By gastropexy is meant attaching the stomach to the abdominal wall. This surgical procedure is performed after gastric dilation and volvulus to prevent this from happening again.
The actual gastropexy can only be performed when the stomach has been completely emptied and restored to its correct position. Since gastric volvulus is often preceded by dilation, accumulated gas and any food remnants are removed from the stomach. To do this, a flexible tube is passed through the mouth and gullet as far as the stomach. This can be done with the dog awake but at the latest when the dog is under anaesthetic to undergo surgery. Alternatively, the excess gas can be released through what is known as a trocar. This is a large needle which is inserted directly through the side wall of the abdomen directly into the bloated stomach; a small tube is then left there to keep the hole open. This looks a bit alarming to a layperson but is a tried and tested method of giving the dog rapid relief.
The volvulus (twisting) can interfere with the stomach’s blood supply, leading to some areas being severely underperfused. Sometimes they recover when fresh blood flows through them again. Otherwise they are removed in the course of the operation. The spleen is closely connected with the stomach and can also be damaged during gastric volvulus. Therefore, it sometimes must be removed during the operation. If possible, however, the veterinary surgeon will naturally try to preserve it.
When the stomach is in correct position again, the operation wound is closed and a large part of the stomach is sutured with it at the same time. This can be done at the side or middle of the abdominal wall. That way, the stomach is attached well and cannot twist again. Only in very rare cases does this attachment come apart and gastric volvulus occurs again.
After gastropexy due to gastric volvulus, the dog has to stay in intensive care for quite a while. Only when its circulation is stable again, respiration is functioning safely and it can consume water and food again without vomiting is it safely on the way to recovery. It is not seldom followed by gastritis, that is, inflammation of the mucous membrane of the stomach, which must then be treated appropriately.
For other possible consequences of gastric volvulus, see here.
Dogs with gastric dilation and volvulus are often in very poor condition, with their circulation and respiration greatly impaired. In this situation, immediate action is necessary. However, these dogs are also not easy to operate on as a general anaesthetic always affects the blood circulation and breathing. They are therefore monitored more closely and also have a higher risk of unexpected complications during the anaesthetic.
Gastropexy is the standard treatment for gastric volvulus. If gastric volvulus is treated only by releasing the gas and emptying the stomach and by stabilising the dog, there is a very high likelihood that the disease will recur within a year.