Henry’s Story – Laparoscopic Gastropexy
Henry is a 2-yr-old neutered male Great Dane that came to our clinic for an elective surgery called Prophylactic Laparoscopic Gastropexy. In the past, having a gastropexy meant opening the entire abdominal cavity. Now, endoscopy allows the same procedure to be performed using specialized instruments that are inserted into small openings, instead of making a full length incision into the abdomen. This minimally-invasive procedure ensures a faster recovery, with less pain and trauma for the dog.
Henry’s owner was interested in a gastropexy because Great Danes are one of a handful of breeds that are predisposed to a potentially life-threatening condition known as gastric dilatation-volvulus (GDV), commonly called “bloat.”
When GDV occurs, the stomach rotates on its axis, effectively pinching off the stomach’s entrance and exit. As gas builds up and has no way to escape, the stomach expands painfully, and can rupture, causing sepsis (tissue or blood infection) and death. When discovered and treated quickly this condition can be reversed. However, before medical treatment begins, the dog still runs the risk of life-threatening complications from GDV, such as necrosis of the stomach or spleen, heart arrhythmias and potentially fatal bleeding disorders.
To prevent this, a gastropexy can be performed, which involves attaching the stomach to the body wall to prevent it from twisting (also called torsion). After this surgery, there is still the possibility that the patient’s stomach could distend uncomfortably with gas or food, but the life-threatening complication of torsion is unlikely to occur.
The Day of Surgery:
Henry was dropped off in the morning, so that the surgeon, Dr. Allen Johnson, could examine him once more. Dr. Johnson felt that running bloodwork was warranted, since it had been some time since Henry’s last checkup. Henry had his blood drawn by one of the licensed veterinary technicians, who processed it using the in-house laboratory instruments, so that the results were immediately available to Dr. Johnson. Henry was then given an injection that both eased his anxiety in being away from home, and acted as the first step in the pain control program that is customized for each surgical patient.
Dr. Johnson discussed Henry’s anesthetic plan with the surgical technician, and the surgery was scheduled for early afternoon. The equipment technician prepared the surgical suite in advance, setting up the endoscopic equipment, as well as the sterile surgical packs. The technician placed an intravenous catheter in Henry’s front leg, and his anesthesia and his surgical preparation proceeded normally. After his fur was clipped and his skin scrubbed, he was transported to a surgical suite to begin his laparoscopic gastropexy. He was placed on a customized surgical table, to allow the best positioning possible for the procedure. A technician trained in this type of anesthetic procedure monitored Henry at all times using specialized equipment. Throughout the procedure, a surgical assistant prepared the instruments for the next phase of the surgery, to minimize Henry’s anesthetic time.
Dr. Johnson began the surgery by making two small incisions into the abdomen to place the endoscopic equipment. He then used the endoscopic surgical instruments to correctly position the stomach.
The stomach was sutured into place, and the surgery finished quickly.
Henry was then transported from the surgical suite to the recovery area, where he was placed on a soft bed under a warming blanket called a Bair Hugger, to maintain his temperature. His vital signs were closely monitored by the surgical technician until he was fully recovered.
Henry stayed in the hospital under full veterinary care for the night to ensure that his pain was fully controlled. The next morning he was re-assessed by Dr. Johnson. After receiving a clean bill of health, Henry’s owner met with a technician in the afternoon to go over the medications and printed discharge instructions regarding his post-surgical care.
Henry’s owner stated that she was surprised at how quickly he recovered: after thirty-six hours, he acted completely normal. Her only concern was keeping him quiet enough for the next few weeks so that he could fully heal! She later wrote a note to us regarding this surgery: “I am so glad that I had this done for him. I would rather have this surgery now, and not as an emergency when his health is already compromised. I am amazed at how quickly and easily he recovered. Thank you!”
Read more about Gastric Dilatation and Volvulus.
Posted August 12, 2015 by ASCS in Patient Heroes with No Comments
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