A novel method of 2-channel dual-pulse gastric electrical stimulation improves solid gastric emptying in dogs

Guan, Song; Hou, Xiaohua; Yang, Bin; Sun, Yan; Qian, Wei; Chen, J. D.Z.

doi:10.1016/j.surg.2007.07.001

Cited by 24 publications

(20 citation statements)

References 26 publications

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“…172 Another direction of research involves dual pulse stimuli with alternating delivery of short neuro stimulation and long pacing pulses to elicit antiemetic and motor stimulatory effects with a single device. 173 Percutaneous and endoscopic systems to implant elec trodes in the gastric wall without surgery may broaden the applicability of electrical pacing technologies. 174 Other surgical treatment Other surgeries are rarely performed in patients with refractory gastroparesis.…”

Section: Gastric Electrical Stimulationmentioning

confidence: 99%

Gastroparesis: pathogenesis, diagnosis and management

Hasler

2011

Nat Rev Gastroenterol Hepatol

110

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Gastroparesis is a prevalent condition that produces symptoms of delayed gastric emptying in the absence of physical blockage. The most common etiologies of gastroparesis are idiopathic, diabetic, and postsurgical disease, although some cases stem from autoimmune, paraneoplastic, neurologic or other conditions. Histologic examination of gastric tissues from patients with severe gastroparesis reveals heterogeneous and inconsistent defects in the morphology of enteric neurons, smooth muscle and interstitial cells of Cajal, and increased levels of inflammatory cells. Diagnosis is most commonly made by gastric emptying scintigraphy; however, wireless motility capsules and nonradioactive isotope breath tests have also been validated. A range of treatments have been used for gastroparesis including dietary modifications and nutritional supplements, gastric motor stimulatory or antiemetic medications, endoscopic or surgical procedures, and psychological interventions. Most treatments have not been subjected to controlled testing in patients with gastroparesis. The natural history of this condition is poorly understood. Active ongoing research is providing important insights into the pathogenesis, diagnosis, treatment and outcomes of this disease.

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Section: Gastric Electrical Stimulationmentioning

confidence: 99%

Gastroparesis: pathogenesis, diagnosis and management

Hasler

2011

Nat Rev Gastroenterol Hepatol

110

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“…Short-pulse GES has been reported to improve nausea and vomiting in gastroparetic patients with limited or no effects on gastric motility or slow-wave stabilization (1,3,31). Dual-pulse GES, combined with both short pulses and long pulses, has advantages of both long-pulse GES and short-pulse GES and is capable of improving dysrhythmia and nausea and vomiting (48). Recently, a number of studies have shown that synchronized GES (or SGES, electrical stimuli are delivered at the occurrence of intrinsic slow waves) has a prokinetic effect: increasing antral contractions and accelerating gastric empty (47,57,59).…”

mentioning

confidence: 99%

Synchronized gastric electrical stimulation improves vagotomy-induced impairment in gastric accommodation via the nitrergic pathway in dogs

Chen¹,

Koothan²,

Chen³

2009

American Journal of Physiology-Gastrointestinal and Liver Physi

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Impaired gastric accommodation and gastric dysrhythmia are common in gastroparesis and functional dyspepsia. Recent studies have shown that synchronized gastric electrical stimulation (SGES) accelerates gastric emptying and enhances antral contractions in dogs. The aim of this study was to investigate the effects and mechanism of SGES on gastric accommodation and slow waves impaired by vagotomy in dogs. Gastric tone, compliance, and accommodation as well as slow waves with and without SGES were assessed in seven female regular dogs and seven dogs with bilateral truncal vagotomy, chronically implanted with gastric serosal electrodes and a gastric cannula. We found that 1) vagotomy impaired gastric accommodation that was normalized by SGES. The postprandial increase in gastric volume was 283.5 +/- 50.6 ml in the controlled dogs, 155.2 +/- 49.2 ml in the vagotomized dogs, and 304.0 +/- 57.8 ml in the vagotomized dogs with SGES. The ameliorating effect of SGES was no longer observed after application of N(omega)-nitro-L-arginine (L-NNA); 2) vagotomy did not alter gastric compliance whereas SGES improved gastric compliance in the vagotomized dogs, and the improvement was also blocked by L-NNA; and 3) vagotomy impaired antral slow wave rhythmicity in both fasting and fed states. SGES at the proximal stomach enhanced the postprandial rhythmicity and amplitude (dominant power) of the gastric slow waves in the antrum. In conclusion, SGES with appropriate parameters restores gastric accommodation and improves gastric slow waves impaired by vagotomy. The improvement in gastric accommodation with SGES is mediated via the nitrergic pathway. Combined with previously reported findings (enhanced antral contractions and accelerated gastric emptying) and findings in this study (improved gastric accommodation and slow waves), SGES may be a viable therapy for gastroparesis.

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“…This observation was also in agreement with the results on multichannel gastric pacing previously published in both healthy and diseased canine models. [18][19][20] One of the major drawbacks for single-channel gastric pacing with long pulses is that it needs high stimulation energy to entrain gastric slow waves and normalize dysrhythmias. This is explained by the fact that the stimulating electrode has to be placed in the proximal stomach to avoid reverse pacing.…”

Section: Gastric Pacingmentioning

confidence: 99%

“…This is explained by the fact that the stimulating electrode has to be placed in the proximal stomach to avoid reverse pacing. 20 To entrain gastric slow waves, the stimulation energy for the single-channel gastric pacing has to be high enough to ensure the stimulation pulses are propagated a distance of 20 cm or greater from the proximal stomach to the distal antrum. Therefore, multichannel GES was designed to mimic the natural propagation and characteristics of the gastric slow waves.…”

Section: Gastric Pacingmentioning

confidence: 99%