What is the success rate for a pacemaker implanted in the stomach for Gastroparisis?

Answer 1

The trouble with your question is that it would be difficult to define something called a "success rate".

The product that you are talking about is the Medtronics gastric pacemaker named "Enterra". This tool was approved by the FDA several years ago as it was deemed safe and effective. The studies that had been done in Europe and the US were aimed at detecting the reduction in symptoms for those who had undergone the procedure.

In those studies, the patients were evaluated for how often they vomitted per week using medical therapy alone, and then again, after the device implant. On average, the reduction in vomitting episodes went from 25 times per week down to about 5. There were no patients who had total failure to respond, but there was a distribution of responses.

When you ask for a "success rate" you'd have to develop some sort of artificial measure above which, you'd call it a success, and below you'd call it a failure. You could ask patients whether or not they thought it had been helpful and whether or not they'd undergo the procedure again, but that's hardly scientific.

To that end, however, I've planted this device laparoscopically in two patients. Both had been problem-riddled type 1 diabetics. One had previously undergone a kidney/pancreas transplant, the other was a brittle diabetic who uses an insulin pump. Both were debilitated by nausea and were malnourished. They were both wonderfully skinny and easy to operate on! Both reported immediate reduction in nausea and vomitting. Both patients gained weight over the following three months. I have not seen one for almost a year, and the other for six months, so I can give you no further information.

After contacting a colleague a few minutes ago who has also done this procedure, she reports that she has used it about 6 times in the last 3 years. She reports that most of her patients were obese type 2 diabetics (she does mostly obesity surgery). She reports to me that nausea and vomitting appear to be decreased, but that the primary endpoint she is following is actually weight loss. My patients were skinny and gained weight, while hers are overweight and lose! There is some literature to support the viewpoint that this device can help with weight loss, my guess is the stimulated stomach feels full with less food.

Hope that helps...

Answer 2

Gastroparesis is the slowing of the stomach ability to process and move out the food. New treatments are available but have no measurable track record.

A gastric neurostimulator has been developed to assist people with gastroparesis. The battery-operated device is surgically implanted and emits mild electrical pulses that help modulate stomach emptying. This helps relieve the nausea and vomiting associated with gastroparesis. This option is available to people whose nausea and vomiting do not improve with medications.

The use of botulinum toxin has been shown to improve stomach emptying and the symptoms of gastroparesis by decreasing the prolonged contractions of the muscle between the stomach and the small intestine (pyloric sphincter). The toxin is injected into the pyloric sphincter.

Answer 3

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