Clark Gerhart MD FACS

Clark Gerhart MD FACS

Robotic General and Bariatric Surgeon

CONTACT & SCHEDULING SURGERY

Please contact us to schedule your surgery appointment today!

GASTROPARESIS SURGERY

Dr. Gerhart offers a variety of robotic laparoscopic options for treating gastroparesis. His experience began after training in this exclusive field in 2003. Very few surgeons are trained in surgical options for gastroparesis so finding care can be difficult and many patients are left without options when diet and medications fail.

SURGICAL TREATMENT OF GASTROPARESIS


Robotic Laparoscopic Pyloromyotomy. One way to improve gastric emptying is to weaken the pylorus, the valve at the bottom of the stomach that prevents it from emptying too quickly in normal situations. By cutting the pylorus the outlet of the stomach remains open and food can drain into the intestines by gravity even if the muscular contraction of the stomach is poor.


Robotic Laparoscopic Gastric Pacemaker. Much like the heart, the muscles of the stomach can be made to contract when stimulated with an electrical current. The pacemaker is made by Medtronic and is called the Enterra II Neurostimulator. The neurostimulator (pacemaker) generator is implanted under the skin of the abdominal wall and wires pass into the abdomen and are implanted in the wall of the stomach. The operation is done through 3 small punctures using robotic laparoscopic technique. Patients are home the same day with only a few days off work. After it is inserted the pacemaker fires regularly throughout the day helping the stomach contract and empty. The gastric pacemaker helps about half of the patients. Those people generally have dramatic results with improved eating and drinking, eliminating the need for hospitalization.


Robotic Gastric Bypass. In patients with severe vomiting a gastric bypass will divert food from their stomach directly into their intestines. This operation is similar to the gastric bypass but is altered to limit weight loss in non-obese patients. If patients are overweight, it has the added benefit weight loss. It also improves type 2 diabetes which is a great advantage since many patients with gastroparesis also have this disease.

WHAT IS GASTROPARESIS?

Gastroparesis is a difficult medical problem that occurs when the stomach does not empty properly. The muscles in the stomach wall do not contract well so peristalsis is ineffective at moving food into the intestines. The result is that food sits in the stomach and does not digest. This causes bloating, nausea and vomiting. In severe cases it leads to an inability to eat or drink. This often results in multiple hospitalizations to control dehydration and malnutrition.

WHAT CAUSES GASTROPARESIS?

Peristalsis in the stomach relies on functioning muscle fibers and functioning nerves to stimulate those muscle fibers. The causes of muscle dysfunction are poorly understood. Viral infections may attack and injure the muscles of the stomach. Other illness that affect muscle function like hypothyroidism and autoimmune diseases, such as scleroderma, may cause gastroparesis. Nerves to the stomach can be injured during surgery around the stomach, or by nervous system disorders, such as Parkinson's disease and multiple sclerosis. Diabetes is the number one cause of gastroparesis. It is believed that diabetes damages the nerves to the stomach much in the same way it causes peripheral neuropathy leading to numbness of the hands or feet.

TREATMENT FOR GASTROPARESIS IS AVAILABLE

Diet and medication can control some people’s gastroparesis symptoms. Unfortunately, very few medical options are available. Many patients are left to suffer without options. But help is available. Surgical options are effective for helping many people with gastroparesis.

To schedule an appointment to have your gastroparesis evaluated go to  Contact & Scheduling Surgery page. If you are from outside of the Wilkes-Barre area, gather your tests results and follow instructions for submitting them for review found on the same page.