Vagotomy

Interventions infobox
Name = PAGENAME


Caption = Course and distribution of the glossopharyngeal, vagus, and accessory nerves.
ICD10 =
ICD9 = 44.0
MeshID = D014628
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A vagotomy is a surgical procedure that is performed only in humans. It is resection (removal of, or at least severing) of part of the vagus nerve. It is not to be confused with vasectomy.

For weight loss

The use of vagotomy to treat obesity is being studiedcite web |url=http://www.usatoday.com/news/health/2007-07-02-obesity-nerve-snip_N.htm |title=Could nerve-snipping spur weight loss? - USATODAY.com |format= |work= |accessdate=] cite web |url=http://www.vcu.edu/lesspainsurgery/obesity/empower/aboutstudy.htm |title=VCU Surgical Weight Loss Center |format= |work= |accessdate=] . Early results show an average of 18% weight loss [ [http://hurtbyadoctor.com/labels/vagotomy.html Research into 20 minute nerve cutting procedure results in average 18% weight loss] ] .Vagotomy may have an impact upon ghrelin.cite journal |author=Williams DL, Grill HJ, Cummings DE, Kaplan JM |title=Vagotomy dissociates short- and long-term controls of circulating ghrelin |journal=Endocrinology |volume=144 |issue=12 |pages=5184–7 |year=2003 |month=December |pmid=14525914 |doi=10.1210/en.2003-1059 |url=http://endo.endojournals.org/cgi/pmidlookup?view=long&pmid=14525914]

For ulcers

The operation was popular up until the mid-1990s as a way of treating peptic ulcer disease, and preventing its recurrence. It was (incorrectly) thought that peptic ulcer disease was due to excess secretion of the acid environment in the stomach, or at least that peptic ulcer disease was made worse by hyperacidity. Vagotomy was a way to reduce the acidity of the stomach, by denervating the peptic cells that produce acid. This was done with the hope that it would treat or prevent peptic ulcers. It also had the effect of reducing or eliminating symptoms of gastro-esophageal reflux in those who suffered from it.

The incidence of vagotomy decreased following the discovery by Barry Marshall and Robin Warren that "Helicobacter pylori" is responsible for most peptic ulcers. The first-line treatment for peptic ulcer disease, if due to H. pylori, is "triple therapy": 2 antibiotics (clarithromycin and amoxicillin or metronidazole) and a proton pump inhibitor (e.g. omeprazole). However, in chronic ulceration or in gastric outlet obstruction there is still an important role for truncal vagotomy.

Types

A plain vagotomy is a very destructive procedure, since all the parasympathetic supply from the stomach to the left side of the transverse colon relies on the vagus nerves. The gut will still function without vagus supply, but not as well.

Vagotomy technique was therefore improved by restricting resection to only those branches that go to the stomach (selective vagotomy),cite journal |author=Jordan PH, Thornby J |title=Twenty years after parietal cell vagotomy or selective vagotomy antrectomy for treatment of duodenal ulcer. Final report |journal=Ann. Surg. |volume=220 |issue=3 |pages=283–93; discussion 293–6 |year=1994 |month=September |pmid=8092897 |doi= |url=] and further by selecting only those branches that appear to supply peptic cells (highly selective vagotomy).

Humans have two vagus nerves, whose fibres decussate and intermingle around the stomach. Accordingly, a vagotomy operates on both nerves simultaneously and in practice there is no need or way to make a distinction between them.

References

External links

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* [http://www.surgeryencyclopedia.com/St-Wr/Vagotomy.html Overview and illustrations at surgeryencyclopedia.com]
* [http://www.endoscopy-sages.com/manual/chapter19.html Four types, at endoscopy-sages.com]
* [http://www.healthatoz.com/healthatoz/Atoz/ency/vagotomy.jsp Overview at healthatoz.com]

* http://www.news8austin.com/content/headlines/?ArID=203956&SecID=2