ABSTRACT
To evaluate the safety of laparoscopic vagotomy this study included 20 patients with chronic duodenal ulcer, admitted in Al-Zahraa university hospital in the period between 1994-1997. Preoperatively, full history, clinical examination upper gastrointestinal endoscopy, abdominal ultrasonography and barium meal were done to all patients. Laparoscopic posterior truncal vagotomy associated with anterior highly selective vagotomy was done to all patients and any operative or postoperative complications were recorded. Postoperatively clinical evaluation and endoscopy were repeated to compare with the preoperative data and to assess ulcer healing. 90 to 180 minutes [mean 135 mm.]. Intraoperatively there was minimal bleeding in 2 cases and was controlled by diathermy and clips, two cases of arrthymia and one case of hypercapnoea improved spontaneously after temporal desufflation of co2. Postoperatively scapular pain, diffuse abdominal pain and mild fever were noticed in 6,2 and 2 patients respectively. Postoperative stay in the hospital was ranged from one to 5 days [mean 3 days]. Two patients were still complaining of dyspepsia and were improved by medical treatment. Six months follow up by endoscopy revealed that 19 cases were completely free and one case still had an ulcer which also was improved by medical treatment. One patient developed a very small hernia at the site of laparoscopic port above the umbilicus. However laparoscopic vagotomy is a new promising, minimally invasive technique. Its simplicity, safety, efficacy, minimal scarring and early mobilization support its wider use, but it will be necessary to validate this initial experience with a large number of patients and adequate long term follow up. So we concluded that laparoscopic vagotomy should not be developed so as to avoid or be contrary to the established principles of open surgery, but rather it should be designed as a continuation of classical surgery with new and different techniques