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Percutaneous implantation of gastric electrodes - a novel technique applied in animals and in patients

Journal article
Authors Anders Elfvin
S. Andersson
Hasse Abrahamsson
Anders Edebo
Magnus Simrén
Hans Lönroth
Published in Neurogastroenterology and motility
Volume 19
Issue 2
Pages 103-9
ISSN 1350-1925 (Print)
Publication year 2007
Published at Institute of Medicine, Department of Internal Medicine
Institute of Clinical Sciences
Pages 103-9
Language en
Links www.ncbi.nlm.nih.gov/entrez/query.f...
Keywords Aged, 80 and over, Animals, Dyspepsia/diagnosis/physiopathology, Electric Stimulation/instrumentation/*methods, *Electrodes, Implanted, Electromyography/instrumentation/*methods, Female, Gastric Emptying/physiology, Gastroscopy, Humans, Intestinal Pseudo-Obstruction/diagnosis/*physiopathology, Male, Manometry, Middle Aged, Stomach/*physiology, Swine, Vomiting/diagnosis/physiopathology
Subject categories Medical and Health Sciences

Abstract

Temporary electrodes implanted under general anaesthesia, or via an oral or percutaneous endoscopic gastrostomy route have been used for testing of gastric electrical stimulation (GES). We have developed a principle for percutaneous electrode implantation. Leads were constructed so that the tip could be anchored to the gastric submucosa under gastroscopic control. Acute experiments were performed in anaesthetized pigs. Three patients referred for nausea and/or vomiting and non-established indications for GES (chronic intestinal pseudo-obstruction, functional dyspepsia without gastroparesis) were evaluated. Electrode function was tested by recording and stimulation techniques. In the pigs, a slow-wave (SW) rhythm (3 min(-1)) was recorded with decrease in frequency at the end of the experiments. In the patients, implantation time from start of gastroscopy to end of electrode placement was 12-20 min. Electrode distance varied from 12 to 45 mm. Gastric electromyography showed a regular SW rhythm of about 3 min(-1). Antral pressure waves had intervals being multiples of the SW-to-SW time. With temporary GES for 7-9 days, weekly frequency of the referral symptoms decreased >80% in two patients and 33% in one patient. Temporary percutaneous gastric leads can easily be implanted and may be used for testing of GES and study of gastric electrophysiology.

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