The distance between the pylorus and left vagus nerve during sleeve gastrectomy.

Parpex, Guillaume; Demouron, Marion; Arapis, Konstantinos; Chosidow, Denis; Rebibo, Lionel; Msika, Simon

BACKGROUND The sleeve gastrectomy (SG) can be performed with or without antral preservation (distance from the pylorus < 50mm). The objective of this study was to evaluate the distance between the pylorus and the end of the left vagus nerve in order to determine whether it could be used as a constant anatomical landmark to start gastric transection. METHODS This was a prospective, non-randomized study of 120 patients undergoing SG from January to October 2018. The distance measurement between pylorus and vagus nerve was performed at the beginning of the SG. The primary endpoint was the distance between the beginning of the pylorus and the end of the 2nd branch of the vagus nerve on the upper edge of the antrum. The secondary endpoints was the correlation factors between the preoperative data and the position of the end of the vagus nerve. RESULTS A total of 120 patients, with a mean BMI of 42.2 kg/m2 , underwent primary SG. The mean distance between pylorus and the end of the vagus nerve was 50.4 mm (35-64) on the upper part of the antrum. When considering the inferior part of the antrum, the minimum distance was 50 mm. No correlations were found between pre-operative data and distance measurements. CONCLUSION The vagus nerve can be considered as a constant and reliable anatomical landmark for performing SG with antral preservation. However, no correlation was found between the preoperative data and the location of the end of the vagus nerve. This article is protected by copyright. All rights reserved.