Laparoscopic Gastropexy Using Knotless Unidirectional Suture and an Articulated Endoscopic Suturing Device: Seven Cases

OBJECTIVE: To describe a technique for laparoscopic incisional gastropexy using an articulated endoscopic suturing device with knotless unidirectional barbed suture in healthy large breed dogs. STUDY DESIGN: Prospective case series. ANIMALS: Healthy client-owned dogs presented for prophylactic gastropexy and weighing >20 kg (n=7). METHODS: Incisional gastropexy was performed using a single port access system with an articulated endoscopic suturing device. An additional 5 mm cannula was placed in the right caudal abdomen. A 2-0 knotless unidirectional barbed suture was used to complete the gastropexy with 2 separate simple continuous suture lines. All dogs underwent a focal abdominal ultrasound to evaluate the gastropexy site 3-12 months postoperatively. RESULTS: Median weight of the dogs was 33.5 kg (range, 20-51 kg) and the median age was 2 years (range, 0.6-8.5 years). Median surgical time was 60 minutes (range, 39-88). The articulated suturing device malfunctioned twice. On abdominal ultrasound between 3 and 12 months, all gastropexy sites were intact. No motion was detected between the stomach and body wall during distal antral contractions or respiratory motion and a focal thickening of the gastric wall was present in dog. No complications were reported in the postoperative periods as of the 2 week suture removal visit or as of the time of their ultrasound appointment. CONCLUSION: This technique using an endoscopic articulated suturing device with a knotless unidirectional barbed suture provides a feasible technique to perform laparoscopic gastropexy.