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Vagotomy refers to several variations of a surgery that operate on the vagus nerve. This is a very long nerve extending from the brain that enervates parts of the body like the heart and also the stomach. When this surgery is being discussed, it means cutting or changing the lowest part of this nerve so that its influence on creation of stomach acid and stomach function are ended. At time of development, the principal reason to perform this surgery was to treat ulcers, and this is now less common. Instead, the surgery is being researched because it appears to reduce hunger and it might have a positive effect on weight loss.
The reason that vagotomy has been largely discarded as peptic ulcer treatment is principally due to better understanding about ulcers. Many of these can be effectively treated with antibiotics and medications that control acid conditions. Not all people respond to drug treatment, and when ulcers are significant, doctors might still recommend this surgery as a means of controlling ulcers. It does tend to eliminate ulcers that are present, and it also shows reduction in development of new ulcers over time. It may also be combined with some removal of the stomach.
There are several ways a vagotomy might be performed and surgeons can each have their preference. One method that is often preferred is resecting or removing just the parts of the vagus nerve that supply the stomach. This is called a selective surgery and it can be refined even more if an even smaller section of the nerves is removed. The goal is to be very specific in resection, so that the smallest parts of the vagus nerve are eliminated. Surgeries of this type are often performed laparoscopically.
Recovery from a vagotomy can still be lengthy, and people could stay in the hospital for a week or longer. Getting the stomach to drain properly can be difficult and there may be other procedures performed with the surgery to promote better emptying of the stomach or to avoid a condition called dumping, where the body suddenly sends most bowel contents to the intestines resulting in pain, severe diarrhea and feelings of faintness. People may expect a total of about six weeks recovery prior to being able to resume all normal activities.
While vagotomy for ulcers is used less frequently, another use has been proposed for vagus nerve resection. Doctors are investigating the tendency for this surgery to greatly reduce appetite, which might make it extremely attractive to people who are obese or who have difficulty controlling this. Early findings of studies in the late 2000s suggest that this works for some people, but not all people. It is still too early for a conclusion on whether vagotomy would be appropriate as a weight loss treatment, and whether it might need to be combined with other stomach surgeries, such as bariatric surgery or banding, for best results.