title: Laparoscopic gastric electrical stimulation for medically refractory diabetic and idiopathic gastroparesis.
abstract: BACKGROUND
  Gastric electrical stimulator (GES) implantation is effective in certain patients with gastroparesis; however, laparotomy is often employed for placement. The aim of this study is to review outcomes of patients who underwent laparoscopic GES therapy for diabetic and idiopathic gastroparesis at a large referral center.
  
  
  METHODS
  Patients who underwent GES (Enterra Therapy System; Medtronic, Minneapolis, MN) implantation with subsequent interrogation and programming between March 2001 and November 2011 were analyzed.
  
  
  RESULTS
  A total of 113 patients underwent GES placement or revision during the study period. One hundred eleven patients underwent primary GES at our institution, while two patients underwent GES generator revision at our institution. Primary operations were completed laparoscopically in 110 of 111 cases, with one conversion to laparotomy due to severe adhesions. At a mean follow-up of 27 months (1-113), symptom improvement was achieved in 91 patients (80 %) and was similar for both the diabetic and idiopathic subgroups. Need for supplemental nutrition (enteral and/or parental) decreased in both groups.
  
  
  CONCLUSIONS
  GES placement is feasible using a laparoscopic approach. Medical refractory gastroparesis in the diabetic and idiopathic groups had significant symptom improvement with no difference between the two groups. Need for supplemental nutrition is decreased following GES.
authors.affiliation: Cleveland Clinic, Bariatric and Metabolic Institute, Cleveland, OH 44195, USA. timratp@ccf.org
authors.forename: P
authors.initials: P
authors.lastname: Timratana
authors.forename: K
authors.initials: K
authors.lastname: El-Hayek
authors.forename: H
authors.initials: H
authors.lastname: Shimizu
authors.forename: M
authors.initials: M
authors.lastname: Kroh
authors.forename: B
authors.initials: B
authors.lastname: Chand
mesh_terms: D000328:Adult; D048909:Diabetes Complications / Q000150:complications*; D003920:Diabetes Mellitus / Q000097:blood; D004599:Electric Stimulation Therapy / Q000009:adverse effects; D005260:Female; D005500:Follow-Up Studies; D018589:Gastroparesis / Q000209:etiology* / Q000628:therapy*; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D058542:Implantable Neurostimulators / Q000009:adverse effects; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D009767:Obesity, Morbid / Q000150:complications; D019919:Prosthesis Implantation / Q000379:methods*; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D006442:Glycated Hemoglobin