Paramedian incisional complications after prophylactic laparoscopy‐assisted gastropexy in 411 dogs

Abstract

Objective To determine the frequency and types of paramedian incisional complications after prophylactic laparoscopy‐assisted gastropexy (LAG) in dogs and to evaluate potential risk factors for complications. Study design Multi‐institutional retrospective study. Animals Client‐owned dogs (N = 411). Methods Records for dogs that underwent single‐incision–port laparoscopy‐assisted gastropexy (SIPLAG) or multiple‐port laparoscopy‐assisted gastropexy (MPLAG) at five veterinary referral hospitals were reviewed. Information regarding signalment, surgical procedures, perioperative care, and incisional complications was collected. Follow‐up information was obtained by review of medical records and/or communication with owners. Potential risk factors for complications were examined statistically. Results Paramedian incisional complications were observed in 78 of 411 (19%) dogs. The most common complication was seroma formation, which occurred in 51 (12.4%) dogs. Surgical site infections were observed in 16 (3.9%) dogs, and dehiscence or development of excessive scar tissue at the incision site were each observed in nine (2.2%) dogs. Complications resolved with conservative treatment in 75 of 78 (96.2%) dogs and with surgical treatment in three of 78 (3.8%) dogs. The odds of complications were approximately twice as high in dogs undergoing SIPLAG than in dogs undergoing MPLAG (odds ratio, 2.03; P = .006). Conclusion Minor paramedian incisional complications, particularly seroma formation, were frequently observed after LAG. Most complications were successfully managed conservatively. Single‐incision–port laparoscopy‐assisted gastropexy was associated with a higher complication rate compared with MPLAG. Clinical significance Owners should be informed that there is a relatively high rate of minor paramedian incisional complications after LAG. The risk of complications appears to be higher for SIPLAG than for MPLAG.

A systematic review of complications related to laparoscopic and laparoscopic‐assisted procedures in dogs

“…The most commonly reported postoperative complication identified in this review was portal incision related. Despite a lower reported rate of surgical site infection and shorter incision lengths with laparoscopy compared with open surgical technique, 6,37 fairly high rates of incisional‐related complications have been reported with certain laparoscopic procedures 11,83 . In the study by Pope and Knowles, 11 postoperative incisional complications (inflammation, seroma, herniation) occurred in approximately 16% of dogs.…”

“…In a recent multi‐institutional study not included in this review, approximately one in five dogs undergoing laparoscopic‐assisted gastropexy experienced a postoperative incision‐related complication. These included seroma in just over 12% of dogs and surgical site infection in approximately 4% of dogs 83 . Finally, 30% of dogs experienced postoperative incisional complications in a study involving laparoscopic‐assisted gastropexy 18 .…”

The Animal Welfare Science of Working Dogs: Current Perspectives on Recent Advances and Future Directions

“…Based on the mortality associated with gastric dilatation and volvulus documented in the US military working dog program (85), prophylactic gastropexy should be considered in large breed, deep chested working dogs. Current minimally invasive techniques (107), and limited complications (108) support the welfare recommendation to perform this elective procedure in dogs at risk. Other management decisions, such as spay or neutering working dogs, may also be associated with impacts to health and longevity in breeds such as Labrador and Golden Retrievers [e.g., (109)(110)(111)].…”