Simultaneous Robotic Placement of Gastric Electrical Neurostimulation System and Pyloroplasty in Gastroparesis Patients

Brian R. Davis, MD, FACS, FASGE1 Alejandro Rios Tovar, MD1 Irene Sarosiek, MD, AGAF, FACG2 Richard W. McCallum, MD, FACP, FRACP, FACG, AGAF2 1Texas Tech University Health Sciences Center Paul L. Foster School of Medicine Department of Surgery and 2Department of Internal Medicine, El Paso, TX Early diagnosis and treatment of gastroparesis eludes pharmacologic solutions. Gastroparesis starts as a clinical disorder which progresses to nausea and emesis resulting from chronic food retention and gastric distention. The negative feedback loop occurs when this disease becomes refractory to pharmacologic treatments, limited by multiple side effects and when pain results in narcotic dependence. The deteriorating condition leads to malnutrition and recurrent hospitalizations. Since the 1990’s Dr. Richard McCallum has been a pioneer in gastric electrical neurostimulation to interrupt the cycle of nausea and emesis. Over the last 6 years our experience at Texas Tech University Health Sciences Center, El Paso has led to the evolution of a robotic technique for simultaneous gastric electrical neurostimulation and pyloroplasty. This provides a concise algorithm for treatment with advocacy for early surgical intervention using a novel robotic platform that minimizes the surgical insult thus speeding recovery from this debilitating disorder.