Gastric Electrical Stimulator Placement Resolves Severe Feeding Intolerance in Pediatric Patients
Orlando Health Arnold Palmer Hospital for Children is the only hospital in the Southeast — and one of the few nationwide — offering gastric electrical stimulator (GES) placement for refractory gastroparesis in pediatric patients. The implanted GES device addresses the patient’s severe feeding intolerance by stimulating the stomach’s motility with programmed electrical impulses.

“GES uses neuromodulation with neurostimulation to assist with the mechanosensory aspects of what happens when food is delivered into the stomach,” says Shaista Safder, MD, a dual fellowship-trained pediatric gastroenterologist with the Orlando Health Arnold Palmer Hospital for Children Center for Digestive Health.
“This surgery offers an option for children who have exhausted all other interventions and are still unable to tolerate oral nutrition without severe nausea, vomiting and pain,” says Dr. Safder, who specializes in neurogastrointestinal motility disorders. “We are now able to provide this highly specialized treatment for new patients, as well as continuity of care for those implanted in other states.”

The multidisciplinary surgery requires both a pediatric gastroenterologist and pediatric surgeon. Dr. Safder works in tandem with Marc Levy, MD, a board-certified pediatric surgeon at Orlando Health Arnold Palmer. In 2024, the specialists successfully implanted four GES devices in pediatric patients ages seven to 15 years old.
Prior to surgery, Dr. Safder gauges patient response by placing a temporary test stimulator endoscopically with external leads. For those who respond positively, a permanent GES can be placed using laparoscopy or the surgical robot.

“The device and battery are positioned in subcutaneous sites,” says Dr. Levy. “The wires are implanted in the antrum of the stomach 10 centimeters proximal to the pylorus, in the stomach’s muscle layer.”
During the procedure, Dr. Safder collaborates endoscopically to ensure placement and programming are appropriate, while customizing the device’s frequency and amplitude.
“This is a therapeutic approach that offers a long-term treatment modality that is less invasive and reversible,” says Dr. Safder. Patients are kept overnight for observation. “Following surgery, our patients are eating normally for the first time in years.”
“The outcomes are dramatic for patients,” says Dr. Levy. “To go from not being able to eat to actually eating is life changing.”
Orlando Health Arnold Palmer is nationally ranked and offers personalized attention by a team of board-certified specialists dedicated to advancing patient care in all types of pediatric digestive disorders.