Gastric pacemaker surgery

When medication and diet therapies don't relieve severe gastroparesis effects, surgery may be appropriate. Penn Medicine is one of few centers in the Northeast to offer gastric electrical stimulation (also called gastric pacemaker). This specialized gastroparesis treatment has offered some patients life-changing results.

Gastroparesis (delayed gastric emptying) is a condition where damaged nerves and muscles in the stomach don't move food through the digestive tract properly (or fast enough).

Gastroparesis has many potential causes. The most common is consistently high blood sugar levels due to diabetes. In that case, doctors refer to the complication as diabetic gastroparesis. When doctors are unable to pinpoint a cause, it’s called idiopathic gastroparesis. Gastroparesis can cause a wide range of symptoms, including nausea, vomiting, and abdominal pain. Symptoms range from mild to severe. It is usually a chronic (lifelong) condition.

While no therapy can cure gastroparesis, medication and dietary therapies have shown helpful for reducing symptoms for many people. If other therapies haven’t helped and your gastroparesis symptoms severely disrupt your life, your doctor may consider surgery.

Gastric stimulators offer varying levels of relief to many people with gastroparesis. If the device doesn't work for you, your surgeon will perform a second procedure to remove it. In general, people with diabetic gastroparesis tend to benefit more from this surgery and people with idiopathic gastroparesis (no known cause) may see fewer benefits.

It's important to seek care from an experienced surgeon who can offer guidance on whether it may benefit you. At Penn Medicine, determining whether someone is a candidate for a gastric pacemaker starts with a thorough evaluation and diagnostic tests. You then meet with an expert surgeon to discuss the pros and cons of surgery, and whether a gastric pacemaker is right for you. Deciding whether this treatment fits your needs takes time and thoughtful consideration. With our patient portal (MyChart by myPennMedicine), we make it easy to connect with your doctor and actively engage in your care.

Gastric electrical stimulation is not new, but it requires special training and expertise. Our team’s experience with this therapy traces back to its FDA approval more than 20 years ago. During gastric electrical stimulation, a surgeon:

1. Makes an incision in the lower abdomen area.
2. Carefully positions a small battery-operated device (called a gastric stimulator) under the skin in the abdomen.
3. Attaches two wires (leads) that connect the device to a specific area on the outside of the stomach wall.
4. Closes up the incision.

After surgery, the surgeon programs the device according to the details of your case. It sends very low electrical shock waves to the stomach at certain times (such as after eating). These electrical currents stimulate the stomach to function properly.

We implant the gastric pacemaker device using the latest minimally invasive laparoscopic techniques. Laparoscopic surgery offers several benefits over traditional open surgery. It lowers the risk of certain complications and leaves a less obvious scar.

In some people with gastroparesis, these mild electrical shocks help the stomach to empty and lessen how often or how severely they experience nausea and vomiting.

Recovery following gastric pacemaker implantation typically involves a short hospital stay, typically from one to three days. While some pain at the incision site is expected, pain medication will be prescribed to manage discomfort. To ensure optimal healing, it's essential to avoid strenuous activity, heavy lifting, and excessive bending or twisting for up to several weeks, following direction from your post-operative health care provider.

Regular follow-up appointments with your physician are crucial to monitor your healing progress and allow for adjustments to the pacemaker settings as needed. Long-term management of the gastric pacemaker will require ongoing care, including regular checkups and potential battery replacements.

It's important to remember that recovery timelines can vary significantly between individuals. As with any surgical procedure, potential risks and complications exist, which will be thoroughly discussed by your Penn Medicine provider ahead of the surgery.