Type of Surgery
Last updated: 02/17/2009
Standard surgical risks, such as excessive bleeding and infection, are potential complications. In addition, the emptying patterns of the stomach are changed. This can lead to dumping syndrome and diarrhea. Dumping syndrome is a condition in which...
the patient experiences palpitations, sweating, nausea, cramps, vomiting, and diarrhea shortly after eating.
The following complications are also associated with vagotomy surgery:
- Gastric or esophageal perforation. May occur from an electrocautery injury or by clipping the branch of the nerve of Latarjet.
- Delayed gastric emptying. Most common after truncal and selective vagotomy, particularly if a drainage procedure is not performed.
People who use alcohol excessively, smoke, are obese, and are very young or very old are at higher risk for complications.
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.
As a urologist, I've found it's easier to do the PSA test and then sit down with the patient and say here's what the results mean for you. Given what we know right now, that seems a very sensible approach.
-Dr. Evan Vapnek
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