3 The procedure

Guidance

3.1 Electrical stimulation is delivered via an implanted system that consists of a neurostimulator and 2 leads. Implantation is done with the patient under general anaesthesia by an open or laparoscopic approach. The stimulating electrode of each intramuscular lead is fixed to the muscle of the distal part of the stomach. The connector end of each lead is then attached to the neurostimulator, which is placed in a pocket in the abdominal wall. When the neurostimulator is turned on, electrical impulses are delivered. The rate and amplitude of stimulation can be adjusted wirelessly with a hand-held external programmer. Patients may need to return to hospital for adjustment or reprogramming of the device, to optimise the effect on gastric emptying.