VAGOTOMY

General Information

DEFINITION-Disconnecting branches of the vagus nerve to slow acid production in the stomach. Usually, this surgery is performed before other surgeries such as gastroenterostomy (see in Surgery section).

BODY PARTS INVOLVED-Stomach; branches of the vagus nerve.

REASONS FOR SURGERY-Treatment of the complications of peptic ulcers such as: obstruction of digestive flow; ulcer perforation; bleeding of an ulcer; or intolerable pain.

SURGICAL RISK INCREASES WITH

• Obesity; smoking; stress.
• Poor nutrition.
• Recent or chronic illness.
• Use of drugs such as: antihypertensives; muscle relaxants; tranquilizers; sleeping pills; insulin; sedatives; beta-adrenergic blockers; or cortisone.
• Use of mind-altering drugs, including: narcotics; psychedelics; hallucinogens; marijuana; sedatives; hypnotics; or cocaine.

What To Expect

WHO OPERATES-General surgeon.

WHERE PERFORMED-Hospital.

DIAGNOSTIC TESTS

• Before surgery: Blood and urine studies; x-rays of gastrointestinal tract; gastroscopy (See Glossary).
• After surgery: Blood studies; tissue studies

ANESTHESIA-General anesthesia by injection and inhalation with an airway tube placed in the windpipe.

DESCRIPTION OF OPERATION

• An incision is made in the abdomen, and the abdominal muscles are separated.
• The vagus nerve is identified, and the branches that control stomach-acid production are isolated, divided and clipped. Segments of the vagus nerve are removed for laboratory study.
• The abdominal muscles are sewn together in layers. The skin is closed with sutures or clips, which usually can be removed about 7 to 10 days after surgery.

POSSIBLE COMPLICATIONS

• Excessive bleeding.
• Surgical-wound infection.
• Incisional hernia.
• Dumping syndrome.
• Diarrhea.
• Recurrent ulcer due to incomplete vagotomy.

AVERAGE HOSPITAL STAY-7 days.

PROBABLE OUTCOME-Expect complete healing without complications. Allow about 6 weeks for recovery from surgery.

Postoperative Care

† Move and elevate legs often while resting in bed to decrease the likelihood of deep--vein blood clots.

† You may use non-prescription drugs, such as acetaminophen and antacids, for minor pain. Avoid aspirin and other non-steroidal anti--inflammatory drugs because they can irritate the lining of the stomach.

ACTIVITY

• Return to daily activities and work as soon as possible to promote healing.
• Avoid vigorous exercise for 6 weeks after surgery.
• Resume driving 2 weeks after returning home.

DIET-Nasogastric suctioning is required for 3-4 days, followed by clear liquid diet until the gastrointestinal tract functions again. Then eat a well--balanced diet to promote healing. Avoid coffee, tea, cocoa, cola drinks, alcoholic beverages and any food or spice that aggravates ulcer symptoms.

Call Your Doctor If

† Pain, swelling, redness, drainage or bleeding increases in the surgical area.

• You develop signs of infection: headache, muscle aches, dizziness or a general ill feeling and fever.
• You experience nausea, vomiting, constipation, diarrhea, black tarry stools or abdominal swelling.
• New, unexplained symptoms develop. Drugs used in treatment may produce side effects.