Laparoscopic Selective Proximal Vagotomy

Shunji Sakuramachi, Taizo Kimura, Masayuki Yoshida, Toshihiko Kobayuashi, Hisao Matsuda, Hideki Goto, Naoki Takabayashi, Tsuyoshi Imaizumi, Yukio Harada

First Department of Surgery, Hamamatsu University School of Medicine

In recent years, internal treatment for peptic ulcer disease has made the remarkably progress. Therefore indication of surgical treatment for it has decreased because of its invasiveness. Aiming at less invasive surgery, we performed selective proximal vagotomy using a laparoscopic approach. The patient was 51-year-old man who had recurrent ulcer disease. Under general anesthesia, pneumoperitoneum was performed. Five trocars were inserted to allow the surgical procedure. Branches of the vagus were dissected and separated from the stomach and the abdominal esophagus, preserving the nerve of Laterjet to the antrum. Intra- and postoperative course were uneventful, the wound pain was minimal, and return to work was rapid. The patient underwent a gastric acid secretion test before and 1 month after the operation. The rates of reduction of the basal acid output and the maximal acid output were 70.9% and 42.7%, respectively, and the results of the post operative Hollander test were negative. This procedure was time-consuming and required skillful manipulation. It was considered that improvement in the instruments and the device for maneuvering would make this procedure acceptable.

Key words
laparoscopic selective proximal vagotomy, surgical treatment of duodenal ulcer

Reprint requests
Shunji Sakuramachi First Department of Surgery, Hamamatsu University School of Medicine
3600 Handa-cho, Hamamatsu-shi, 431-31 JAPAN

Accepted
July 6, 1992

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