Gastric dilatation volvulus. Surgical prevention.

Definitive surgical management of gastric dilatation volvulus involves gastric repositioning, gastric resection when indicated and surgical formation of a permanent adhesion to prevent recurrence of the problem. Derotation and gastropexy procedures are recommended as soon as the patient is a reasonable anesthetic risk. Splenectomy and pyloric outlet procedures are of questionable value in preventing recurrence in the majority of cases. In North America, most veterinary surgeons perform right-sided antral gastropexy as a means of preventing recurrence. The technical advantages and disadvantages and experimental and clinical results of several techniques, including the tube gastrostomy, incisional gastropexy, circumcostal gastropexy, and belt-loop gastropexy, are discussed.