• Skip to primary navigation
  • Skip to main content
  • Skip to footer

SAGES

Reimagining surgical care for a healthier world

  • Home
    • Search
    • SAGES Home
    • SAGES Foundation Home
  • About
    • Who is SAGES?
    • SAGES Mission Statement
    • Advocacy
    • Strategic Plan, 2020-2023
    • Committees
      • Request to Join a SAGES Committee
      • SAGES Board of Governors
      • Officers and Representatives of the Society
      • Committee Chairs and Co-Chairs
      • Full Committee Rosters
      • SAGES Past Presidents
    • Donate to the SAGES Foundation
    • SAGES Store
    • Awards
      • George Berci Award
      • Pioneer in Surgical Endoscopy
      • Excellence In Clinical Care
      • International Ambassador
      • IRCAD Visiting Fellowship
      • Social Justice and Health Equity
      • Excellence in Community Surgery
      • Distinguished Service
      • Early Career Researcher
      • Researcher in Training
      • Jeff Ponsky Master Educator
      • Excellence in Medical Leadership
      • Barbara Berci Memorial Award
      • Brandeis Scholarship
      • Advocacy Summit
      • RAFT Annual Meeting Abstract Contest and Awards
    • “Unofficial” Logo Products
  • Meetings
    • NBT Innovation Weekend
    • SAGES Annual Meeting
      • 2024 Scientific Session Call For Abstracts
      • 2024 Emerging Technology Call For Abstracts
    • CME Claim Form
    • Industry
      • Advertising Opportunities
      • Exhibit Opportunities
      • Sponsorship Opportunities
    • Future Meetings
    • Related Meetings Calendar
  • Join SAGES!
    • Membership Benefits
    • Membership Applications
      • Active Membership
      • Affiliate Membership
      • Associate Active Membership
      • Candidate Membership
      • International Membership
      • Medical Student Membership
    • Member News
      • Member Spotlight
      • Give the Gift of SAGES Membership
  • Patients
    • Healthy Sooner – Patient Information for Minimally Invasive Surgery
    • Patient Information Brochures
    • Choosing Wisely – An Initiative of the ABIM Foundation
    • All in the Recovery: Colorectal Cancer Alliance
    • Find a SAGES Member
  • Publications
    • SAGES Stories Podcast
    • SAGES Clinical / Practice / Training Guidelines, Statements, and Standards of Practice
    • Patient Information Brochures
    • TAVAC – Technology and Value Assessments
    • Surgical Endoscopy and Other Journal Information
    • SAGES Manuals
    • SCOPE – The SAGES Newsletter
    • COVID-19 Annoucements
    • Troubleshooting Guides
  • Education
    • OpiVoid.org
    • SAGES.TV Video Library
    • Safe Cholecystectomy Program
      • Safe Cholecystectomy Didactic Modules
    • Masters Program
      • SAGES Facebook Program Collaboratives
      • Acute Care Surgery
      • Bariatric
      • Biliary
      • Colorectal
      • Flexible Endoscopy (upper or lower)
      • Foregut
      • Hernia
      • Robotics
    • Educational Opportunities
    • HPB/Solid Organ Program
    • Courses for Residents
      • Advanced Courses
      • Basic Courses
    • Fellows Career Development Course
    • Robotics Fellows Course
    • MIS Fellows Course
    • Facebook Livestreams
    • Free Webinars For Residents
    • SMART Enhanced Recovery Program
    • SAGES OR SAFETY Video
    • SAGES at Cine-Med
      • SAGES Top 21 MIS Procedures
      • SAGES Pearls
      • SAGES Flexible Endoscopy 101
      • SAGES Tips & Tricks of the Top 21
  • Opportunities
    • NEW-Area of Concentrated Training Seal (ACT)-Advanced Flexible Endoscopy
    • SAGES Fellowship Certification for Advanced GI MIS and Comprehensive Flexible Endoscopy
    • Multi-Society Foregut Fellowship Certification
    • SAGES Research Opportunities
    • Fundamentals of Laparoscopic Surgery
    • Fundamentals of Endoscopic Surgery
    • Fundamental Use of Surgical Energy
    • Job Board
    • SAGES Go Global: Global Affairs and Humanitarian Efforts
  • Search
    • Search All SAGES Content
    • Search SAGES Guidelines
    • Search the Video Library
    • Search the Image Library
    • Search the Abstracts Archive
  • OWLS
  • Log In

Effect on Gastroparesis Symptoms After Explantation of Gastric Electrical Stimulators

Matthew J Davis, MD1, Andrew T Strong, MD1, Ivy N Haskins1, Kevin M El-Hayek, MD1, Michael S Cline, DO2, Matthew D Kroh, MD1, John Rodriguez, MD1. 1Section of Surgical Endoscopy, Department of General Surgery, Cleveland Clinic, 2Department of Gastroenterology, Cleveland Clinic

Introduction: Gastroparesis is a chronic and debilitating disease, with an increasing prevalence in the United States. Prokinetic, antiemetic medications and behavioral modification are mainstays for therapy, but the failure rate remains high. For patients refractory to medical therapy, Gastric Electrical Stimulator (GES) may be considered. There are various indications for device removal. Outcomes of patients who have previously undergone GES therapy have not been studied after explantation.

Methods: An IRB approved, prospectively maintained database of 209 patients who have received GES at our institution was queried for patients who underwent explantation. Demographic data, pre- and post-operative symptomatology, as well as perioperative data were collected. All patients who eventually underwent explantation were included in this study.

Results: Twenty-two patients met inclusion criteria, which represents 11% of our total implants. Nineteen patients were female (86%). Nine patients had gastroparesis secondary to diabetes, while the remaining were classified as idiopathic. Age at implantation ranged from 21 – 74 years. Mean pre-stimulator BMI was 26 kg/m2 (range 16 – 40). The most common pre-implantation symptoms were nausea (86%, n=19), vomiting (82%, n=18), inability to finish a meal (68%, n=15) and chronic abdominal pain (64%, n=14). Routine follow up after stimulator insertion to a mean of 12 months (range, 1 – 73) showed improvement or resolution of nausea in 59% of patients (n=13), vomiting in 55% (n=12), and abdominal pain in 27% (n=6).

Average time to explantation was 44 months (range 1 – 149). Indications for stimulator explant included: failure of symptomatic relief (50%, n=11), generator and/or lead infection (18%, n=4), lead erosion (14%, n=3), generator pain and/or discomfort (14%, n=3), and patient complaint of shocking sensation (5%, n=1). Two of the patients in the failure of relief group had their devices removed as part of a small bowel transplant. Three patients underwent conversion to Roux-en-Y gastrojejunostomy (RYGJ) and three had new enteral access placed at the time of device removal.

Post-operative data was available for eighteen patients. Twelve patients (67%) suffered from nausea, seven (39%) reported continued emesis, four (22%) were unable to finish a meal, and eight (44%) reported chronic abdominal pain. Notably, two of the patients who reported no further symptoms were from those who were converted to RYGJ.

Conclusion: GES has shown efficacy in the treatment of gastroparesis. Indications for explantation are variable, but may occur in over 10% of patients. Some patients may maintain symptomatic improvement even following explant.


Presented at the SAGES 2017 Annual Meeting in Houston, TX.

Abstract ID: 80333

Program Number: P380

Presentation Session: Poster (Non CME)

Presentation Type: Poster

36

Share this:

  • Twitter
  • Facebook
  • LinkedIn
  • Pinterest
  • WhatsApp
  • Reddit

Related

Hours & Info

11300 West Olympic Blvd, Suite 600
Los Angeles, CA 90064
1-310-437-0544
[email protected]
Monday - Friday
8am to 5pm Pacific Time

Find Us Around the Web!

  • Facebook
  • Twitter
  • YouTube

Important Links

SAGES 2023 Meeting Information

Healthy Sooner: Patient Information

SAGES Guidelines, Statements, & Standards of Practice

SAGES Manuals

 

  • taTME Study Info
  • Foundation
  • SAGES.TV
  • MyCME
  • Educational Activities

Copyright © 2023 Society of American Gastrointestinal and Endoscopic Surgeons