What is a vagotomy?
A vagotomy is a type of surgery that removes all or part of your vagus nerve. This nerve runs from the bottom of your brain, through your neck, and along your esophagus, stomach, and intestines in your gastrointestinal (GI) tract.
The vagus nerve has a range of functions, including helping your stomach produce acid for digestion and making you feel full after eating. Vagotomy procedures are used to help treat stomach ulcers, which are sores that result from an H. pylori infection or erosion from stomach acid.
While vagotomy procedures used to be a standard treatment for stomach ulcers, advances in medications and a better understanding of the bacteria in the gut have made them less common. When they are performed, they’re usually done in conjunction with other procedures, such as pyloroplasty.
Why is it done?
Vagotomies are traditionally done to treat peptic ulcers by reducing the amount of acid your stomach produces. These days, it’s rarely done on its own. Instead, people usually start taking antibiotics to clear up an H. pylori infection or proton pump inhibitors to reduce stomach acid.
If medications alone aren’t enough, your doctor might suggest a vagotomy procedure in combination with:
- Resection. Your doctor removes a damaged or diseased part of your digestive tract.
- Abdominal drainage. This removes extra abdominal fluid, called ascites.
- Diversion. Your GI tract is modified so that the digestion process moves around the damaged or diseased part.
- Pyloroplasty. This procedure widens the pylorus, which is located near the end of your stomach. It helps to control the movement of partially digested food and digestive juices into your small intestine.
In addition, research suggests that it may also help to treat:
What are the different types?
Several types of vagotomy are used for different purposes:
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- Truncal vagotomy. This type is commonly used with pyloroplasty or abdominal drainage to treat chronic peptic ulcers. It involves cutting one or more of the branches that split off the main trunk of the vagus nerve and travel down your esophagus to your stomach and other digestive organs.
- Selective vagotomy. This option cuts the vagus nerve further down, closer to your organs, so that only some of its function is removed. It’s a good option for treating stomach ulcers without having a huge impact on other organs that rely on the vagus nerve, such as your liver.
- Highly selective vagotomy. Like a selective vagotomy, this type involves only cutting the part of the vagus nerve that directly affects your stomach, preserving many of the vagus nerve’s other functions. This type is commonly done along with truncal vagotomy.
For each type, you’ll be under general anesthesia.
What’s recovery like?
Following a vagotomy procedure, you’ll likely need to stay in the hospital for about a week. Your doctor may need to periodically drain extra stomach acid while monitoring your body’s response to the procedure.
After about a week, your doctor will also remove your stitches, unless you have dissolvable ones.
It can take about six weeks to fully recover. During this time, your doctor might recommend following a liquid diet until your GI tract adapts to changes in the function of your vagus nerve.
Moving forward, you’ll likely need to avoid acidic or spicy foods as much as possible.
Are there any risks involved?
Vagotomy procedures carry the same potential risks as many other types of surgery, including:
- internal bleeding
- shock from blood loss
- deep vein thrombosis
- trouble urinating
- allergic reactions to anesthesia
You also run the risk of developing dumping syndrome. This causes food to quickly pass through your stomach without being properly digested. It symptoms include:
- stomach cramps
- nausea and vomiting
- rapid heartbeat after eating
These symptoms can come on right after the procedure and become less severe as your digestive system adapts.
The bottom line
A vagotomy is a surgical procedure that removes part of your vagus nerve, which serves many important functions, such as controlling the production of stomach acid. In the past, it was frequently used to treat ulcers, but new medications have made it less common, especially on its own.
These days, it’s usually done alongside another type of procedure. However, new research suggests that vagotomy procedures might have more uses than doctors originally thought.