Laparoscopic correction of LDAs

While the majority of farm veterinary medicine is now aimed at prevention rather than cure, we are only too aware that sometimes things happen outwith our control. 

Displaced abomasums (LDA, twisted stomach) are still a common condition seen in freshly calved high producing dairy cows. 

These normally will occur when conditions and diet change along with increased risk factors such as high body condition at calving, retained placenta, metritis, or any other factor which puts a cow off its feed in the 30 days prior to and 60 days after calving.

Correcting an LDA involves getting the abomasum back into the correct position and fixing it there. 

Until recently, we had two main methods, either rolling and toggling, or surgery. Both have pros and cons.  

Toggling is generally quick, and when all goes well, cows recover quickly, but it does involve turning the cow upside down, and we are working blind when inserting the toggle. This can lead to increased complication rates post correction. 

Surgery allows us to see where we are fixing the stomach, but there is always a risk of infection when operating on cows. 

Over the last few years we have been offering a new approach for our clients – correction of LDAs (twisted stomachs) by key-hole surgery.

Philip Wilkinson performs an LDA correction by key-hole surgery

This technique has been used for some time in Holland and Germany but is relatively new to this country.  It is currently being used by just a small number of other practices in the UK.

A laparoscope is a type of camera that is inserted through a small hole (about 1cm), to look inside the cow. 

This allows us to see the displaced abomasum, insert a toggle and deflate the abomasum. Once deflated, the abomasum sinks back to its correct position, and the toggle is fixed down through the body wall to hold it in place. 

The whole procedure is done with the cow standing, using equipment specifically designed for this procedure. The cow is left with two very small wounds that are stapled closed.

The advantage of the laparoscopic technique over conventional surgery is that it’s less invasive. Therefore, there is much less risk of infection, so antibiotics aren’t routinely used, cows generally recover more quickly and there is the reduced expense due to the lack of drugs and therefore discarded milk. 

With the pressure on all farmers to reduce the amount of antibiotics used on farm any technique we can use to reduce the reliance on these medicines is becoming even more important. 

The advantage over toggling is that we can see exactly what we’re doing, so there are less likely to be complications or recurrences, and the cow can stay standing. On farms with limited labour this can make a big difference to the method chosen.

The laparoscope can be used for more than just LDA correction. Being able to see inside a cow’s abdomen allows us to make a more accurate diagnosis of many conditions without having to resort to full surgery. 

Uptake of this technique has increased greatly with over 60 per cent of LDAs in the practice now being corrected by this technique, with excellent farmer feedback. 

Paragon now has four vets in the practice trained to perform this technique and has just invested in a second laparoscope so that we can increase the service that we provide. 

In addition to this we can provide a second opinion on any cases for non-clients who would like to avail of this service after consultation with their vet practice.