Ethical approval was granted by the Institutional Review Board of The University of Mississippi Medical Center (UMMC). Ten consecutive patients with gastroparesis undergoing surgical implantation of gastric electrical stimulation devices (Enterra, Medtronic, MN, USA) at UMMC were invited to participate. All of these patients consented to undergo full-thickness gastric excisions at the time of device implantation, as part of investigations of cellular pathophysiology (11 (link)),(15 (link)), thereby allowing the opportunity to conduct intraoperative HR mapping after gastric excisions within an ethically rigorous framework. Baseline gastric slow wave propagation in patients with gastroparesis has been described elsewhere (11 (link)).
The excisions were performed through a small midline laparotomy wound from the anterior stomach, midway between the curvatures and approximately 90 mm proximal to the pylorus (15 (link)). A 29 mm circular surgical stapler was applied side-on at the serosal gastric surface, and a full-thickness wedge of gastric wall was taken into the stapling mechanism for retrieval. The excised tissue was approximately an ellipsoid shape of ~20 × 15 mm. The excision site was then oversewn in continuous fashion with close seromuscular sutures.
The excisions were performed through a small midline laparotomy wound from the anterior stomach, midway between the curvatures and approximately 90 mm proximal to the pylorus (15 (link)). A 29 mm circular surgical stapler was applied side-on at the serosal gastric surface, and a full-thickness wedge of gastric wall was taken into the stapling mechanism for retrieval. The excised tissue was approximately an ellipsoid shape of ~20 × 15 mm. The excision site was then oversewn in continuous fashion with close seromuscular sutures.
