Abstract
This study investigated the effectiveness of laparoscopic selective proximal vagotomy using a CO2 laser. Irradiation of the stomach was performed from the serosal aspect using a defocused CO2 laser beam. In the first experiment, the inhibitory effect on cysteamine ulcers in rats was compared between surgical vagotomy and CO2 laser vagotomy using three different irradiation fields. The results suggested that irradiation near the lesser curvature provided sufficient denervation. In the second experiment, CO2 laser vagotomy was performed laparoscopically in dogs. The procedure lasted less than 1 h and a postoperative endoscopic Congo red test confirmed its effectiveness. Subserosal tissues including the vagus nerve branches showed degeneration and were replaced by fibrosis 3 months postoperatively, but the deeper tissues were spared. In conclusion, laparoscopic CO2 laser vagotomy may be as effective for reducing acid secretion as standard surgical vagotomy. Its simplicity and safety suggest that a clinical trial in humans may be warranted.
Similar content being viewed by others
References
Bailey RW, Flowers JL, Graham SM, Zucker KA (1991) Combined laparoscopic cholecystectomy and selective vagotomy. Surg Laparosc Endosc 1: 45–49
Burke L, Rovin RA, Cerullo LJ, Brown JT (1985) Thermal effects of the Nd: YAG and carbon dioxide lasers on the central nervous system. Laser Surg Med 5: 67–71
Donahue PE, Yoshida J, Richter HM, Bombeck CT, Nyhus LM, Maroske D, Thon KP, Roeher HD (1987) Can the use of an endoscopic Congo red test decrease the incidence of incomplete proximal gastric vagotomy? Gastrointest Endosc 33: 427–431
Frantzides CT, Ludwig KA, Quebbeman EJ, Burhop J (1992) Laparoscopic highly selective vagotomy: technique and case report. Surg Laparosc Endosc 2: 348–352
Kadota T, Takahama M (1983) Parietal cell vagotomy with CO2-laser in the rat. J Saitama Med School 10: 221–226
Kadota T, Mimura K, Kanabe S, Tamakuma S (1985) Clinical trial of parietal cell vagotomy with CO2-laser. J Jpn Soc Laser Med 5: 569–572
Kadota T, Mimura K, Kanabe S, Ohsaki Y, Tamakuma S (1990) Proximal gastric vagotomy with carbon dioxide laser: experimental studies in animals. Surgery 107: 655–660
Katkhouda N, Mouiel J (1991) A new technique of surgical treatment of chronic duodenal ulcer without laparotomy by videocoelioscopy. Am J Surg 161: 361–364
Kennedy T, Magill P, Johnston GW, Parks TG (1979) Proximal gastric vagotomy, fundoplication, and lesser-curve necrosis. BMJ 1: 1455–1456
Mimura K, Kadota T, Kanabe S, Tamaki K, Ohsaki Y, Hiraide H, Mizoguchi O, Terashima H, Hatsuse K, Kurokawa T, Iwasa H, Maru E, Okamaoto J, Ashida H, Tatsuno J (1982) An experimental study of selective proximal gastric vagotomy with carbon dioxide laser. J Natl Def Med Coll 7: 179–184
Mouiel J, Katkouda N (1991) Laparoscopic truncal and selective vagotomy. In: Zucker KA (ed) Surgical laparoscopy. Quality Medical Publishing, St Louis, pp 263–279
Saik RP, Greenburg AG, Farris JM, Peskin GW (1976) The practicality of the Congo red test, or is your vagotomy complete? Am J Surg 132: 144–148
Sakuramachi S, Kimura T, Yoshida M, Kobayashi T, Matsuda H, Goto H, Takabayashi N, Imaizumi T, Harada Y (1992) Laparoscopic selective proximal vagotomy. Jpn J Gastroenterol Surg 25: 2813–2817
Selye H, Szabo S (1973) Experimental model for production of perforating duodenal ulcers by cysteamine in the rat. Nature 244: 458–459
Taylor TV, Gunn AA, Mcleod DAD, MacLennan I (1982) Anterior lesser curve seromyotomy and posterior truncal vagotomy in the treatment of chronic duodenal ulcer. Lancet 2: 846–849
Valen B, Dregelid E, Tonder B, Svanes K (1990) Proximal gastric vagotomy for peptic ulcer disease: follow-up of 483 patients for 3 to 14 years. Surgery 110: 824–831
Von Schreiber G, Oswald H, Danz M, Fround E, Staupendahl G (1974) CO2-Laser-Effecte am peripheren markhaltigen Nerven. Z Exp Chir 7: 2–8
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Sakuramachi, S., Kimura, T. & Harada, Y. Experimental study of laparoscopic selective proximal vagotomy using a carbon dioxide laser. Surg Endosc 8, 857–861 (1994). https://doi.org/10.1007/BF00843454
Issue Date:
DOI: https://doi.org/10.1007/BF00843454