Type of Surgery
Information
Last updated: 02/17/2009
The vagus nerve trunk splits into branches that go to different parts of the stomach. Stimulation from these branches causes the stomach to produce acid. Too much stomach acid leads to ulcers that may eventually bleed and create an emergency situation.
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vagotomy is performed when acid production in the stomach can not be reduced by other means. The purpose of the procedure is to disable the acid-producing capacity of the stomach. It is used when ulcers in the stomach and duodenum do not respond to medication and changes in diet. It is an appropriate surgery when there are ulcer complications, such as obstruction of digestive flow, bleeding, or perforation. The frequency with which elective vagotomy is performed has decreased in the past 20 years as it has become clear that the primary cause of ulcers is an infection by a bacterium called Helicobacter pylori. Drugs have become increasingly effective in treating ulcers. However, the number of vagotomies performed in emergency situations has remained about the same.
A vagotomy procedure is often performed in conjunction with another gastrointestinal surgery, such as partial removal of the stomach (antrectomy or subtotal gastrectomy).
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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.
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), 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.
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Circumcision is a controversial topic, because there is so much misinformation and emotion included as fact; the facts are fairly straightforward and there are some definite biological advantages to circumcision.
-Gerald McMorrow
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