Laparoscopic surgery to fix sliding hiatal hernia in dogs

Abstract

OBJECTIVE: To describe a novel laparoscopic technique to treat sliding hiatal hernia in dogs. STUDY DESIGN: Retrospective case series. ANIMALS: Eight dogs with sliding hiatal hernia treated with laparoscopy. METHODS: Surgery reports were reviewed for technique description and animal outcomes. RESULTS: Six dogs were brachycephalic. Dogs were placed in right lateral oblique recumbency. Four dogs were placed in a reverse Trendelenburg position to visualize the esophageal hiatus. A single port was placed 2 cm caudal to the last rib on the left side. An extra cannula was added in four dogs. A large-bore orogastric tube was introduced in five dogs and used in four dogs to reduce the hernia. A unidirectional nonabsorbable barbed suture was used for the closure of the esophageal hiatus and the esophagopexy. A left-sided gastropexy was performed for all the cases. The gastropexy was performed with a gastrostomy tube to bypass the esophagus in four dogs. Intraoperative complications included pneumothorax in three dogs. Conversion was elective in three cases and emergent in one case. Clinical signs were recorded as improved in each dog. The median follow-up time was 16.5 days (range, 9-264). CONCLUSION: Hiatal hernia repair was performed laparoscopically in this population. Repair included a combination of esophageal plication, esophagopexy, and left-sided gastropexy. Reverse Trendelenburg animal positioning and orogastric tube placement facilitated the reduction of the hernia. CLINICAL SIGNIFICANCE: Laparoscopy is an option for the treatment of sliding hiatal hernia in dogs.