Laparoscopic proximal gastric vagotomy--neuralgic points of technique.

Laparoscopic proximal gastric vagotomy is a valuable therapeutic tool in the management of patients suffering from recurrent duodenal ulcer disease, the therapeutic principle being the effective reduction of gastric acid output without gastrotomy or gastric resection. The method is based on the well-documented conventional technique, which has been evaluated for over 15 years. The division of all vagal fibres to the gastric fundus and body is essential for complete vagotomy in order to ensure a sufficient reduction in gastric acid. The operation time is between 2 and 3 hours. Eighteen patients have been treated successfully with this minimally invasive and safe procedure in our unit. The functional and cosmetic results are excellent. The comparatively lower costs are, last but not least, an important advantage.