Combined Role of Gastric Peroral Endoscopic Myotomy and Gastric Electrical Stimulator

Combined Role of Gastric Peroral Endoscopic Myotomy and Gastric Electrical Stimulator in the Management of Refractory Gastroparesis- A Randomized Single Blinded Control Trial

This study is looking at how safe and effective G-POEM, GES and a combination of both are for people with severe stomach problems (gastroparesis) that haven't gotten better with medicine.

Inclusion Criteria:

• Adult patients of age 18 years and older
• Patients must be able to consent
• Documented diagnosis of refractory GP as determined by the following criteria:
• Medically refractory GP symptoms for > 1 year despite treatment with first-line modalities and pharmacotherapies with anti-emetics and prokinetics AND
• Gastric emptying scintigraphy showing delayed gastric emptying with retention of >60% at 2h and/or greater than 10% at 4h based on standardized radionuclide solid meal test
• Preoperative Gastroparesis Cardinal Symptom Index (GCSI) Score
• A decision to treat patient with surgical therapy of G-POEM and/or electric stimulator

Exclusion Criteria:

• Patients with prior surgical intervention for gastroparesis
• Patients less than 18 years old
• Pregnant women