Clinical study on the development for pacemaker navigation system of the stomach

[背景与目的]胃电图中2.5-3.5cpm的波称为电控制活动（electrical control activity，ECA），被认为是胃起搏器产生的电活动。然而，目前还没有关于含有Cajal神经元的胃起搏点的确切定位的报道，胃起搏点一直被认为存在于胃大弯。如果术中能确定胃起搏器的位置，并加以维护，即使在胃大部切除术后，仍能获得较好的残胃功能。因此，我们尝试开发一种定位胃起搏器的导航系统。[方法]1）术中胃电图检查，并向秋田大学伦理委员会申请获得批准; 2）术中胃电图系统根据以往报道的直接由胃壁诱发的ECA的典型波形设计。日 ...更多信息 与秋田大学工学部和资源科学部合作制作了导航系统，包括几种电极单元和真实的实时诊断程序，以获得定位。3）在完成术中胃电图系统后，获得了对计划进行胃切除术的患者进行术中胃电图检查的知情同意书。术前经皮胃电图显示3cpm波。4）开腹手术时，在胃切除术前将电极装置贴于胃表面，测量ECA。数据由数据记录仪存储，传输到个人计算机，并由能够同时诊断胃起搏器定位的程序进行分析。[结果]研制了胃起搏导航系统。在腹部开放手术中，将电极装置贴在胃壁上，可以获得胃起搏器的方向。通过测量该系统可以确定胃起搏点的位置。少

【Background and purpose】The waves of 2.5-3.5cpm measured with electrogastrogram are called electrical control activity (ECA) and has been thought to be an electric activity generated from the gastric pacemaker. However, there is no report that actually identifies the localization of the gastric pacemaker which contain the Cajal neuron cells, the gastric pacemaker has been assumed to be existed on the greater curvature of the stomach. If the location of the gastric pacemaker is assured during operation and maintained, we can get better function of gastric remnant even after partial gastrectomy. So we tried to develop the navigation system that searches the localization of the gastric pacemaker.【Method】1)Examination of the intraoperative electrogastrogram applied to the ethics committee in Akita University and obtained approval.2)Intraoperative electrogastrogram system was designed for the typical wave form of ECA induced directly by the gastric wall obtained from the previous report. Th … More e navigation system, included several kinds of electrode units and real time diagnostic programs to get the localization, was made by the collaboration with the Faculty of Engineering and Resource Science in Akita University.3)After the completion of the intraoperative electrogastrogram system, informed consent about the examination of the Intraoperative electrogastrogram for the patient planned with gastrectomy was obtained. It was confirmed that the waves of 3cpm was observed by transcutaneous electrogastrogram before the operation.4)In the laparotomy, the electrode unit was attached to the surface of the stomach before gastrectomy and the ECA was measured. Data was storaged with the data recorder, transferred to the personal computer and analyzed by the program that was able to diagnose the localization of the gastric pacemaker simultaneously.【Result】Pacemaker navigation system of the stomach was developed. We can get the direction to the gastric pacemaker by attaching the electrode unit to the gastric wall during the abdominal open surgery. The localization of the gastric pacemaker can be identified by measuring this system. Less