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A vagotomy is a surgical procedure that is performed only in humans. It is resection
Resection

Resection can mean:*Resection, in surgery, the partial or complete removal of an organ or other bodily structure. A doctor may say that a cancer is resectable....
 (removal of, or at least severing) of part of the vagus nerve
Vagus nerve

The vagus nerve is the tenth of twelve paired cranial nerves, and is the only nerve that starts in the brainstem and extends, through the jugular foramen, down below the head , to the neck, chest and abdomen, where it contributes to the innervation of the viscera....
. It is not to be confused with vasectomy
Vasectomy

Vasectomy is a surgical procedure in which the vas deferens of a man are cut for the purpose of Sterilization ....
.

use of vagotomy to treat obesity
Obesity

Obesity is a condition in which excess body fat has accumulated to an extent that health may be negatively affected. It is commonly defined as a body mass index of 30 kg/m2 or higher....
 is being studied. Early results show an average of 18% weight loss. Vagotomy may have an impact upon ghrelin
Ghrelin

Ghrelin is a hormone produced mainly by P/D1 cells lining the fundus of the human stomach and epsilon cells of the pancreas that stimulates appetite....
.

operation was popular up until the mid-1990s as a way of treating peptic ulcer disease, and preventing its recurrence.






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A vagotomy is a surgical procedure that is performed only in humans. It is resection
Resection

Resection can mean:*Resection, in surgery, the partial or complete removal of an organ or other bodily structure. A doctor may say that a cancer is resectable....
 (removal of, or at least severing) of part of the vagus nerve
Vagus nerve

The vagus nerve is the tenth of twelve paired cranial nerves, and is the only nerve that starts in the brainstem and extends, through the jugular foramen, down below the head , to the neck, chest and abdomen, where it contributes to the innervation of the viscera....
. It is not to be confused with vasectomy
Vasectomy

Vasectomy is a surgical procedure in which the vas deferens of a man are cut for the purpose of Sterilization ....
.

For weight loss

The use of vagotomy to treat obesity
Obesity

Obesity is a condition in which excess body fat has accumulated to an extent that health may be negatively affected. It is commonly defined as a body mass index of 30 kg/m2 or higher....
 is being studied. Early results show an average of 18% weight loss. Vagotomy may have an impact upon ghrelin
Ghrelin

Ghrelin is a hormone produced mainly by P/D1 cells lining the fundus of the human stomach and epsilon cells of the pancreas that stimulates appetite....
.

For ulcers

The operation was popular up until the mid-1990s as a way of treating peptic ulcer disease, and preventing its recurrence. It was thought that peptic ulcer disease was due to excess secretion of the acid environment in the stomach
Stomach

In most mammals, the stomach is a hollow muscular organ of the gastrointestinal tract involved in the second phase of digestion, following mastication....
, or at least that peptic ulcer disease was made worse by hyperacidity. Vagotomy was a way to reduce the acidity of the stomach, by denervating the peptic cells that produce acid. This was done with the hope that it would treat or prevent peptic ulcers. It also had the effect of reducing or eliminating symptoms of gastro-esophageal reflux in those who suffered from it.

The incidence of vagotomy decreased following the discovery by Barry Marshall
Barry Marshall

Barry James Marshall, Order of Australia, Fellow of the Royal Society, Fellow of the Australian Academy of Science is an Australian physician, Nobel Prize laureate in Physiology or Medicine, and Professor of Clinical Microbiology at the University of Western Australia....
 and Robin Warren
Robin Warren

Dr. John Robin Warren Order of Australia is an Australian pathologist, Nobel Laureate and researcher who is credited with the 1979 re-discovery of the bacterium Helicobacter pylori....
 that Helicobacter pylori
Helicobacter pylori

Helicobacter pylori is a Gram-negative, microaerophile bacterium that inhabits various areas of the stomach and duodenum. It causes a chronic low-level inflammation of the stomach lining and is strongly linked to the development of duodenal and gastric peptic ulcers and stomach cancer bacteria....
 is responsible for most peptic ulcers. The first-line treatment for peptic ulcer disease, if due to H. pylori, is "triple therapy": 2 antibiotics (clarithromycin
Clarithromycin

Clarithromycin is a macrolide antibiotic used to treat pharyngitis, tonsillitis, acute maxillary sinusitis, acute bacterial exacerbation of chronic bronchitis, pneumonia , skin and skin structure infections, and, in HIV and AIDS patients to prevent, and to treat, disseminated Mycobacterium avium complex ....
 and amoxicillin
Amoxicillin

Amoxicillin or amoxycillin is a moderate-spectrum, bacteriolytic, beta-lactam antibiotic used to treat bacterial infections caused by susceptible microorganisms....
 or metronidazole
Metronidazole

Metronidazole is a nitroimidazole antibiotic medication used mainly in the treatment of infections caused by susceptible organisms, particularly anaerobe bacterium and protozoa....
) and a proton pump inhibitor
Proton pump inhibitor

Proton pump inhibitors are a group of Medications whose main action is a pronounced and long-lasting reduction of gastric acid production. They are the most potent inhibitors of acid secretion available today....
 (e.g. omeprazole
Omeprazole

Omeprazole is a proton pump inhibitor used in the treatment of dyspepsia, peptic ulcer , gastroesophageal reflux disease and Zollinger-Ellison syndrome....
). However, in chronic ulceration or in gastric outlet obstruction there is still an important role for truncal vagotomy.

Types

A plain vagotomy is a very destructive procedure, since all the parasympathetic supply from the stomach to the left side of the transverse colon
Transverse colon

The transverse colon the longest and most movable part of the Colon , passes with a downward convexity from the right hypochondrium region across the abdomen, opposite the confines of the epigastric and umbilical zones, into the left hypochondrium region, where it curves sharply on itself beneath the lower end of the spleen, forming the splen...
 relies on the vagus nerves. The gut will still function without vagus supply, but not as well.

Vagotomy technique was therefore improved by restricting resection to only those branches that go to the stomach (selective vagotomy), and further by selecting only those branches that appear to supply peptic cells (highly selective vagotomy).

Humans have two vagus nerves, whose fibres decussate and intermingle around the stomach. Accordingly, a vagotomy operates on both nerves simultaneously and in practice there is no need or way to make a distinction between them.

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