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The Surgeon’s Role in Gastric Electrical Stimulation Therapy for Gastroparesis

  • Review Article
  • Published:
Journal of Gastrointestinal Surgery Aims and scope

Abstract

Introduction

Gastroparesis, which can be viewed as a syndrome featuring nausea, vomiting, and abdominal pain, and associated other symptoms and findings, is increasingly seen by surgeons. Gastroparesis is associated with a number of gastrointestinal anatomic and physiologic findings.

Materials and Methods

This article reviews the use of bioelectric therapy of neuromodulation, via gastric electrical stimulation, for patients with drug refractory gastroparesis syndromes including surgical aspects of device placement and subsequent management.

Results and Discussion

In addition to an overall approach to the placement and subsequent management of gastric electrical stimulation devices, several newer concepts are discussed. The role of pyloric dysfunction in gastroparesis is also discussed including how stimulation devices and pyloric therapies may be used in concert. The additions of full-thickness gastrointestinal biopsies along with other physiologic, including GI electrophysiology, as well as some serologic measures, are also discussed. In addition, evolving approaches and emerging technologies for bioelectric neuromodulation of the gastrointestinal tract are introduced.

Conclusions

Gastroparesis syndromes can be approached in a systematic manner based on known pathophysiology and when indicated can be helped with surgical therapies including neuromodulation.

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Acknowledgments

The authors would like to thank the colleagues and staff at the Medical University of South Carolina, the University of Mississippi, and the University of Louisville, as well as Catherine McBride for help with manuscript preparation. The figures include slides from Dr. Charu Subramony at the University of Mississippi, whose help is appreciated.

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Authors and Affiliations

  1. Medical University of South Carolina, Charleston, SC, USA

    David Adams & William Lancaster

  2. Division of Gastroenterology, Hepatology, and Nutrition, University of Louisville, Louisville, KY, USA

    Abigail Stocker & Thomas Abell

Authors
  1. David Adams
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  2. Abigail Stocker
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  3. William Lancaster
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  4. Thomas Abell
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Contributions

William Lancaster: concept; drafting, manuscript revisions, final approval

Abigail Stocker: concept; drafting, manuscript revisions, final approval

Thomas Abell: concept; drafting, manuscript revisions, final approval

David Adams: concept; drafting, manuscript revisions, final approval

Corresponding author

Correspondence to Thomas Abell.

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Conflict of Interest

Dr. Abell is a former licensor, investigator, and consultant for Medtronic and is the founder of ADEPT-GI, which holds IP on some aspects of temporary GI stimulation as well as on autonomic and enteric profiling for GI related disorders. The remaining authors declare that they have no conflict of interest.

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Adams, D., Stocker, A., Lancaster, W. et al. The Surgeon’s Role in Gastric Electrical Stimulation Therapy for Gastroparesis. J Gastrointest Surg 25, 1053–1064 (2021). https://doi.org/10.1007/s11605-020-04850-w

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  • DOI: https://doi.org/10.1007/s11605-020-04850-w

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