Left displaced abomasum: surgical correction

• Left displaced abomasum (LDA) surgery is common in dairy cattle, and many different surgical and non-surgical techniques exist Which technique to use?.
• The surgical techniques considered here are the two most common: right flank laparotomy and omentopexy/abomasopexy, and left flank laparotomy and right flank omentopexy/abomasopexy (Utrecht method).

Uses

• To correct left displacement of the abomasum in dairy cattle.

• Current evidence suggests that surgical correction has a higher success rate that percutaneous ‘toggle’ methods or simply rolling the cow.
• Surgery allows assessment of other viscera and confirmation of diagnosis.

• All abdominal surgery carries risk of post-operative infection.
• Surgical correction is more expensive than ‘toggle’ or rolling.

• Success rates increase with increasing surgeon experience.

Alternative techniques

• Laparoscopic-guided abomasopexy Laparoscopic treatment of LDA
• Percutaneous “toggle” fixation Non surgical management of abomasal displacement
• Casting and rolling a cow – often only a “temporary fix”.
• Ventral right paramedian abomasopexy.​

Time required

Preparation

• 20 minutes.

• 40 minutes.

Decision taking

Assessment of level of ketosis is advisable prior to surgery.

• If abdominal adhesions are suspected, a left flank laparotomy with right sided omentopexy (Utrecht method) or a bilateral approach may be preferred.
• If assessment of other viscera would be beneficial for diagnosis a right flank laparotomy and omentopexy would be the preferred.

Risk assessment

• Ketotic cows have poorer recovery.
• Cows who have been showing signs of LDA for several days or weeks prior to surgery may be more likely to have adhesions that increase the difficulty of surgery.
• Adequate facilities for restraint during surgery improve ease and safety of procedure.