Laparoscopic Hill's vagotomy by the abdominal wall lifting method

Area of Science:

• Gastroenterology
• Surgical Innovation
• Minimally Invasive Surgery

Background:

• Intractable duodenal ulcers pose significant clinical challenges.
• Traditional surgical interventions may carry substantial risks.
• Exploring minimally invasive techniques is crucial for improved patient outcomes.

Purpose of the Study:

• To evaluate the efficacy and safety of laparoscopic Hill's vagotomy using an original abdominal wall lifting method.
• To assess the impact of this surgical technique on gastric acid secretion.
• To determine the rate of ulcer healing post-procedure.

Main Methods:

• Laparoscopic Hill's vagotomy was performed in nine patients with intractable duodenal ulcers.
• An original I-type lifting bar was utilized for abdominal wall elevation.
• Vagotomy involved division of the posterior vagus nerve trunk and neurovascular bundle along the lesser curvature.

Main Results:

• The mean operative time was 163 minutes with minimal blood loss.
• Basal acid output decreased by 73.7% and maximal acid output by 63.7%.
• Gastroduodenoscopy at four weeks post-surgery confirmed ulcer healing to a scar in all patients.

Conclusions:

• Laparoscopic Hill's vagotomy with the I-type lifting bar is a safe and effective treatment for intractable duodenal ulcers.
• The procedure significantly reduces gastric acid secretion, promoting rapid ulcer healing.
• This minimally invasive technique offers a promising alternative for managing complex duodenal ulcer disease.