title: Laparoscopic Gastropexy Using Knotless Unidirectional Suture and an Articulated Endoscopic Suturing Device: Seven Cases.
abstract: 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.
  
  
  METHODS
  Prospective case series.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  This technique using an endoscopic articulated suturing device with a knotless unidirectional barbed suture provides a feasible technique to perform laparoscopic gastropexy.
authors.affiliation: Department of Clinical Sciences, Colorado State University, Fort Collins, Colorado.
authors.forename: Kristin A
authors.initials: KA
authors.lastname: Coleman
authors.affiliation: Department of Environmental and Radiological Health Science, Colorado State University, Fort Collins, Colorado.
authors.forename: Sean
authors.initials: S
authors.lastname: Adams
authors.affiliation: Department of Clinical Sciences, Colorado State University, Fort Collins, Colorado.
authors.forename: Daniel D
authors.initials: DD
authors.lastname: Smeak
authors.affiliation: Department of Clinical Sciences, Colorado State University, Fort Collins, Colorado.
authors.forename: Eric
authors.initials: E
authors.lastname: Monnet
mesh_terms: D000818:Animals; D004285:Dogs / Q000601:surgery*; D004724:Endoscopy / Q000662:veterinary*; D005260:Female; D059485:Gastropexy / Q000379:methods / Q000662:veterinary; D010535:Laparoscopy / Q000379:methods / Q000662:veterinary*; D008297:Male; D011446:Prospective Studies; D013536:Suture Techniques / Q000662:veterinary*; D013537:Sutures / Q000662:veterinary