Laparoscopic gastric pacing
Epublication WebSurg.com, Nov 2013;13(11). URL: http://websurg.com/doi/vd01en4055
We present the case of a 38-year-old woman with intractable gastroparesis. Her background history was significant for type I diabetes mellitus (DM), a pancreas kidney transplant in 2006, Nissen fundoplication, gastrotomy for bleeding Dieulafoy’s lesion, diabetic retinopathy, peripheral vascular disease, and gastroparesis which was diagnosed in 2007. She complained of daily vomiting, early satiety, abdominal discomfort, nocturnal diarrhea, and significant weight loss. In addition, she had required multiple hospital admissions with severe electrolyte derangement and repeat OGDs. Her symptoms were refractory to motility agents and to Botox therapy. Following a multidisciplinary discussion, she was offered a gastric stimulator. We present a laparoscopic approach to gastric stimulator insertion. The device that we use is the Medtronic Enterra® therapy system. The patient was discharged well after 48 hours. At a follow-up of 4 weeks, her symptoms had improved significantly: her vomiting had reduced to once per week, and she no longer suffered from nocturnal diarrhea. At a follow-up of 3 months, her vomiting had ceased completely and she was gaining weight. The patient returned to work and to normal daily activities.