Gastric Vagi in the Dog. Erroneous Assumption of Uninterrupted Vagal Innervation in the Pavlov Pouch. ∗

Abstract

The fundamental difference in concept between the Pavlov pouch and the Heidenhain pouch is that the vagal innervation of the former is intact. Fig. 1, reproduced from Khigine 1 and Pavlov, 2 , 3 indicates the anatomical concept upon which they based their operative procedure. According to this diagram, after the anterior vagus trunk leaves the anterior gastric plexus, it descends the anterior surface of the stomach along the lesser curvature to the pylorus. The main posterior vagus trunk, however, after leaving the posterior gastric plexus, descends the corresponding stomach surface along the greater curvature to approximately the beginning of the pars pylorica. The incision which separates the pouch from the main stomach passes between these two main trunks and their arborizations. Consequently, the posterior trunk passes intact through the sero-muscular isthmus which joins the pouch to the stomach proper, insuring the integrity of the vagus supply to the pouch.

With only minor modifications in technique, the method of Khigine and Pavlov has been utilized by practically all physiologists who found use in their work for a “vagus-intact” pouch. These investigators, as well as other writers on the subject, state without reservation that in the Pavlov pouch the integrity of the nervous connections is preserved, and most of them employ as illustration the Pavlov diagram shown herewith.