BIOMECHANICAL AND HISTOLOGICAL-EVALUATION OF A LAPAROSCOPIC STAPLED GASTROPEXY TECHNIQUE IN DOGS

The biomechanical holding strength and histological characteristics of a laparoscopic stapled gastropexy (LG) adhesion were compared with th at of an incisional gastropexy (IG) adhesion. An LG was performed in 1 4 dogs and an IG was performed in six dogs. During the LG procedure, t he abdomen was insufflated with carbon dioxide and three cannulae were placed in the caudal aspect of the right side of the abdomen. A 35 mm laparoscopic stapler was used to staple the gastric antrum to the adj acent right lateral abdominal wall. The IG procedure was performed thr ough a ventral midline celiotomy. A 35 mm IG was made by apposing the gastric antrum to the adjacent right lateral abdominal wall with two c ontinuous rows of suture. Half of each group of dogs was euthanatized at 7 and 30 days after surgery. The mean tensile load to failure at 7 days was 44.86 +/- 18.54 N for the LG group and 85.33 +/- 23.59 N for the IG group (P <.05). At 30 days the values were 72.93 +/- 18.01 N fo r the LG group and 71.17 +/- 12.11 N for the IG group (P = .41). The g astropexy adhesions in the 7-day postoperative group contained variabl e amounts of fibrin, hemorrhage, mononuclear cell inflammation, loose fibrovascular tissue, and mature collagenous connective tissue. Adhesi ons in the 7-day postoperative group were divided subjectively into th ree histological subgroups based on the relative amounts of mature con nective tissue within the adhesion. The LG and IG adhesions were rando mly distributed among these subgroups (P = 1.0). Adhesions in the 30-d ay postoperative group contained well-organized fibrous connective tis sue. No difference in the amount of connective tissue could be detecte d histologically in the LG or IG adhesions. Complications with the LG procedure included stomach perforation (2 cases), splenic puncture (2 cases), and subcutaneous emphysema (4 cases). (C) Copyright 1996 by Th e American College of Veterinary Surgeons