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Laparoscopic Gastric Electrical Stimulation for Medically Refractory Diabetic and Idiopathic Gastroparesis

Journal of Gastrointestinal Surgery volume 17, pages 461–470 (2013)Cite this article

Abstract

Background

Gastric electrical stimulator (GES) implantation is effective in certain patients with gastroparesis; however, laparotomy is often employed for placement. The aim of this study is to review outcomes of patients who underwent laparoscopic GES therapy for diabetic and idiopathic gastroparesis at a large referral center.

Methods

Patients who underwent GES (Enterra Therapy System; Medtronic, Minneapolis, MN) implantation with subsequent interrogation and programming between March 2001 and November 2011 were analyzed.

Results

A total of 113 patients underwent GES placement or revision during the study period. One hundred eleven patients underwent primary GES at our institution, while two patients underwent GES generator revision at our institution. Primary operations were completed laparoscopically in 110 of 111 cases, with one conversion to laparotomy due to severe adhesions. At a mean follow-up of 27 months (1–113), symptom improvement was achieved in 91 patients (80 %) and was similar for both the diabetic and idiopathic subgroups. Need for supplemental nutrition (enteral and/or parental) decreased in both groups.

Conclusions

GES placement is feasible using a laparoscopic approach. Medical refractory gastroparesis in the diabetic and idiopathic groups had significant symptom improvement with no difference between the two groups. Need for supplemental nutrition is decreased following GES.

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Disclosures

Dr. Kroh has served as a consultant and received honoraria for Intuitive, Bard, Ethicon, and Covidien. Dr. Bipan Chand has served as a consultant and received honoraria from Bard, Covidien, Ethicon, and Sanofi-Aventis. Drs. Timratana, El-Hayek, and Shimizu have no conflicts of interest or financial ties to disclose.

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Affiliations

  1. Cleveland Clinic, Bariatric and Metabolic Institute, Cleveland, Ohio, 44195, USA

    P. Timratana, K. El-Hayek, H. Shimizu & M. Kroh

  2. Division of Gastrointestinal and Minimally Invasive Surgery, Loyola University Medical Center, Maywood, IL, 60153, USA

    B. Chand

  3. Stritch School of Medicine, Loyola University Medical Center, 2160 South First Avenue, Bldg. 110-Room 3291, Maywood, IL, 60153, USA

    B. Chand

Authors
  1. P. Timratana
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  2. K. El-Hayek
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  3. H. Shimizu
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  4. M. Kroh
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  5. B. Chand
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Corresponding author

Correspondence to B. Chand.

Additional information

Accepted for Poster Presentation at Digestive Diseases Week, 18–22 May 2012, San Diego, California. Abstract number: 1296366. Poster ID: Su1567.

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Timratana, P., El-Hayek, K., Shimizu, H. et al. Laparoscopic Gastric Electrical Stimulation for Medically Refractory Diabetic and Idiopathic Gastroparesis. J Gastrointest Surg 17, 461–470 (2013). https://doi.org/10.1007/s11605-012-2128-7

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  • DOI: https://doi.org/10.1007/s11605-012-2128-7

Keywords

  • Laparoscopy
  • Gastric stimulation
  • Gastroparesis