Problem addressed, background and strategic significance

Surgery on the bowel often leads to postoperative ileus (POI) – a condition in which the bowel “goes to sleep”. In most patients, the bowel soon returns to normal, but in 12% of patients POI is prolonged. This delays recovery and increases the risk of vomiting, constipation, breathing difficulties, and blood clots in the legs and lungs. A new device, GammaCore®, aims to minimise the occurrence of POI by stimulating the nerves to the bowel and reducing the time taken for return of normal bowel function. It is easy to use, has no known serious side-effects and the device can be used at home or in hospital.

Method used

We will ask patients to use the device twice a day. It is used by placing it gently on the neck for 2 minutes (both sides) in the morning and at night. Half of patients will have a functioning device and the other half will have a “dummy” device which looks and feels the same but does not produce nerve stimulation. The treatment will be assessed in several ways, including: time taken for the bowel to recover, blood tests before and after surgery, an MRI scan to look at the bowel and patients’ acceptance of the device.

Hoped for results of this research

There is currently no effective treatment for POI. It is hoped that this new treatment will provide a much-needed solution to a long-standing problem and make surgery safer for patients.

How will this project help build on the BDRF Delphi Research Strategy and what further plans are proposed for future development?

This feasibility study will provide early data on GammaCore® for reducing POI. It will not provide a definitive answer, but will give valuable information about possible benefits and early patient acceptance. This will inform the design of a larger, randomised comparison to formally test the device, its underlying mechanisms, patient satisfaction and wider adoption in the NHS.