*4.2.2.1 Technique*

The system is implanted with the use of a laparoscope, whereby the three bipolar leads are placed in the sub-serosa of the gastric wall. One lead is placed in the fundus area to detect the intake of food, while the other two are positioned in the antrum for slow-wave detection and signal delivery. Nonabsorbable sutures and two clips are to ensure proper fixation at, respectively, the proximal and distal part of the lead. The procedure is carried out under both laparoscopic and gastroscopic visualization to prevent perforation of the gastric wall. After successful lead placement, the leads are connected to the implantable pulse generator which is placed in a subcutaneous pocket at the left side of the abdomen.
