Philipp D Mayhew1, Dorothy Cimino Brown. 1. Department of Clinical Studies, Matthew J. Ryan Veterinary Hospital, University of Pennsylvania, Philadelphia, PA, USA. philmayhew@gmail.com
Abstract
OBJECTIVE: To report technique, surgical time, complication rate, and postoperative activity in dogs undergoing 2 intracorporeally-sutured total laparoscopic gastropexy (TLG) techniques compared with a laparoscopic-assisted gastropexy (LAG) technique. STUDY DESIGN: Randomized clinical trial. ANIMALS: Dogs (n=30) weighing >25 kg. METHODS: Dogs were randomly assigned to 1 of 3 groups. Two TLG techniques were performed using a median 3 portal technique. One of 2 suturing techniques was used to approximate corresponding incisions made in the stomach and body wall; using intracorporeal hand-suturing or a suture-assist device (Endostitch). In a 3rd group, a previously reported LAG technique was used. All dogs had an activity monitor placed for 7 days pre- and postoperatively. Linear regression analyses were performed to evaluate the association of surgical procedure on gastropexy time and the percentage change in activity counts. RESULTS: Median gastropexy time was 28 minutes (range, 20-41 minutes) for LAG, 48 minutes (range, 39-61 minutes) for the hand suture TLG technique, and 56 minutes (range, 30-90 minutes) for the Endostitch TLG technique. LAG was performed faster than TLG (P<.05). LAG dogs had a greater decrease in postoperative activity than TLG dogs (P=.005); however there was no difference in surgical time or postoperative activity between TLG techniques. CONCLUSIONS: TLG can be performed safely and effectively in dogs and although it takes longer, it has less impact on postoperative activity compared with LAG. CLINICAL RELEVANCE: TLG techniques may have advantages over LAG as measured by a greater willingness of dogs to move around postoperatively.
OBJECTIVE: To report technique, surgical time, complication rate, and postoperative activity in dogs undergoing 2 intracorporeally-sutured total laparoscopic gastropexy (TLG) techniques compared with a laparoscopic-assisted gastropexy (LAG) technique. STUDY DESIGN: Randomized clinical trial. ANIMALS: Dogs (n=30) weighing >25 kg. METHODS:Dogs were randomly assigned to 1 of 3 groups. Two TLG techniques were performed using a median 3 portal technique. One of 2 suturing techniques was used to approximate corresponding incisions made in the stomach and body wall; using intracorporeal hand-suturing or a suture-assist device (Endostitch). In a 3rd group, a previously reported LAG technique was used. All dogs had an activity monitor placed for 7 days pre- and postoperatively. Linear regression analyses were performed to evaluate the association of surgical procedure on gastropexy time and the percentage change in activity counts. RESULTS: Median gastropexy time was 28 minutes (range, 20-41 minutes) for LAG, 48 minutes (range, 39-61 minutes) for the hand suture TLG technique, and 56 minutes (range, 30-90 minutes) for the Endostitch TLG technique. LAG was performed faster than TLG (P<.05). LAG dogs had a greater decrease in postoperative activity than TLGdogs (P=.005); however there was no difference in surgical time or postoperative activity between TLG techniques. CONCLUSIONS:TLG can be performed safely and effectively in dogs and although it takes longer, it has less impact on postoperative activity compared with LAG. CLINICAL RELEVANCE: TLG techniques may have advantages over LAG as measured by a greater willingness of dogs to move around postoperatively.
Authors: Andrea J Sundholm Tepper; Odd V Höglund; Bonnie G Campbell; Chi-Ya Chen; Boel A Fransson Journal: Can J Vet Res Date: 2017-07 Impact factor: 1.310