vagotomy with open rny

hi: if and when i ever get approved, my surgeon usually does a vagotomy when he does rny to reduce the chance of ulcers.  i don't know a lot about it. did anyone have it done, not have it done, problems?? just wondering. thanks for any input.  Judi

I found this for you!! 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.

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.

Vagotomy became obsolete when it was discovered by Barry Marshall and Robin Warren that Helicobacter pylori is responsible for most peptic ulcers. The correct treatment for peptic ulcer disease, therefore, is antibiotics. However, there are many patients alive who have had vagotomies performed. 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 less 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).

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

thanks for finding that. even tho it sounds disturbing and worth a second or third thought. i tried to do a quick search and came up blank. appreciate it!  judi

With all the acid-production supression drugs like prevacid on the market.......is this still a good practice?!??!  My father was a diabetic for 38 years - and suffered gastroparesis - diabetic neuropathy that impacted the vagus nerve - his digestive processes were inhibited and he was miserable for 20 years with GI problems.   I'm not at all familiar with the procedure, but it makes me nervous.  Hopefully you'll get some informed opinions.  Susan

thanks for the info. more research definitely needed. after i posted this  i thought i shoulda put it on the grads board but i don't want to start multiple posting everywhere so i'll wait and see. thanks again, judi

this procedure also prevents dumping

did you have it done?  any problems?  judi

Our vagus nerve is transected during the surgery to separate the stomach to create the small pouch fron the upper part of the stomach. So the vagus nerve is severed from it's branches in remnant stomach that is completely disconnected from the pouch and just lies in the abdomen forever. No food ever enters it again, and the acid and secretions enter the digestive system futher down the intestional tract than it used to. I suspect the remnant stomach doesn't secrete as much acid as it did with a working connection to the rest of the vagus nerve.

Ok..I popped in before I leave for Key West this afternoon..ahh..sun and sand! Anyways, *I* had a truncal vagotomy (total severing of teh vagus nerve) for postop ulcers that wouldn't heal. A vagotomy does NOT..and I repeast does NOT prevent dumping...that is total misinformation. I still dump even 6 years postop. Aside from slight gastroparesis (slow motility of the pouch) I have had no side effects. If you're curious about it..speak to a gastroenterologist....THEY are specialists..not your surgeon. They will be able to give the best information possible. It's not as destructive as people say...plus it's done for a variety of reasons. I chose it..so I wouldnt have to suffer after a year of meds etc..with no results. Mariall

Hi Jui- Yes, Dr Howell did that to me also.  I have had no problems whatsoever.  He told me this is what he does and because I had so much faith in him, I had no problems with it.  He knows what he is doing and why.  Thats also why he takes the gallbladder so you dont run into problems with gall stones down the road.  He had done surgery on my mother awhile back (not GBS) so that is another  reason why I trust him so.   Sue