Laparoscopic Gastric Pacing

  • Karl MillerEmail author


Laparoscopic gastric pacing (LGP) is a minimally invasive technique that is performed for the treatment of obesity. LGP was first developed in the early 1990s for gastroparesis, and was also found to be effective in the treatment of obesity. The application of electrical current to the stomach alters gastric myoelectrical activity, without any changes in the gastrointestinal anatomy. The exact mechanism of LGP remains to be elucidated. However, potential mechanisms to assess the success of LGP might include an increased feeling of satiety as the result of reduced gastric emptying, or changes in neuropeptide levels.

LGP is a minimally invasive technique that is potentially safe and effective for treating obesity; nevertheless, the selection of patients for gastric stimulation therapy appears to be an important determinant of the outcome of this treatment.

This article reviews the current status, potential mechanisms of action, operating techniques, complications, postoperative management and outcomes, and possible future applications of gastric stimulation in obesity management.


Gastric pacing Obesity Neuromodulation Surgery Outcomes 

Supplementary material

Video 49.1

The lead of the pacemaker is inserted into the muscle tunnel of the stomach which positions are on the lesser curvature. An adequate length of the tunnel is mandatory, to ensure that both of the electrodes are buried within the tunnel wall. The location of the generator should be on the anterior abdominal wall. The device that controls the settings (wand) is covered with a sterile cover and the system impedance is checked. (MP4 16338 kb)


  1. 1.
    Cigaina V, Pinato GP, Rigo V, Bevilacqua M, Ferraro F, Ischia S, Saggioro A. Gastric peristalsis control by mono situ electrical stimulation: a preliminary study. Obes Surg. 1996;6:247–9.CrossRefPubMedGoogle Scholar
  2. 2.
    D’Argent J. Gastric electrical stimulation as therapy of morbid obesity: preliminary results from the frenchstudy. Obes Surg. 2002;12 Suppl 1:21S–5.CrossRefPubMedGoogle Scholar
  3. 3.
    Favretti F, De Luca M, Segato G, Busetto L, Ceoloni A, Magon A, Enzi G. Treatment of morbid obesity with the Transcend® Implantable Gastric Stimulator (IGS®): a prospective survey. Obes Surg. 2004;14:666–70.CrossRefPubMedGoogle Scholar
  4. 4.
    Greenway F, Zheng J. Electrical stimulation as treatment for obesity and diabetes. J Diabetes Sci Technol. 2007;1(2):251–9.PubMedCentralCrossRefPubMedGoogle Scholar
  5. 5.
    Zhang J, Tang M, Chen JD. Gastric electrical stimulation for obesity: the need for a new device using wider pulses. Obesity (Silver Spring). 2009;17(3):474–80.CrossRefGoogle Scholar
  6. 6.
    Yao SK, Ke MY, Wang ZF, Xu DB, Zhang YL. Visceral response to acute retrograde gastric electrical stimulation in healthy human. World J Gastroenterol. 2005;11(29):4541–6.PubMedCentralPubMedGoogle Scholar
  7. 7.
    Bohdjalian A, Prager G, Aviv R, Policker S, Schindler K, Kretschmer S, Riener R, Zacherl J, Ludvik B. One-year experience with Tantalus: a new surgical approach to treat morbid obesity. Obes Surg. 2006;16(5):627–34.CrossRefPubMedGoogle Scholar
  8. 8.
    Miller KA. Implantable electrical gastric stimulation to treat morbid obesity in the human: operative technique. Obes Surg. 2002;12 Suppl 1:17S–20.CrossRefPubMedGoogle Scholar
  9. 9.
    Miller K, Hoeller E, Aigner F. The implantable gastric stimulator for obesity: an update of the European experience in the LOSS (Laparoscopic Obesity Stimulation Survey) Study. Treat Endocrinol. 2006;5(1):53–8.CrossRefPubMedGoogle Scholar
  10. 10.
    Callegari A, Michelini I, Squazzin C, Catona A, Klersy C. Efficacy of the SF-36 questionnaire in identifying obese patients with psychological discomfort. Obes Surg. 2005;15(2):254–60.CrossRefPubMedGoogle Scholar
  11. 11.
    Bohdjalian A, Ludvik B, Guerci B, Bresler L, Renard E, Nocca D, et al. Improvement in glycemic control by gastric electrical stimulation (TANTALUS™) in overweight subjects with type 2 diabetes. Surg Endosc. 2009;23:1955–60.CrossRefPubMedGoogle Scholar
  12. 12.
    Mizrahi M, Ben Ya’acov AB, Ilan Y. Gastric stimulation for weight loss. World J Gastroenterol. 2012;18(19):2309–19.PubMedCentralCrossRefPubMedGoogle Scholar
  13. 13.
    Miller K, Höller E, Hell E. Intragastric stimulation (IGS) for the treatment of morbid obesity. Zentralbl Chir. 2002;127:1049–54.CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing Switzerland 2016

Authors and Affiliations

  1. 1.Mohamed Bin Rashid Al Maktoum Academic Medical CentreDubai Health Care CityDubaiUnited Arab Emirates

Personalised recommendations