Feedback control of retrograde peristalsis using Neural Gastric Electrical Stimulation

Neural Gastric Electrical Stimulation (NGES) is a new method for invoking gastric contractions under microprocessor control. However, optimization of this technique using feedback mechanisms to minimize power consumption and maximize effectiveness has been lacking. The present work proposes a prototype feedback-controlled neural gastric electrical stimulator for the treatment of obesity. Both a force-based and an interelectrode impedance-based feedback neurostimulator were implemented and tested. Four mongrel dogs (2 M, 2 F, weight 14.9 ++/- 2.3kg) underwent subserosal implantation of 2-channel 1-cm bipolar electrode leads in the distal antrum. Two of the dogs were stimulated with a force-based feedback system and the other two animals were stimulated utilizing an interelectrode impedance-based feedback system. Both feedback systems were able to recognize Erythromycin-driven contractions of the stomach and were capable of overriding them with NGES-invoked retrograde contractions. The proposed technique could be helpful for retaining food longer in the stomach, thus inducing early satiety and diminishing food intake.