Endoscopic truncal vagotomy. Exploring the fourth space. A technical feasibility study in a porcine model

This study demonstrates technical feasibility of (1) EUS-guided vagus nerve identification and targeting using a fine-needle aspiration as needed, and (2) endoscopic transection of both the anterior and posterior vagus nerves. Controlled dissection, low carbon dioxide insufflation, and meticulous technique are essential for safety. Further research is needed to refine the technique, assess safety and efficacy, and explore its full clinical potential.