Chapter 10: Table of Contents
With clean gloves, gently palpate the stomach (from the outside) to ensure that all foreign material has been retrieved while preventing spillage from the gastrotomy incision. Then, clean the edges of the stomach wall with a moist sponge and close the incision in two layers using 3-0 (or 2-0 in very large dogs) monofilament, absorbable suture such as Biosyn® or PDS®. Do not use chromic gut on the gastrointestinal tract… I place a full thickness, simple continuous pattern and I oversew with a Lembert or Cushing pattern. Wipe the serosal surface with a moist sponge before returning the stomach to the abdomen. If spillage occurred, lavage and suction the abdominal cavity before closing. Soiled instruments and gloves should be discarded and changed (or washed) following closure of the gastrotomy.
2 layer closure (inverting at least in the second layer)Simple continuous + Cushing or Lembert
Two inverting suture lines (Cushing or Lembert)
What layers to include?
First layer can be just mucosa and submucosa leaving the muscularis and serosa for the 2nd layer
First layer can be full thickness and 2nd layer partial thickness through the serosa & muscularis