Journal of Gastrointestinal Surgery

, Volume 23, Issue 5, pp 982–989 | Cite as

Colon Myoelectric Activity Measured After Open Abdominal Surgery with a Noninvasive Wireless Patch System Predicts Time to First Flatus

  • Anand NavalgundEmail author
  • Steve Axelrod
  • Lindsay Axelrod
  • Shyamali Singhal
  • Khoi Tran
  • Prithvi Legha
  • George Triadafilopoulos
Original Article



Passage of flatus after abdominal surgery signals resolution of physiological postoperative ileus (POI) and often, particularly after complex open surgeries, serves as the trigger to initiate oral feeding. To date, there is no objective tool that can predict time to flatus allowing for timely feeding and optimizing recovery. In an open, prospective study, we examine the use of a noninvasive wireless patch system that measures electrical activity from gastrointestinal smooth muscles in predicting time to first flatus.


Eighteen patients who underwent open abdominal surgery at El Camino Hospital, Mountain View, CA, were consented and studied. Immediately following surgery, wireless patches were placed on the patients’ anterior abdomen. Colonic frequency peaks in the spectra were identified in select time intervals and the area under the curve of each peak times its duration was summed to calculate cumulative myoelectrical activity.


Patients with early flatus had stronger early colonic activity than patients with late flatus. At 36 h post-surgery, a linear fit of time to flatus vs cumulative colonic myoelectrical activity predicted first flatus as much as 5 days (± 22 h) before occurrence.


In this open, prospective pilot study, noninvasive measurement of colon activity after open abdominal surgery was feasible and predictive of time to first flatus. Interventions such as feeding can potentially be optimized based on this prediction, potentially improving outcomes, decreasing length of stay, and lowering costs.


Noninvasive wireless patch Postoperative recovery Colon myoelectrical activity First flatus Ileus Open abdominal surgery 



We would like to thank Ryan Schroeder, Director of Clinical Research, and his team at the El Camino Hospital, Mountain View, CA, for their help in recruiting and consenting patients for the study.

Grant Support

Work supported in part by a grant from the Kenneth Rainin Foundation. This work also received support from the Fogarty Institute for Innovation and Breakout Labs.

Author Contributions

Study design: AN, SA, SS, GT

Acquisition of data: AN, SA, LA, SS, KT, PL

Analysis and interpretation: AN, SA, LA, SS, KT, PL, GT

Manuscript draft: AN, SA, KT, GT

Critical review and revision: AN, SA, SS, KT, GT

Compliance with Ethical Standards

Conflict of interest

Authors SA, LA, and AN are employees of G-Tech Medical. Author GT is an advisor to G-Tech Medical. Patches for this study were supplied by G-Tech Medical.


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Copyright information

© The Society for Surgery of the Alimentary Tract 2018

Authors and Affiliations

  1. 1.G-Tech MedicalFogarty Institute for InnovationMountain ViewUSA
  2. 2.El Camino HospitalMountain ViewUSA
  3. 3.Palo Alto Medical Foundation, Sutter HealthMountain ViewUSA
  4. 4.Department of Medicine, Division of GastroenterologyStanford University School of MedicineStanfordUSA

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