Laparoscopic sleeve gastrectomy (LSG) is increasingly being applied to treat obesity. LSG includes excision of the normal gastric pacemaker, which could induce electrical dysrhythmias impacting on post-operative symptoms and recovery, but these implications have not been adequately investigated. This study aimed to define the effects of LSG on gastric slow-wave pacemaking using laparoscopic high-resolution (HR) electrical mapping.
Laparoscopic HR mapping was performed before and after LSG using flexible printed circuit arrays (64-96 electrodes; 8-12 cm(2); n = 8 patients) deployed through a 12 mm trocar and positioned on the gastric serosa. An additional patient with chronic reflux, nausea, and dysmotility 6 months after LSG also underwent gastric mapping while undergoing conversion to gastric bypass. Slow-wave activity was quantified by propagation pattern, frequency, velocity, and amplitude.
Baseline activity showed exclusively normal propagation. Acutely after LSG, all patients developed either a distal unifocal ectopic pacemaker with retrograde propagation (50%) or bioelectrical quiescence (50%). Propagation velocity was abnormally rapid after LSG (12.5 ± 0.8 vs baseline 3.8 ± 0.8 mm s(-1); p = 0.01), whereas frequency and amplitude were unchanged (2.7 ± 0.3 vs 2.8 ± 0.3 cpm, p = 0.7; 1.7 ± 0.2 vs 1.6 ± 0.6 mV, p = 0.7). In the patient with chronic dysmotility after LSG, mapping also revealed a stable antral ectopic pacemaker with retrograde rapid propagation (12.6 ± 4.8 mm s(-1)).
Resection of the gastric pacemaker during LSG acutely resulted in aberrant distal ectopic pacemaking or bioelectrical quiescence. Ectopic pacemaking can persist long after LSG, inducing chronic dysmotility. The clinical and therapeutic significance of these findings now require further investigation.
Pharmacology, Toxicology and Pharmaceutical Science
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Agricultural and Biological Sciences
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Attention Score in Context
Attention Score in Context
This research output has an Altmetric Attention Score of 4. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 01 March 2018.
All research outputs
#11,055,597
of 34,089,221 outputs
Outputs from Obesity Surgery
#2,096
of 5,280 outputs
Outputs of similar age
#129,275
of 349,320 outputs
Outputs of similar age from Obesity Surgery
#19
of 66 outputs
Altmetric has tracked 34,089,221 research outputs across all sources so far. This one has received more attention than most of these and is in the 67th percentile.
So far Altmetric has tracked 5,280 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 6.9. This one has gotten more attention than average, scoring higher than 59% of its peers.
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We're also able to compare this research output to 66 others from the same source and published within six weeks on either side of this one. This one has gotten more attention than average, scoring higher than 71% of its contemporaries.
