Laparoscopic technique of proximal selective vagotomy

Area of Science:

• Gastroenterology
• Surgical Oncology
• Minimally Invasive Surgery

Background:

• Peptic ulcer disease (PUD) of the duodenum requires effective and definitive treatment.
• Proximal selective vagotomy (PSV) has demonstrated long-term efficacy in managing PUD.
• Laparoscopic techniques offer potential advantages in surgical precision and patient recovery.

Purpose of the Study:

• To evaluate the efficacy and safety of laparoscopic proximal selective vagotomy (PSV) for peptic ulcer disease.
• To assess the recurrence rates and postoperative complications associated with laparoscopic PSV.
• To determine the suitability of laparoscopic PSV as a preferred technique for PUD management.

Main Methods:

• A cohort of 13 patients underwent laparoscopic PSV for indications including chronic duodenal ulceration and reflux esophagitis.
• PSV was performed as a standalone procedure or in conjunction with an antireflux procedure.
• Data collected included operative time, peri- and postoperative complications, hospital stay, and long-term follow-up outcomes.

Main Results:

• Laparoscopic PSV demonstrated high accuracy due to enhanced visualization, reducing the risk of missing critical vagal nerve connections.
• The median operative time was 3 hours, with no serious peri- or postoperative complications reported.
• Median postoperative hospital stay was 3 days, and during a median follow-up of 27 months, no ulcer recurrence or significant side effects (e.g., diarrhea, dumping syndrome) were observed.

Conclusions:

• Laparoscopic PSV is an effective and definitive treatment for duodenal peptic ulcer disease.
• The technique is associated with a low incidence of recurrence and minimal gastrointestinal side effects.
• Laparoscopic PSV represents a safe and advantageous approach for managing PUD, particularly when compared to open procedures.