Laparoscopic highly selective vagotomy using CO2 laser: experimental study in dogs.

We attempted to establish a modified laparoscopic highly selective vagotomy using CO2 laser in dogs and evaluated its effectiveness and feasibility. After the laser dose based on gross and histologic measurements was determined, five dogs underwent anterior CO2 laser vagotomy with posterior truncal vagotomy under laparoscopy (lap-laser vagotomy) and five others underwent anterior selective vagotomy with posterior truncal vagotomy in the standard fashion via laparotomy (open surgical vagotomy). No complications such as gastric perforation were observed in any of the dogs subjected to lap-laser vagotomy, and the operating time was approximately half of that required for open surgical vagotomy. After surgery, acid secretion significantly decreased versus preoperative values in both groups of animals and remained stable for 6 months. We conclude that anterior CO2 laser vagotomy with posterior truncal vagotomy is as effective as conventional vagotomy and easier to perform; thus, we recommend it as a method of laparoscopic highly selective vagotomy.