in Highly Selective Vagotomy distal 6-8cm of esophagus is skeletonised. I couldn’t understand this point sir and why it’s done so for highly selective Vagotomy?
In highly selective vagotomy, a surgical procedure used to treat certain gastric disorders, the distal 6-8cm of the esophagus is skeletonized. This means that the nerves supplying the esophagus in that specific region are carefully identified and preserved while surrounding tissues are removed.
The purpose of selectively skeletonizing this portion of the esophagus is to preserve the innervation to the lower esophageal sphincter (LES). The LES is a specialized muscular ring located at the junction between the esophagus and the stomach. It functions to prevent the backflow of stomach acid and contents into the esophagus, thus maintaining proper gastric function.
By selectively preserving the nerves supplying the LES, highly selective vagotomy aims to maintain the normal function of the sphincter while still interrupting the parasympathetic innervation to the stomach, which is responsible for stimulating acid secretion. This selective approach helps reduce the risk of postoperative complications, such as gastroesophageal reflux disease (GERD), which can occur if the LES is impaired.
The skeletonization technique involves carefully isolating and sparing the nerves responsible for innervating the LES while dividing and removing other branches of the vagus nerve that supply the stomach. This allows for a more targeted and precise surgical intervention, preserving the function of the LES while achieving the desired reduction in gastric acid secretion.
It’s important to note that highly selective vagotomy is a specialized surgical technique performed by experienced surgeons for specific indications. The selection of the surgical approach depends on various factors, including the underlying condition being treated, the patient’s clinical presentation, and the surgeon’s expertise. It is always best to consult with a healthcare professional or surgeon for a comprehensive evaluation and discussion of treatment options.