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

【背景与目的】胃电图测量到的2.5 ~ 3.5cpm的波被称为电控制活动（ECA），被认为是由胃起搏器产生的电活动。然而，目前还没有关于胃起搏器定位的报道，其中包含Cajal神经元细胞，胃起搏器一直被认为存在于胃的大弯曲处。如果术中确定胃起搏器的位置并加以维护，即使在胃部分切除后，残胃仍能获得较好的功能。所以我们尝试开发导航系统来搜索胃起搏器的位置。【方法】1)术中胃电图检查向秋田大学伦理委员会申请并获得批准。2)术中胃电图系统针对先前报道中直接由胃壁诱发的ECA的典型波形进行设计。与秋田大学工程与资源科学学院合作制作了包含多种电极单元和实时诊断程序的导航系统。3)术中胃电图系统完成后，获得了对胃切除术患者术中胃电图检查的知情同意。证实术前经皮胃电图可观察到3cpm波。4)剖腹手术时，在胃切除术前将电极单元附着于胃表面，测量ECA。数据存储在数据记录仪中，传输到个人计算机中，并通过能够同时诊断胃起搏器定位的程序进行分析。【结果】研制了胃起搏器导航系统。在腹部开放手术中，我们可以通过将电极单元连接到胃壁上来确定胃起搏器的方向。通过测量该系统，可以确定胃起搏器的定位。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