State-of-the-Art Enterra® Therapy for Gastroparesis
Enterra® Therapy is an innovative treatment for gastroparesis that
has been approved by the FDA as a humanitarian use device when conventional
drug therapies for gastroparesis are not effective.
The Enterra Therapy system consists of a neurostimulator implanted beneath
the skin, usually in the lower abdominal region, and two leads (insulated
wires) that are implanted in stomach muscle. These leads are then connected
to the neurostimulator.
The neurostimulator sends mild electrical pulses through the leads to stimulate
the nerves and smooth muscles of the lower stomach. This helps to control
the chronic nausea and vomiting caused by gastroparesis.
Enterra® Therapy involves two steps: Implantation and Post-Implantation.
Implantation is performed under general anesthesia and can range from one
to three hours. Using laparoscopy or laparotomy, the surgeon fixes the
electrodes to the wall of the stomach. The connector of each lead is attached
to a neurostimulator, also know as a gastric electric stimulator, which
is placed in the abdominal wall, under the patient’s skin. Most
patients spend one to five nights in the hospital before returning home,
depending on their medical condition.
Post-Implantation takes place during an office visit. The physician uses
a handheld, external programmer to turn on the stimulator. Adjustments
to the stimulation of the stomach wall can be then made non-invasively
in an outpatient setting to optimize therapy for each patient. Because
the neurostimulator can be turned on or off, the physician can terminate
Enterra® Therapy if a patient experiences any intolerable side effects.
Follow-up exams to monitor the therapy’s effectiveness may vary in
frequency from six to twelve months.
Determining If Enterra Therapy Is Right for You?
The gastroenterology experts at Hoag-USC Surgical Center for Digestive
Diseases can help you to determine if you are a candidate for therapy.
If you are a good candidate for this procedure, they will also discuss
several points you should consider before choosing Enterra Therapy, including:
- The therapy is intended to reduce symptoms of chronic nausea and vomiting
associated with gastroparesis of idiopathic or diabetic origin that resists
treatment with medication. However, Enterra Therapy is not a cure.
- Improvements in symptoms may be gradual or immediate. The rate of improvement
varies from person to person.
- Implanting an Enterra Therapy system has risks and side effects. Surgical
complications are possible and may include infection, bleeding, bruising,
and pain at the implant site. Once implanted, the system may become infected,
devices may move or wear through the skin, the lead may entangle with
or obstruct the bowel, irritation/inflammation over implant site may occur.
The therapy system could stop suddenly because of mechanical or electrical
problems. Any of these situations may require additional surgery or cause
your symptoms to return.
- Most often, a combination of Enterra Therapy, diet modification, and medication
is necessary to effectively control symptoms of gastroparesis.
- If you have an Enterra Therapy system implanted, some precautions are necessary
around certain electrical and medical equipment and when going through
theft detection and security screening gates.
- Enterra Therapy is not appropriate for patients who are not candidates
for surgical procedures and/or anesthesia because of physical or mental
- Enterra Therapy should not be used for patients who will be exposed to
diathermy (deep heat treatment).
- Enterra Therapy has not been evaluated in pregnant women or in patients
younger than age 18 or older than age 70
Expert Care You Can Trust!
The Hoag Digestive Disease Center, in alliance with USC Norris Comprehensive
Cancer Center, continues to lead the way in complex gastrointestinal care, providing
access to a highly specialized surgical team that works collaboratively
with Hoag-affiliated gastrointestinal surgeons, gastroenterologists and
other medical specialists to provide academic-level care. Hoag’s
accurate diagnosis, combined with
progressive therapeutic options enables Hoag patients to achieve some of the highest clinical outcomes
in the nation.
To schedule a comprehensive diagnostic evaluation, or a second-opinion
consultation with a Hoag gastroenterology expert, visit
Meet the Team, or call us at: 888-566-9712.