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Updated: Dec 23, 2025

Author Spotlight: Exploring Abdominal VNS for Inflammatory Conditions
Published on: January 19, 2024
Ameliorating Effects and Mechanisms of Intra-Operative Vagal Nerve Stimulation on Postoperative Recovery After Sleeve
Ming Tian1,2, Maisiyiti Alimujiang1,3, Jiande Dz Chen4
1Division of Gastroenterology and Hepatology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Purpose:
Sleeve gastrectomy is a common bariatric procedure. The aim of this study was to explore the effects and mechanisms of intra-operative vagal nerve stimulation (iVNS) on postoperative recovery after sleeve gastrectomy in rats.
Materials And Methods:
Rats were randomly divided into groups of sham-iVNS (n = 12) and iVNS (n = 12), and received sleeve gastrectomy, and were implanted electrodes for the electrocardiogram (ECG) and gastric pace-making activity or slow wave (GSW). iVNS or sham-iVNS was performed during surgery. Postoperative animal behaviors, pain, gastrointestinal functions, autonomic functions, inflammatory cytokines, and hormones in plasma were assessed.
Results:
In comparison with sham-iVNS, (1) iVNS accelerated the first drinking time (P = 0.01) and first defecation time (P = 0.02), increased the weight of stool in postoperative day (POD) 1 (P = 0.01) and POD3 (P = 0.01), and reduced postoperative pain at 24 h after surgery (P = 0.01); (2) physiologically, iVNS improved gastric emptying (P < 0.01) at 72 h after surgery, and increased the dominant frequency (P < 0.01) and the percentage of normal GSW (P = 0.04) at 6 h after surgery; (3) mechanistically, iVNS increased vagal activity and decreased sympathovagal ratio at 6 h (vagal, P < 0.01; sympathovagal ratio, P < 0.01) and 24 h (vagal, P = 0.02; sympathovagal ratio, P = 0.01) after surgery, increased the plasma pancreatic polypeptide (P = 0.03) at 1 h after surgery, and decreased the plasma tumor necrosis factor-α (TNF-α) at 1 h (P = 0.02) and 6 h (P = 0.03) and the plasma interleukin-6 (IL-6) at 1 h (P = 0.02) after surgery.
Conclusion:
Intra-operative VNS is effective in accelerating post-surgical recovery in rats after sleeve gastrectomy by enhancing gastric pace-making activity and suppressing proinflammatory cytokines mediated via the autonomic mechanisms.

