Obesity Surgery

, 17:100 | Cite as

Laparoscopically Implanted Gastric Pacemaker after Kidney-Pancreas Transplantation: Treatment of Morbid Obesity and Diabetic Gastroparesis

  • Hugo Bonatti
  • Gerald Brandacher
  • Elisabeth Hoeller
  • Ingrid Stelzmueller
  • Walter Mark
  • Raimund Margreiter
  • Helmut WeissEmail author
Case Report

Combined kidney-pancreas transplantation is the treatment of choice for end-stage diabetic nephropathy. Weight gain post-transplant increases the risk for post-transplant complications and death due to cardiovascular events. Gastric pacemakers have been used for therapy of diabetic gastropathy and for the treatment of moderate morbid obesity. We report a patient who experienced significant weight gain following successful kidney-pancreas transplantation and was thereafter successfully treated for diabetic gastroparesis and morbid obesity by use of a laparoscopically implanted gastric pacemaker.

Key words

Gastric pacing transplantation morbid obesity bariatric surgery diabetes mellitus 


  1. 1.
    Sutherland DE, Gruessner RW, Dunn DL. Lessons learned from more than 1,000 pancreas transplants at a single institution. Ann Surg 2001; 233: 463–501.CrossRefPubMedGoogle Scholar
  2. 2.
    Bumgardner GL, Henry ML, Elkhammas E et al. Obesity as a risk factor after combined pancreas/kidney transplantation. Transplantation 1995; 60: 1426–30.CrossRefPubMedGoogle Scholar
  3. 3.
    McCallum RW, Brown RL. Diabetic and nondiabetic gastroparesis. Curr Treat Options Gastroenterol 1998; 1: 1–7.CrossRefPubMedGoogle Scholar
  4. 4.
    Forster J, Sarosiek I, Delcore R et al. Gastric pacing is a new surgical treatment for gastroparesis. Am J Surg 2001; 182: 676–81.CrossRefPubMedGoogle Scholar
  5. 5.
    Shikora SA. “What are the yanks doing?” the U.S. experience with implantable gastric stimulation (IGS) for the treatment of obesity - update on the ongoing clinical trials. Obes Surg 2004; 14 (Suppl 1): S40–S48.CrossRefPubMedGoogle Scholar
  6. 6.
    Miller KA. Implantable electrical gastric stimulation to treat morbid obesity in the human: operative technique. Obes Surg 2002; 12 (Suppl 1): 17S–20S.CrossRefPubMedGoogle Scholar
  7. 7.
    Weiss H, Nehoda H, Labeck B et al. Organ transplantation and obesity: evaluation, risks and benefits of therapeutic strategies. Obes Surg 2000; 10: 465–9.CrossRefPubMedGoogle Scholar
  8. 8.
    Alexander JW, Goodman HR, Gersin K et al. Gastric bypass in morbidly obese patients with chronic renal failure and kidney transplant. Transplantation 2004; 78: 469–74.CrossRefPubMedGoogle Scholar
  9. 9.
    Humar A, Ramcharan T, Kandaswamy R et al. Technical failures after pancreas transplants: why grafts fail and the risk factors — a multivariate analysis. Transplantation 2004; 78: 1188–92.CrossRefPubMedGoogle Scholar
  10. 10.
    Jones JW Jr, Mizrahi SS, Bentley FR. Type II diabetes after combined kidney and pancreas transplantation for type I diabetes mellitus and end-stage renal disease. Clin Transplant 1996; 10 (6 Pt 1): 574–5.PubMedGoogle Scholar
  11. 11.
    Parkman HP, Hasler WL, Fisher RS. American Gastroenterological Association technical review on the diagnosis and treatment of gastroparesis. Gastroenterology 2004; 127: 1592–622.CrossRefPubMedGoogle Scholar
  12. 12.
    Forster J, Sarosiek I, Lin Z et al. Further experience with gastric stimulation to treat drug refractory gastroparesis. Am J Surg 2003; 186: 690–5.CrossRefPubMedGoogle Scholar
  13. 13.
    Lin Z, Forster J, Sarosiek I et al. Treatment of diabetic gastroparesis by high-frequency gastric electrical stimulation. Diabetes Care 2004; 27: 1071–6.CrossRefPubMedGoogle Scholar
  14. 14.
    Chen J. Mechanisms of action of the implantable gastric stimulator for obesity. Obes Surg 2004; 14 (Suppl 1): S28–32.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science + Business Media B.V. 2007

Authors and Affiliations

  • Hugo Bonatti
    • 1
    • 2
  • Gerald Brandacher
    • 1
  • Elisabeth Hoeller
    • 1
  • Ingrid Stelzmueller
    • 1
  • Walter Mark
    • 1
  • Raimund Margreiter
    • 1
  • Helmut Weiss
    • 1
    Email author
  1. 1.Department of General and Transplant SurgeryMedical University InnsbruckInnsbruckAustria
  2. 2.Department of SurgeryMayo Clinic FoundationJacksonvilleUSA

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