoscopic procedures, laparoscopic gastropexies offered several advantages over traditional open procedures. Smaller incisions resulted in reduced postoperative pain, quicker recovery times, and improved outcomes as well as reducing intraoperative complications. As VSs continued observing these benefits, laparoscopic gastropexies gained popularity, particularly among dog owners seeking a less invasive yet equally effective preventive solution.
Laparoscopic gastropexies have become a standard preventive procedure in many veterinary practices, especially for breeds prone to gastric torsion. Pet owners and veterinary surgeons alike appreciate the benefits of reduced surgical trauma and enhanced recovery, leading to increased awareness and demand for this minimally invasive approach.