Gastroenterologists at Temple University Hospital are now using a surgically implanted device to treat patients suffering from gastroparesis, a disorder that prevents the stomach from emptying itself into the intestines and can cause nausea, vomiting or feeling full after eating only a small amount of food.
The Medtronic Enterra II Neurostimulator is inserted under the abdomen and can connect to the stomach, stimulating it with small electric pulses. The new version Temple doctors are using also comes with a unique feature.
Doctors operating the machine can wave a “wand” over the device, giving them access to change the device’s settings, turn it on or off, program it and even track the patient’s records. The settings to accommodate a particular patient’s symptoms are available through a code number embedded in a microchip within the device.
“It used to be that the information would be in our microchip,” gastroenterologist Dr. Henry P. Parkman said. “Now the microchip is inside the pacemaker that’s inside the patient … if the patient goes to some other center they can access the stimulator and get that information.”
The hospital has been using a variant of the system since 2000, and has since treated about 380 patients.
The Enterra stimulator is available to patients 18 or older who are non-respondent to dietary recommendations, antibiotics or drugs like Reglan or Azithromycin, which are used to enhance the stomach’s emptying process.
A team of five, including Parkman, ensure the patients’ comfort by implanting the device in one of two ways: by performing a laparotomy – an incision in the abdominal region – or a laparoscopy, a moderately-invasive surgery.
“If the patient shows no success through dietary recommendations, medicine or botox, we then suggest the Enterra system,” another member of the team, nutritionist Vanessa Lytes, said. “There’s a chance for a better quality of life. It’s worth trying.”
The team concluded that about 70 percent of treated patients showed signs of improvement after being operated. The doctors presented their research in the 2014 American Oncology Gastroenterology nationwide meeting.
“We have had good success with this, we see a lot of patients with gastroparesis,” Parkman said.
Their research also pointed at patients – generally with diabetes – showing primary symptoms of nausea abdominal pain and vomiting to be the candidates with the highest productivity.
“Most hospitals in the area, if they have patients with gastroparesis not responding to therapy, refer them to us here at Temple,” Parkman said.
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