Intragastric stimulation (IGS) for treatment of morbid obesity

The technique of implantable gastric stimulator (IGS(R)) placement for treatment of morbid obesity is described. There are three components of the IGS, the programing system, the lead and the electrical stimulator itself. It is placed in the anterior abdominal wall. It is connected to the bioplar lead that is positioned in the muscle wall of the stomach. The nominal parameters were: pulse width 208 musec 24 hours per day, pulse rate 40 Hertz and amplitude 6.2-10.0mA. Fourty eight patients have been treated using techniques that were developed and refined around the world in a prospective open study. 32 and 7 patients, resp. were available for investigation after 6 and 15 months. Twenty-seven (56%) intra-operative gastric penetrations occurred, as noted on operative gastroscopy, without any clinical sequelae. Six patients (12%) showed lead dislodgements and a new procedure for lead replacement. There were no operative deaths. All procedures were successfully completed laparoscopically. Two connections required revision (4%) because the leads were not fully inserted into the lead connector of the generator. No abscess formation or severe complication were noted. The excessive weight loss after 15 months ranged to 32 %. The operation for IGS placement is safe and simple to perform. Attention to technical details is essential for safe performance of the procedure.