What Is Gastropexy in Dogs and How Suture Choice Affects the Result

Gastropexy is a surgical procedure that fixes the stomach to the body wall so that it cannot rotate. The question "what is gastropexy" arises most clearly for large, deep-chested breeds, which the American College of Veterinary Surgeons names as at-risk dogs. It is performed to prevent gastric dilatation volvulus in dogs, a life-threatening condition, and the attachment is made with suture, so the suture has to hold.

This article sets out what the American College of Veterinary Surgeons, RCVS Knowledge and a 2025 laboratory study report about gastropexy, how suture choice could influence the result, and where the evidence stops. It also explains which materials in the Gexfix range have the properties that a load-bearing attachment calls for.

What Is Gastropexy in Dogs?

Gastropexy in dogs is the attachment of the stomach to the abdominal wall. The American College of Veterinary Surgeons describes it as tacking the stomach to the body wall to prevent gastric dilatation volvulus (GDV), and it describes open surgery as suturing the stomach to the body wall. The same page names large and giant breeds, such as the Great Dane, Rottweiler and Standard Poodle, as examples of at-risk dogs. It also lists deep-chested dogs, anxious dogs and dogs with a close relative that has had GDV, and it says GDV can affect about 1 in 5 at-risk dogs that do not have the procedure.

A gastropexy is a deep tissue closure that carries load, and the guide to selecting a deep tissue suture for veterinary surgery explains why absorption should match the healing rate of each layer.

Stomach Tacking in Dogs

Stomach tacking in dogs is a common description of the same procedure, and the ACVS page uses the same image when it says the stomach is tacked to the body wall. The word describes the purpose well. The stomach is anchored so that it stays in its normal position, and the anchor is only as reliable as the suture and tissue that hold it.

Gastric Dilatation Volvulus in Dogs

Gastric dilatation volvulus in dogs is the condition that gastropexy is designed to prevent, and the ACVS page calls it life-threatening. The recurrence evidence discussed below concerns dogs that already had the condition. In those studies, dogs were treated with gastric decompression alone or with gastric decompression plus gastropexy, and in this article GDV surgery refers to the second pathway.

Open and Laparoscopic Gastropexy

The ACVS page describes two approaches. Open surgery uses a larger incision on the abdominal midline, usually 8 to 12 inches in length. Laparoscopic gastropexy uses 2 to 3 small incisions of less than 1.5 inches, with the abdomen inflated with carbon dioxide and a camera used for viewing, and the page says this causes less pain and a shorter recovery.

A 2025 study in Frontiers in Veterinary Science notes that total laparoscopic gastropexy has become increasingly popular because it is minimally invasive, and that intracorporeal suturing is difficult and time consuming. The study tested a modified technique that used a knotless barbed suture material to avoid intracorporeal suturing.

What the Evidence Shows About Recurrence

The RCVS Knowledge summary by Zagan reviewed four studies, two retrospective and two prospective, and rates the strength of evidence as strong. Its conclusion is that gastropexy significantly reduces the risk of recurrence. Across the four studies, recurrence with gastropexy ranged from 0% to 22.9%, and recurrence without it ranged from 50% to 80%.

The limits matter. The studies were published between 1975 and 1998, the summary lists small sample sizes among the limitations of some of them, and the techniques differed, including circumcostal gastropexy, incisional gastropexy and incorporation of the stomach into the linea alba closure. The summary does not report suture material for any of the four studies, so it cannot say whether one suture performs better than another. Gastropexy lowers the risk, but this evidence does not show which suture gives the best result.

How Suture Choice Affects the Result

What the Suture Has to Do

In gastropexy the suture holds the stomach against the body wall while the attachment forms. The ACVS page describes the stomach as tacked to the body wall, but none of the sources reviewed states how long the suture itself must carry load. A material that keeps its strength for a long period does not depend on that unknown. The Gexfix Product Reference lists PDS at about 180 to 210 days, with long tensile support and low tissue reactivity, and positions it for fascia, tendons and slow-healing or high-tension tissue. The article on PDS suture absorption time and strength explains how that figure should be read.

The same reference describes PDS as stiffer and advises planning extra throws. The guide to suture knot and throw count sets out how throw count follows the material.

Shorter-Acting Materials

The Product Reference lists PGCL at about 90 to 120 days with moderate support duration, and braided PGA at about 60 to 90 days. Both suit routine soft tissue closures, but no source reviewed tests either in gastropexy. A surgeon who chooses a shorter-acting material is relying on the attachment becoming secure before the suture loses strength, and the sources do not show when that happens.

Knotless Barbed Suture

The Frontiers study compared two laparoscopic gastropexy techniques in 12 canine cadavers, 6 per group. Both groups used barbed suture with a 3 cm suture length and four bites. The modified technique used knotless barbed suture material passed percutaneously as four separate sutures tied with square knots buried under the skin, with no intracorporeal suturing, and the total laparoscopic technique used a simple continuous barbed suture. Maximum load to failure was 35.86 ± 8.24 N for the modified technique and 24.04 ± 7.16 N for the total laparoscopic technique (p = 0.024). Total surgical time (61.83 ± 4.80 minutes against 65.33 ± 12.05 minutes) and suturing time (31.33 ± 3.13 minutes against 37.5 ± 7.06 minutes) did not differ significantly.

This is a comparison of techniques, not of suture materials, because both groups used barbed suture. The model was cadaveric, the groups were small, and the authors say further evaluation in clinical cases is needed. FILBLOC® is the Gexfix knotless barbed suture, made from PDS with precision cut barbs. The Product Reference positions it for laparoscopic, reconstructive and time-sensitive closures with even tension and no knots, and it warns that the suture is technique sensitive and difficult to back out once engaged. Neither the Product Reference nor the study tests FILBLOC® in gastropexy. The guide to barbed suture material in veterinary surgery describes where knotless closures fit more broadly.

Comparing Suture Options for Gastropexy

The Product Reference does not name gastropexy as an indication for any suture. The table sets the manufacturer properties beside what the sources reviewed say about each material in this procedure.

The comparison supports a narrow conclusion. A long-acting monofilament such as PDS, or its knotless barbed form, matches the demand for sustained strength under load, while shorter-acting materials leave more to the surgeon's judgement about when the attachment is secure. That is reasoning from the manufacturer's figures and the mechanics of a load-bearing attachment, not a finding from a gastropexy trial.

When Suture Choice Is NOT the Deciding Factor

Patient Selection

The ACVS page says a primary care veterinarian may recommend gastropexy based on breed, temperament, chest shape or family history of GDV. Suture choice does not change which dogs need the procedure.

Technique

The recurrence studies used different gastropexy techniques, and the Frontiers study shows that two techniques differed in load to failure even though both groups used barbed suture.

Residual Risk

Recurrence with gastropexy reached 22.9% in one of the four studies, so the procedure lowers the risk without removing it in every series. The evidence reviewed does not show that suture choice changes that figure, and an owner should be told that gastropexy reduces risk without guaranteeing protection.

Choosing a Suture for Gastropexy in Dogs

The evidence establishes that gastropexy works and that laparoscopic technique raises a real suturing problem. It does not establish which suture is best. The reasoned choice is a monofilament with long tensile support, handled with enough throws, or a knotless barbed form where a surgeon is trained in it.

Gexfix International Corp., in partnership with Assut Europe S.P.A., supplies ASSUFIL® MONOFILAMENTO PDS monofilament sutures in a range of USP sizes and needle configurations for veterinary practice. The absorbable range also includes PGCL MONOFIL®, ASSUFIL® PGA, ASSUCROM® Chromic Catgut and FILBLOC® Barbed Sutures. With over 30 years of manufacturing expertise and ISO 13485-certified production standards, Gexfix provides veterinary practices with the reliable monofilament absorbable sutures and full suture portfolio that consistent outcomes require.

Explore the full range at medicaldevicevet.com.

Sources

American College of Veterinary Surgeons, Prophylactic Gastropexy (undated; page copyright 2026). Professional society public information page, with no author or date listed and no manufacturer funding stated. Supports the description of the procedure, the at-risk dogs, the 1 in 5 figure and the open and laparoscopic approaches.

RCVS Knowledge (Veterinary Evidence), Recurrence rates in dogs with GDV treated with gastric decompression versus dogs treated with gastric decompression and gastropexy (2025). Knowledge summary by Zagan C. of four studies. The author declares no conflicts of interest, and no funding statement is given. Supports the recurrence ranges, the strength of evidence and the study limitations.

Frontiers in Veterinary Science (Kim D.W., Kwak H.H., Kim J., Woo H.M.), Description and biomechanical evaluation of the modified laparoscopic-assisted percutaneous gastropexy technique in dogs (2025). Peer reviewed cadaver study. The authors report no financial support and no commercial or financial conflicts of interest. Supports the laparoscopic suturing statements and the load to failure and timing results.

Absorption windows, handling notes and infection field guidance come from technical data supplied by Gexfix International Corp. and Assut Europe S.P.A. and are manufacturer information.

FAQs

Q. What is gastropexy in dogs and why does suture choice matter?

A. Gastropexy in dogs attaches the stomach to the body wall with suture to guard against gastric dilatation volvulus. Suture choice matters because the suture carries load while the attachment forms. The sources reviewed show that gastropexy works but do not show which suture gives the best result.

Q. How effective is gastropexy at preventing GDV from recurring?

A. The RCVS Knowledge summary of four studies reports recurrence of 0% to 22.9% with gastropexy and 50% to 80% without it, and it concludes that gastropexy significantly reduces recurrence. The studies are small and were published between 1975 and 1998. GDV surgery with gastropexy lowers the risk but does not remove it in every series.

Q. What is stomach tacking in dogs and is it the same as gastropexy?

A. Stomach tacking in dogs is a common description of gastropexy. The ACVS page says the stomach is tacked to the body wall to prevent GDV.

Q. Is laparoscopic gastropexy better than open surgery?

A. The ACVS page says the laparoscopic approach uses 2 to 3 incisions of less than 1.5 inches, compared with a midline incision of usually 8 to 12 inches, and that it causes less pain and a shorter recovery. The Frontiers study adds that intracorporeal suturing is difficult and time consuming. Choosing between the approaches is a decision for the surgeon.

Q. Which dogs are considered for gastropexy?

A. The ACVS page names large and giant breeds such as the Great Dane, Rottweiler and Standard Poodle, and it lists deep-chested dogs, anxious dogs and dogs with a close relative that has had GDV. A primary care veterinarian may recommend the procedure on those grounds.