Vagotomy is a surgical procedure that is performed to remove part of your vagus nerve, which serves many important functions, such as controlling the production of stomach acid.
Some facts about Vagotomy:
- Vagotomy is usually done alongside another type of procedure.
- The part of the nerve that controls digestion can be removed by Vagotomy to reduce stomach acid.
- The sensory and motor functions of the internal organs such as heart, lungs and the gastrointestinal system is controlled by the vagus nerve which runs from the brain, down the neck, alongside the esophagus, and over the stomach and intestines.
- A part or the whole of the portion of the vagus nerve that controls the digestive system will be removed during a vagotomy.
- Gastrointestinal functions such as acid production for digestion is stimulated by the vagus nerve. It also help moving the food through the gastrointestinal system.
- The stomach can corrode the stomach lining and cause peptic ulcers when the stomach produces excessive acid. So, the acid producing capacity of stomach can be disabled by a vagotomy.
- A vagotomy is performed to treat Pyloric stenosis, or narrowing of the stomach’s opening into the intestine, Peptic ulcers that do not respond to medication, diet and lifestyle modification, Chronic, recurring ulcers and Emergencies with gastrointestinal inflammation and bleeding due to ulcers.
- Truncal vagotomy, Selective vagotomy and Highly selective vagotomy are different types of vagotomy.
- The two main trunks of the vagus nerve are cut above the gastroesophageal junction during a Truncal vagotomy.
- The nerve going through the entire gastrointestinal system including the liver, gallbladder, pancreas and bowels will be removed in a Truncal vagotomy.
- It is commonly used with pyloroplasty or abdominal drainage to treat chronic peptic ulcers as the digestive system also loses its peristalsis function.
- The vagus nerve will be cut further down, closer to your organs, in Selective vagotomy so that only some of its function is removed.
- Stomach ulcers can be treated without having a huge impact on other organs that rely on the vagus nerve, such as your liver in Selective vagotomy.
- Only the part of the vagus nerve that directly affects your stomach will be cut, while preserving many of the other functions of vagus nerve in Highly selective vagotomy.
- Highly selective vagotomy is commonly done along with truncal vagotomy.
Preparation for Vagotomy:
- Medications containing aspirin or ibuprofen (Advil, Motrin IB, others) should be stopped before and after surgery as these medications may increase bleeding.
- Smoking should be stopped as smoking can increase your risk of having problems during and after surgery and also can slow the healing process.
- You should not eat or drink anything after midnight, the night before surgery.
- Blood, urine and imaging tests, and possibly a gastroscopy will be performed before a vagotomy.
- You may need blood transfusion in case of bleeding peptic ulcers.
Procedure for Vagotomy:
- A vagotomy is usually performed by a gastrointestinal surgeon as an open or laparoscopic surgery under general anesthesia.
- The vital functions of the patient will be monitored during the procedure by an anesthesiologist.
- One or more incisions will be made by the surgeon in the abdomen depending on the type of surgery.
- The surgeon will cut the vagus nerve above or below the gastroesophageal junction or just the parts connected to the body of the stomach depending on the type of vagotomy.
- A part of the lower stomach (antrectomy) may also be removed or a pyloroplasty may be performed.
- The duodenum may be removed in certain situations and the stomach will be connected directly to the jejunum, the middle part of the small intestine (gastrojejunostomy).
- The abdominal muscles and the incision will be closed by the surgeon with sutures
