Laparoscopic Hill's vagotomy by the abdominal wall lifting method.
We performed laparoscopic Hill's vagotomy by the abdominal wall lifting method in nine patients with intractable duodenal ulcer. Our original I-type lifting bar is a curved stainless-steel rod 5 mm in diameter. One I-type lifting bar is inserted intraperitoneally into each of the right and left hypochondrial regions. An incision is made in the lesser omentum near the gastroesophageal junction, and the right esophageal wall and right crus of the diaphragm are dissected and exposed. The posterior trunk of the vagus nerve is identified and divided. Then the neurovascular bundle is dissected and divided repeatedly along the lesser curvature of the stomach from the first branch of the crow's foot to the gastroesophageal junction. The mean operating time was 163 min, with little blood loss. The reduction rate of basal acid output and maximal acid output was, respectively, 73.7 +/- 0.1 and 63.7 +/- 0.1%. Four weeks after surgery, gastroduodenoscopy revealed ulcer healing to a scar.
Nisii
H
H
Department of Surgery, Fujieda Heisei Memorial Hospital, Japan.
Hirai
T
T
Ohara
H
H
Masuda
Y
Y
D000328:Adult; D000368:Aged; D004381:Duodenal Ulcer / Q000601:surgery; D006801:Humans; D020706:Laparoscopes; D010535:Laparoscopy / Q000379:methods*; D008875:Middle Aged; D013525:Surgical Instruments; D014628:Vagotomy / Q000295:instrumentation / Q000379:methods*