Vagotomy pp 167-177 | Cite as

Operating Technique of SPV and Pyloroplasty

  • Fritz Holle
  • Sven Andersson


The most careful technique is essential SPV = selective proximal vagotomy is an operation which must be conducted with the precision of a neurosurgical technique. The criterion of success is that the patient be insulin-negative, if possible in accordance with 5 criteria (cf. p. 144, fig. 1). This goal was achieved in 3 stages of development.
  1. 1.

    1960 to 1964: SPV of the most important ventral and dorsal branches to the corporal-fundal region was carried out in man similar to “partial vagotomy” in dogs (Griffith and Harkins, 1957). Results: Basal secretion reduced; basal residual acid often remains; stimulated secretion almost unchanged.

  2. 2.

    1964 to 1968: SPV extended caudally and cranially up to the angulus and the cardiac crossway. Results: Basal secretion eliminated; stimulated secretion reduced by 30 to 50 %.

  3. 3.

    1968 to 1970: SPV completed up to the cranial and caudal borderline nerves; in addition, complete removal of all connections to the His angle: Since 1970 use of intraoperative blue staining (according to LEE) for the preparatory removal of all vagal nerve elements in the subserous layer. Results: Complete elimination of all basal acid, complete insulin negativeness in 2-h tests in 71 % of cases (5 criteria); late-positive 22%; early-positive 7%. Since 1970 the technique has been standardized (cf. fig. 1–5).



Vagus Nerve Basal Secretion Gastric Plexus Abdominal Esophagus Lateral Crus 
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  1. Grassi, G., Orecchia, C, Cantarelli, J., Fivoli, E., Sbuelz, B.: Risultati e consideration! sullo studio della secretione gastrica nella malattia ulcerosa in fase operatoria. Chir. Gastroenterologica 3,465 (1969)Google Scholar
  2. Inberg, K. R., Moller, C, Tavela, K., Keromaki, M. P.: The Burgetest for completeness of vagotomy. Acta Chir. Scand. 139, 66–71 (1973)PubMedGoogle Scholar
  3. Lee, M.: A selective stain to detect the vagus nerve in the operation of vagotomy. Brit. J. Surg. 56, 1 (1969)CrossRefGoogle Scholar
  4. Rosenbaum, D.: Wirkung und Nutzen der intraoperativen Methylenblaufarbung bei der selectiven proximalen Vagotomie (SPV). Inaug. Diss. Miinchen (1972)Google Scholar
  5. Holle, G.: Staff Meeting, Univ. of Illinois, Dep. of Surg, Chicago, Nov. 21 (1970)Google Scholar
  6. Hedenstedt, S., Adner, M.: Antrectomy after staining with Congo red and transillumination. Acta Chir. Scand. 133, 539–543 (1967)PubMedGoogle Scholar
  7. Moe, R. E., Klopper, P. J.: Demonstration of the functional anatomy of the canine gastric antrum. Amer. J. Surg. 111, 80 (1966)PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin · Heidelberg 1974

Authors and Affiliations

  • Fritz Holle
    • 1
  • Sven Andersson
    • 2
  1. 1.Chirurg. Poliklinik der Universität8 München 2Germany
  2. 2.Farmakoligska InstitutioneKarolinska InstitutetStockholm 60Sweden

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