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for larger version       Peninsula Hospital Introduces New Surgical Technique Nick H. Gabriel, D.O. F.A.C.O.S, Chief of Minimally Invasive Surgery at Peninsula Hospital Center, recently performed the first two Gastric Pacemaker insertions at the Hospital Center. Dr. Gabriel joined the staff of the Hospital Center in March of 2005. In April, 2006 Dr. Gabriel performed a peninsula medical-history making surgery when he first utilized the new state-of-the-art laparoscopic surgical technology acquired by PHC. He has published articles on electric stimulation for gastroparesis and has performed numerous identical surgeries at other facilities. The two breakthrough operations performed by Dr. Gabriel at the Hospital Center mark the first of such surgeries in this area of the city and the surrounding areas. The out-of-town patients who have undergone this groundbreaking surgery traveled from as far away as Virginia and Florida for the opportunity of receiving first hand Dr. Gabriel's special brand of proficiency. In both cases the patients were suffering from gastroparesis, a disabling and sometimes fatal, disease that often does not respond to medical treatment. Gastroparesis is a disorder in which food moves through the stomach more slowly than normal. Many patients diagnosed with this disease have difficulty eating and experience severe, chronic vomiting and nausea. In serious cases, some patients may need to have a feeding tube inserted to ensure sufficient nutrition. Causes of the disease include diabetes mellitus, anorexia and bulimia, lupus, and brain disorders. However, researchers who have studied this disease for sometime have found that nearly sixty percent of cases diagnosed as gastroparesis have no known origin. Dr. Peter Galvin, Chief Medical Officer of the Hospital Center said, "Unfortunately diabetes is a growing problem, not just in our community, but world-wide. Some diabetic patients develop gastroparesis, which is essentially a paralysis of the stomach. This causes the patient severe eating and intestinal problems. Howard L. Sussman, M.D., Director, Department of Surgery at the Hospital Center added that, "This innovative procedure is very often the last hope for patients suffering from the frustrating realities of living with gastroparesis." When patients are first diagnosed with gastroparesis they are encouraged to eat a diet consisting of frequent small meals low in fiber and fat. Although there are medications that are currently available in the United States to combat gastroparesis, many patients do not respond to them or become intolerant of their debilitating side effects. Until recently, when standard dietary and medicinal therapies have failed, a feeding tube or removing part of the stomach have been found to be the only remaining options for patients suffering from gastroparesis. However, the development of a gastric electrical simulation device, called Enterra Therapy, has opened a whole new world of opportunity for patients suffering from this devastating disease who have not responded to standard dietary or medicinal treatment. Gastric electrical stimulation (GES) uses the Enterra device, a gastric pacemaker, to provide mild electrical stimulation to the lower stomach nerves. Once inserted into the patient, mild electrical pulses encourage the stomach to contract and help to relieve the nausea and vomiting associated with gastroparesis. GES is only utilized when medication is not effective in controlling symptoms that can include malnutrition and severe dehydration. The Enterra Therapy system was designated as a Humanitarian Use Device by the Federal Drug Administration in the fall of 1999. Enterra and other such devices are medical "tools" specially designated by the FDA for use in the treatment of rare medical conditions with an incidence of less than 4,000 patients per year. Clinical studies to date show that GES reduces vomiting frequency by up to 81% from pre-surgery to the 12 month follow-up point. Using the surgical expertise mastered by Dr. Gabriel, minimally invasive surgical techniques are used to insert the gastric pacemaker and place it just below the rib case inside of the abdomen. Two intramuscular lead wires with electrodes are implanted into the stomach muscle wall in order to deliver the mild electrical pulses that will be needed to combat the incapacitating symptoms of gastroparesis. According to Dr. Galvin, "We at PHC are pleased to be offering this new procedure to the public. Dr. Gabriel and his minimally invasive surgical team are on the cutting edge of medical care. Potential surgical candidates have been calling from far and wide to determine whether or not they might be able to avail themselves of this new procedure. Once again, PHC is proud to lead new developments in medical care in the Rockaways." Dr. Gabriel also serves as the Director of the Surgical Residency Program. He is Board Certified in General Surgery, with expertise in minimally invasive surgery. He has been in practice in the New York area for the past five years. Dr. Gabriel is widely published and trains surgeons in innovative minimally invasive techniques. Dr. Gabriel performs advanced laparoscopic procedures at Peninsula Hospital Center and maintains a private practice in the Department of Surgery on the fourth floor of the Hospital Center.
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