Gastrotomy / Gastrectomy

Gastrotomy or gastrectomy is recommended when a problem inside the stomach cannot be addressed by endoscopy, medication, or watchful waiting. Common situations include:

• Foreign body obstruction — toys, bones, rocks, fabric, or other objects lodged in the stomach that are too large or too irregular for endoscopic retrieval
• Suspected ingestion of a sharp or toxic object that cannot safely wait for passage
• Gastric tumors — adenocarcinoma, gastrointestinal stromal tumor (GIST), or leiomyoma — requiring surgical biopsy or resection
• Non-viable (necrotic) stomach wall segments following GDV, requiring removal of the dead tissue as part of the emergency procedure
• Gastric ulcers or perforations that have failed medical management or that have breached the stomach wall

In dogs and cats, swallowed foreign material is one of the most common reasons for gastrotomy — especially in curious puppies and kittens. Early surgery when the object is still in the stomach (rather than having moved into the intestine) is significantly safer than waiting.

Both gastrotomy and gastrectomy are performed under general anesthesia with full monitoring:

• A midline abdominal incision provides access to the stomach; the surgical field is carefully isolated with moistened laparotomy sponges to minimize contamination if the stomach must be opened
• For gastrotomy: the stomach is incised in a region away from major blood vessels; the foreign material or biopsy sample is retrieved; the incision is closed in two layers with absorbable sutures using a technique designed to minimize leakage
• For partial gastrectomy: the margins of the diseased or necrotic tissue are identified; the area is resected using a combination of vessel-sealing devices and suturing or surgical stapling; the remaining stomach edges are closed and tested for integrity
• The abdomen is examined for additional abnormalities and irrigated before closure
• Removed tissue is sent to pathology for tumor typing and margin evaluation when neoplasia is suspected

Gastrotomy for a straightforward foreign body typically takes 45 to 90 minutes; partial gastrectomy for neoplasia or GDV-related necrosis may take longer depending on the extent of tissue involved.

Preparation depends on whether the procedure is urgent or planned:

• Pre-anesthetic bloodwork assesses organ function and flags any anemia or electrolyte abnormalities from vomiting or GI blood loss
• Abdominal radiographs (X-rays) confirm the location and nature of a foreign body — metal, bone, and dense objects are clearly visible, while soft material may require a contrast study or ultrasound
• Chest X-rays are added when a tumor is suspected, to screen for pulmonary spread
• IV fluids are started before surgery to correct dehydration from vomiting or inappetence
• Food is withheld the night before planned cases; emergency cases proceed as quickly as the patient can be stabilized
• IV antibiotics are given before the first incision when gastric content contamination is anticipated

Gastric surgery recovery focuses on gradually restoring the stomach's normal motility and protecting the surgical closure:

• Hospitalization (1–2 days for gastrotomy; 2–3 days for gastrectomy): IV fluids, pain management, anti-nausea medications, and monitoring for signs of leakage such as pain, fever, or deterioration
• Feeding protocol: water in small amounts is offered a few hours after surgery if no vomiting occurs; small, bland, soft meals (boiled chicken and rice, or a veterinary GI diet) begin the next day and are increased gradually over five to seven days
• Days 5–14 at home: small frequent meals, restricted activity, leash walks only; avoid anything that causes straining or pressure on the abdomen
• Week 2 recheck: incision check and clinical assessment; transition back toward a regular diet begins if the pet is tolerating food well
• Weeks 3–4: full return to normal diet and activity in uncomplicated cases

Pathology results for tumor biopsies typically return within a week and guide the conversation about further treatment or follow-up monitoring.

Gastric surgery carries risks specific to opening the gastrointestinal tract:

• Leakage at the gastrotomy or anastomosis closure — the most serious complication; it is uncommon when performed by an experienced surgeon using proper technique, but it warrants vigilance in the first 72 hours post-op
• Peritonitis (abdominal infection) if gastric contents spill during surgery or if a closure breaks down — managed with irrigation, drainage, and antibiotics
• Delayed gastric motility (ileus) — the stomach may be sluggish in moving food initially, causing nausea and delayed appetite; this usually resolves within a few days with supportive care
• Anesthetic risk from dehydration or electrolyte abnormalities caused by prolonged vomiting
• Incomplete foreign body removal if a piece has moved into the small intestine — full abdominal exploration at surgery addresses this

For foreign body gastrotomies in an otherwise healthy pet, outcomes are very good. For gastric neoplasia, prognosis depends on the tumor type and whether margins are clean — pathology and oncology consultation guide the next steps.