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.
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.
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