Perspective on extra-gastric vagal fibers: should they be preserved when possible?

A number of discoveries have forced both basic scientists and practitioners of medicine to reinterpret their view of the relation of the autonomic nervous system, the brain, and the gastrointestinal tract. There is growing support for the concept of an autonomous enteric nervous system, one which has many participant and regulatory peptide neurotransmitters, but which can apparently function independently of certain afferent or efferent (vagal) connections to the central nervous system. Recognizing the possibility that extra-gastric vagus nerves may serve an essential role in physiologic functions, it is logical to support the concept that these nerves be preserved when possible. Whether operations which spare extra-gastric vagal nerves will pass the test of time remains to be seen.