A vagotomy is a surgical procedure that is performed, in the treatment of chronic duodenal or peptic ulcers, to reduce the amount of acid secreted within the stomach. The vagus nerve, which stimulates the production of stomach acid, is surgically cut during the vagotomy procedure. The vagotomy procedure is performed either laparoscopically or as an open surgical procedure, with general anesthesia. A vagotomy is performed as a last resort in the treatment of ulcers, because most ulcers are responsive to medication.
Preparing for the Vagotomy Procedure
Before undergoing a vagotomy, the doctor will conduct a full physical and medical examination. The following diagnostic procedures that may be performed include the following:
- X-rays
- Upper endoscopy
- Blood tests
- Urinalysis
The doctor should be informed of any medications being used, as they may need to be stopped before the surgery. A detailed list of instructions will be provided to the patient in preparation for the procedure.
The Vagotomy Procedure
Vagotomy is performed either as an open procedure or laparoscopically, with general anesthesia. A vagotomy procedure may be performed by one of the following methods:
Laparoscopic Vagotomy
A laparoscopic vagotomy cuts portions of the vagus nerves, depending on the patient's individual condition.
Truncal Vagotomy
A truncal vagotomy, also known as a total abdominal vagotomy, cuts the main trunk of the vagus nerve. This method affects the ability of the stomach to empty, and an additional procedure must be performed simultaneously to promote stomach emptying.
Selective Vagotomy
A selective vagotomy, also known as proximal gastric vagotomy, dissects the main trunk of the vagus nerve. This procedure is rarely performed.
Highly selective vagotomy
A highly selective vagotomy, also known as parietal vagotomy, cuts the parietal cells of the vagus nerve.
Thoracoscopic Vagotomy
A thoracoscopic vagotomy cuts the posterior trunk of the vagus nerve and is typically performed on those patients who have previously undergone a vagotomy procedure.
After the Vagotomy Procedure
Patients that undergo a laparoscopic vagotomy usually spend an average of 1 to 3 days in the hospital, while a longer hospital stay is required for those patients that have had an open procedure or if multiple procedures have been performed at the same time. Patients with desk jobs can usually be return to work within 10 days after surgery, while additional recovery time is needed for those patients with a job that involves physical labor. Patients should follow all postoperative instructions carefully to ensure a speedy recovery and avoid complications.
Risks and Complications of the Vagotomy Procedure
As with most surgical procedures, there are certain risks associated with a vagotomy, although they rarely occur. These risks may include the following:
- Complications from general anesthesia
- Bleeding
- Infection
- Accidental perforation of the stomach or esophagus
- Dumping syndrome
- Diarrhea
Only a qualified doctor can determine if you are a candidate for the vagotomy procedure. Call us or contact us to schedule a consultation.
