Research Into Gastric Pacemaker Stimulator to Reduce Obesity

Study into effectiveness, safety of implantable gastric stimulator
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Research - Gastric Pacemaker, Implantable Stimulator

Tests on Pigs

In 1995, Cigaina et al. discovered, when experimenting with pigs, that electrical stimulation of the stomach wall resulted in characteristic patterns of gastric peristalsis in both directions. A further pig study demonstrated that stimulation of the stomach wall influenced the animals eating habits. Animals whose stomach wall had been stimulated ate less. Weight loss is attributed to lower absorption of food or absorption in the gut.

Clinical Trials of Transcend Implantable Gastric Stimulator

In February 2000, a randomised, placebo-controlled double-blind trial was launched in the USA and Europe to check the clinical effectiveness and safety of the Transcend implantable gastric stimulator. The implantable gastric stimulation (IGS) system consists of two electrodes that are introduced into the stomach wall with a needle. A wire connects the electrodes to a 60×40×10.3-mm stimulator, which is implanted below the left costal arch in a subcutaneous pouch and can be programmed from outside. A suitable site is selected on the stomach wall in the gastro-oesophageal transition region, at which the electrodes can be placed in a strictly intra-mural position. The needle entry and exit points should be 2.5 cm apart and are marked with electrocautery. The electrodes are then introduced under gastroscopic control to prevent perforation of the stomach wall The probe is secured proximally with two PDS sutures and distally with a clip. The conductor wire is then taken to the outside and connected to the stimulator system.


Forty-eight IGS systems have been implanted in patients throughout Europe in a clinical trial. There have been no serious complications, either post-operatively or later. Among the implants in Austria, two patients required tightening of the connection between the wire and the stimulator. This was done under local anaesthetic in day surgery. Current results of trials in all the centres show a significant excess weight loss of 32% after 15 months with a stimulator. All the implantations of IGS systems have been successful, and there have been no life-threatening or fatal complications.

Gastrointestinal Stimulation: Least Invasive Surgery

The principle of gastro-intestinal stimulation for weight loss in morbid obesity is currently one of the least invasive surgical techniques. Many more studies and examinations of eating habits and quality of life will be necessary before clear statements about the ranking of implantable gastric stimulation can be made in comparison with other treatment methods for morbid obesity. Whether the high costs (about five-times higher than the material cost of an AGB) will be justified in terms of outcome remains to be seen from further studies.

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Cigaina V, Pinato GP, Rigo V, Bevilacqua M, Ferraro F, Ischia S, Saggioro A (1996) Gastric peristalsis control by mono situ electrical stimulation: a preliminary study. Obes Surg 6:247–249
Cigaina V, Saggioro A, Rigo V, Pinato GP, Ischia S (1996) Long-term effects of gastric pacing to reduce feed intake in swine. Obes Surg 6:250–253
Miller K (2002) Implantable electrical gastric stimulation to treat morbid obesity in the human: operative technique. Obes Surg 12:17S–20S
Miller K, Höller E, Hell E (2002) Intragastric stimulation (IGS) for the treatment of morbid obesity. Zentralbl Chir 127:1049–1054
International Federation For The Surgery of Obesity


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