Dennis Van Dorp, MD, Bruce Ramshaw, MD, Sarah Campbell, PAC, Matt Mancini, MD. University of Tennessee
Introduction: Gastroparesis is a chronic gastric motility disorder that is difficult to treat and results in a poor quality of life for affected patients. Treatment options are typically focused on medical therapy, and primarily involve pro-motility agents. Surgical options include gastric stimulator implantation, subtotal gastrectomy, and pyloroplasty. Pyloroplasty has been a recent focus for the surgical treatment of gastroparesis, particularly utilizing minimally invasive approaches. Here we report our experience with minimally invasive robotic-assisted pyloroplasty.
Study Design: We have implemented a clinical quality improvement (CQI) effort in an attempt to better measure and improve outcomes for patients who have refractory gastroparesis. We analyzed 15 patients who underwent robotic-assisted pyloroplasty for refractory gastroparesis from December 2015 to July 2017. Patient factors, treatment factors, and outcome measures were collected in an attempt to gain insight and to generate ideas to potentially improve outcomes.
Results: There were no operative complications. Six patients (40%) had failed gastric pacemaker placement prior to intervention. Nine patients (60%) reported improvement in their symptoms and overall quality of life. Four patients (26%) reported no improvement in symptoms and required additional intervention for symptom control and supportive care (one underwent roux-en-Y gastric bypass, three underwent laparoscopic jejunostomy feeding tube placement to maintain nutrition).
Conclusion: Robotic-assisted pyloroplasty is a safe option that improves symptoms and quality of life in 60% of our patients. Several of our patients underwent additional surgery due to ongoing symptoms. Based on this analysis of data, ideas will be generated in an attempt to improve outcomes in these patients.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 87437
Program Number: P782
Presentation Session: iPoster Session (Non CME)
Presentation Type: Poster