A Window Opens and a Shunt Closes: A New Laparoscopic Approach for the Attenuation of the Gastrophrenic Shunt

The portosystemic shunt is characterized by the presence of an anomalous vessel, whether congenital or acquired, that connects the portal circulation to the systemic circulation. Surgical treatment is indicated in congenital cases and involves the progressive occlusion of the anomalous vessel. The objective of this study is to report the use of an innovative and fully laparoscopic technique for the attenuation of a gastrophrenic shunt. The procedure was performed on a two-year-old female German Spitz dog with a history of frequent vomiting and diarrhea. The diagnosis was established through computed tomography. For the procedure, three portals were placed in the left lateral region, employing an ameroid constrictor. This device featured a specific perforation for the passage of a pre-mounted suture, which was subsequently occluded intracorporeally, facilitating the closure of the ring defect. The absence of flow in the anomalous vessel was confirmed five weeks after the procedure. It is concluded that the reported implantation technique represents a new modality for the treatment of this type of shunt using a minimally invasive approach.