“inadvertent Vagotomy”: What Does This Mean for the Patient and Surgeon?

Objective: “Inadvertent vagotomy” is often discussed from the podium of national meetings as a cause of complications of Nissen fundoplication. Sometimes the tone of the comments borders on inferring medico-legal liability in such cases. The goal of this review is to see if there is a valid correlation with vagotomy and the suggested complications.
Methods: 300 sequential laparoscopic hiatus hernia repairs were reviewed to assess the incidence of disabling bloating, diarrhea, or dumping. 50 patients who had undergone truncal vagotomy without drainage in combination with laparoscopic adjustable gastric band placement were queried to determine the incidence of these complications.
Results: Of the 300 laparoscopic antireflux/diaphragm repairs, only 2 required takedown or some revision for severe bloating and diarrhea. There was no correlation between the hernia complexity and type of repair and the subsequent symptoms. Of the 50 patients who had vagotomy alone, there have been no complaints of diarrhea, dumping, gastric outlet obstruction, or significant bloating. They have all experienced an ablation of their hunger and in preliminary review, they have lost more weight than their cohorts who had lap band alone.
Conclusions: Results of this review of laparoscopic Nissen fundoplications/ hiatus hernia repairs and truncal vagotomy without drainage does not support the commonly ascribed complications of gastric outlet obstruction, diarrhea, or dumping. “Inadvertent vagotomy” should not be blamed for complex complaints that sometimes occur following antireflux/hiatus hernia surgery.

Session: Poster

Program Number: P211

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