LAPAROSCOPIC ANTERIOR EXTENDED SEROMYOTOMY WITH POSTERIOR TRUNCAL VAGOTOMY - AN EXPERIMENTAL-STUDY

We describe a new laparoscopic modification of parietal cell vagotomy. The laparoscopic anterior extended seromyotomy with posterior truncal vagotomy was performed in five pigs weighing 21 to 25 kg each. Congo- red and pH tests were undertaken 2 weeks later by open gastrotomy. The photographs of the stained gastric mucosa made at the 5-min interval after Congo-red administration were analyzed with a computer-driven ar ea calculation program. Preoperative and postoperative weights were ta ken for all animals. The experimental parietal cell vagotomy group was compared with the sham group and showed a minimal amount of nondenerv ated parietal cell mass (0.9 +/- 0.4% versus 28.2 +/- 3.9%, p < 0.05). The pH values showed an inhibition of gastric acid secretion (7.8 +/- 0.7 versus 2.2 +/- 0.4, p < 0.05). During postoperative follow-up, no significant difference in the weight increase of the experimental and the sham control group was noticed (1.6 +/- 0.6 kg versus 2.0 +/- 0.1 kg, p < 0.27). The laparoscopic anterior extended seromyotomy with po sterior truncal vagotomy efficiently suppresses gastric acid secretion , preserving the motility of the antrum and pylorus and diminishing th e risk of residual areas of innervation. This procedure avoids dissect ion of the esophagus and can provide an easier but equally effective o perative treatment of ulcer disease compared with other types of parie tal cell vagotomy.