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Techniques of Sleeve Gastrectomy and Modified Roux-en-Y Gastric Bypass in Mice
Published on: March 20, 2017
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Intraoperative botulinum toxin injection in sleeve gastrectomy, a pilot randomized controlled trial
Grishma Pradhan1, Tyler D Robinson2, Casey Northrup2
1Department of General Surgery, Albany Medical Center, Sixth Floor, 50 New Scotland Avenue, Albany, NY, 12208, USA. grishma.pradhan18@gmail.com.
Surgical Endoscopy
|August 29, 2025
Summary
Botulinum toxin injection of the pylorus (BP) during sleeve gastrectomy (SG) is safe but does not reduce post-operative nausea and vomiting (PONV). Future research should explore preoperative endoscopic administration for potential benefits.
Area of Science:
- Bariatric Surgery
- Gastroenterology
- Surgical Innovation
Background:
- Botulinum toxin injection of the pylorus (BP) is known to improve gastric transit post-esophagectomy.
- At our institution, BP has been explored as an adjunct to sleeve gastrectomy (SG) to mitigate post-operative nausea and vomiting (PONV).
Purpose of the Study:
- To evaluate the safety and efficacy of intraoperative botulinum toxin injection of the pylorus (BP) as an adjunct to sleeve gastrectomy (SG).
- To assess the impact of BP on reducing post-operative nausea and vomiting (PONV) following SG.
Main Methods:
- A prospective, double-blinded randomized controlled trial (RCT) was conducted comparing SG with and without intraoperative BP.
- The study involved 57 SG procedures over a 3-year period at a tertiary care center.
- Primary outcomes included the safety of intraoperative BP and its efficacy in treating PONV.
Main Results:
- No significant differences were observed in operative time or length of hospital stay between the BP and placebo groups.
- There were no intraoperative complications, and rates of outpatient hydration, anti-emetic usage, and self-reported nausea were comparable.
- One 30-day readmission occurred in the placebo group for chest pain and dehydration.
Conclusions:
- Intraoperative botulinum toxin injection of the pylorus (BP) during sleeve gastrectomy (SG) is a safe procedure.
- BP did not demonstrate significant improvement in peri-operative outcomes or patient-reported PONV compared to standard ERAS measures.
- Future studies may benefit from investigating preoperative endoscopic administration of botulinum toxin.
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