Many know the misery the stomach flu can bring - nausea, vomiting, and the overall malaise that washes over you. While these symptoms typically disappear in a few days with most viruses, there are people living with these abdominal complaints every day of their lives, caused by a chronic digestive disorder called gastroparesis.
The surgical team, led by Dr. Siva Vithiananathan, (right) performs the first implant of the Enterra™ Gastric Electrical Stimulator in a patient at Winthrop.
Gastroparesis is a chronic disorder in which food moves through the stomach more slowly than normal, resulting in a feeling of fullness and chronic nausea. Patients may vomit three or more times a day and suffer from bloating, dehydration, malnutrition and constant abdominal pain. Thirty to 40 percent of those affected are diabetics who have suffered nerve damage in the stomach as a long-term complication of their disease.
Now, there is hope on the horizon at Winthrop-University Hospital's Institute for Digestive Disorders. When other viable therapies fail to alleviate the debilitating symptoms of the disease, a new minimally invasive laparoscopic procedure to implant the FDA approved Medtronic Enterra™ Gastric Electrical Stimulator helps to restore quality of life.
How it Works
The procedure places two wires, attached to a two-inch neurostimulator or battery, into the muscles of the lower stomach. The neurostimulator is implanted into the wall of the lower portion of the abdomen. The device's electrical impulses stimulate the muscles of the stomach to aid in digestion and better gastric emptying. This results in the reduction of the nausea and vomiting that plague patients.
Three fingernail-sized incisions are made in the abdominal wall to perform this minimally invasive procedure, which requires only a few days in the hospital. Patients do not feel the electrical stimulation from the implanted device.
"Upwards of 80 percent of patients who undergo implantation with this new device will experience rather dramatic symptomatic relief," said Siva Vithiananthan, MD, Director, Advanced Laparoscopic Surgery.
Winthrop surgeons work closely with physicians in the Institute for Digestive Disorder's Motility Center to provide the best treatment options and well-rounded continuum of care.
According to Kavita Kongara, MD, Director of the Diagnostic Motility Center in Winthrop's Institute for Digestive Disorders, "The Enterra™ stimulator helps patients live more normal, healthier lifestyles by aiding in digestion and decreasing nausea and the number of vomiting episodes. Patients are also able to eat more to maintain their weight and their nutrition. This new device is a promising option for patients when other treatment modalities have failed."
Treatment options for gastroparesis are somewhat limited in scope and effectiveness. Diet modification and drug therapy (anti-nausea medications) is first line therapy. In severe cases, a feeding tube may be used to deliver necessary nutrients and hydration to patients experiencing extensive bouts of vomiting. Total removal of the stomach is a drastic measure that is often avoided if possible.
A Promising Outlook
Results have been very promising in studies conducted on the efficacy of the Enterra™ system in gastroparesis patients. Hospital admissions for such symptoms as dehydration and malnutrition were cut in half and patients reported a decrease in vomiting episodes and nausea as well as a marked improvement in their overall quality of life.
"This new device and procedure has a high rate of success, particularly in diabetic patients," said Bruce Simon, MD, Director of Trauma and Critical Care at Winthrop.
"There are not many options for these patients," added Dr. Vithiananthan. "Now, with new technology and minimally invasive techniques, we are able to help a group of people who once had little hope."
For more information on the Enterra™ Gastric Electrical Stimulator, call the Institute for Digestive Disorders at Winthrop at 1-866-2-DIGEST.