Highly selective vagotomy

Highly selective vagotomy

Highly selective vagotomy (parietal cell vagotomy or proximal gastric vagotomy) involves selective division of the vagal fibers to the acid-producing parietal cell mass of the gastric fundus, while maintaining vagal fibers to the antrum and distal gut. The anterior and posterior neurovascular attachments are divided along the lesser curvature of the stomach, beginning approximately 7 cm from the pylorus and progressing to the gastroesophageal junction, with additional skeletonization of the distal 6 to 8 cm of the esophagus to ensure division of the criminal nerve of Grassi Innervation of the antrum and pylorus is maintained because the two terminal branches of the anterior and posterior nerves of Latarjet are left intact.

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