Surgery For Gastroparesis In St. Petersburg, FL

G-POEM is an incisionless procedure that cuts the tight pyloric muscle so your stomach can empty again. Dr. Gopal Grandhige performs it at his South Tampa foregut practice, about a 25 to 35 minute drive from central St. Petersburg, and only after testing confirms the pylorus is the cause. It is for refractory gastroparesis, meaning symptoms that have not settled with diet changes and medication.

Gastroparesis surgery, and who it actually helps

The main surgery for gastroparesis is G-POEM (gastric per-oral endoscopic myotomy), also called POP, or per-oral pyloromyotomy. The entire procedure is done through the mouth with a flexible endoscope. There are no incisions on your abdomen. It works by cutting the pylorus, the muscular valve at the outlet of the stomach, so food can pass into the small intestine instead of sitting for hours. Dr. Grandhige is one of a handful of surgeons in the Tampa Bay area who performs it.

G-POEM is for people whose gastroparesis has not responded to diet and medication. If smaller meals, promotility drugs, and anti-nausea medication have failed, the pylorus is often the next thing to address. It is not a first step, and it is not for everyone.

Gastroparesis has several causes (diabetes, prior surgery, medications, or no identifiable cause at all) and a range of overlapping symptoms. Rather than repeat all of that here, you can read our full overview of gastroparesis, its causes, and every treatment option, including diet, medication, pyloroplasty, feeding tubes, and other surgical routes for severe disease. This page focuses on the procedure most St. Petersburg patients ask about, and on how Dr. Grandhige decides who it fits.

Testing comes first: confirming the pylorus is the problem

Dr. Grandhige does not recommend G-POEM based on symptoms alone. He confirms delayed emptying with objective testing, then works out whether the pylorus is the actual bottleneck, before recommending any procedure. This is the same physiology-first approach he applies across every foregut condition.

The core test is a gastric emptying study, a four-hour scan that tracks how fast a light radioactive meal leaves the stomach. He also uses EndoFLIP, a catheter-based tool that measures how the pylorus opens and stretches. Research has linked specific pyloric measurements to which patients respond to G-POEM, which is why measuring the pylorus, and not just the emptying rate, matters before committing to surgery.

Gastroparesis is also frequently mislabeled. Its symptoms overlap heavily with acid reflux (GERD), IBS, and other conditions, and delayed emptying can itself drive reflux and regurgitation. As a foregut specialist who also treats silent reflux (LPR) and motility disorders like achalasia, Dr. Grandhige is set up to separate what is truly gastroparesis from what is not. Before your visit, he personally reviews your prior endoscopy, imaging, emptying studies, and outside physician notes, so the consultation starts with your full history rather than a blank page.

Man with hiatal hernia smiling doing thumbs up

G-POEM vs. a gastric pacer: the two paths for Pinellas patients

St. Petersburg patients researching gastroparesis surgery usually run into two very different procedures, and it helps to understand the split. One is a gastric pacer, or gastric electrical stimulation (the Enterra device), which is available within Pinellas County. The other is G-POEM, the pylorus-directed procedure Dr. Grandhige performs in South Tampa. They are not the same operation, and neither is universally better.

A gastric pacer is an implanted device with a battery that sends electrical stimulation to the stomach muscles. It is placed through a minimally invasive operation, and its settings can be adjusted afterward without repeat surgery. Because it is a device, it involves ongoing follow-up for battery life and programming.

G-POEM is a one-time endoscopic procedure. There is no implanted device and nothing to adjust later. It targets the mechanical problem at the pylorus directly. For many patients with medically refractory gastroparesis, a pylorus-directed approach is a reasonable first procedural step, which is part of why some St. Petersburg patients make the short drive to Tampa for it. Which path fits you depends on your cause, your dominant symptoms, and what the testing shows, and that is a conversation to have after the workup, not before.

How well G-POEM works, and who responds best

In carefully selected patients, published research puts G-POEM’s one-year clinical success at roughly 70 to 72 percent, with technical success (completing the myotomy as intended) above 95 percent. These are pooled figures across many centers, not a single clinic’s marketing number, and they are the honest range to plan around.

Success is not identical for everyone, and the cause of your gastroparesis matters. In a 2024 meta-analysis of 982 patients, one-year clinical success was about 70 percent for postsurgical gastroparesis, 65 percent for diabetic, and 60 percent for idiopathic (no known cause). Patients whose main problem is nausea and vomiting tend to do better than those whose main problem is pain. Durability is real but not permanent: among patients who respond at one year, about 71 percent still benefit at two years and about 58 percent at three years, so symptoms can gradually return for some. Serious complications are uncommon, with an adverse event rate around 8 percent, usually minor issues like transient pain or bleeding.

Careful selection is also about knowing when to say no. Following the American Gastroenterological Association’s clinical guidance on G-POEM, patients on opioids are weaned off and re-tested first, because opioids slow the stomach on their own, and most patients whose gastroparesis followed a viral infection should not be offered G-POEM at all. Dr. Grandhige is known for turning down surgery when the odds do not favor it. That restraint is the point, not a limitation.

From your St. Petersburg consult to recovery

Most St. Petersburg patients move from first consult to surgery in two visits over about four to eight weeks, and many go home within a day or two of G-POEM. The timeline depends mostly on what testing you already have.

If you arrive with a completed gastric emptying study and relevant records, one visit is often enough to confirm the diagnosis and plan the procedure. If testing is still needed, the first visit is for review and test planning, and a second visit, usually about four weeks later, is to go over results and finalize the plan. To spare you repeat trips across the bay, his team consolidates testing and, when possible, arranges for studies to be done closer to home in the St. Petersburg area. His office also handles the insurance authorization paperwork before anything is scheduled, so you are not chasing it yourself.

Every procedure is performed at HCA South Tampa Hospital with the same surgical team, and Dr. Grandhige’s own physician assistant is involved in each case and reachable during recovery. After G-POEM, diet advances on a structured plan, starting with liquids and moving to soft foods and then regular textures over several weeks as the pylorus heals. You are given a clear point of contact rather than a rotating call line.

Waking up happy after recent treatment on hiatal hernia

Why St. Petersburg patients choose Dr. Grandhige

Dr. Gopal Grandhige is a board-certified surgeon and Fellow of the American College of Surgeons who has focused only on foregut surgery, the esophagus, diaphragm, and stomach, in the Tampa Bay area since 2009. That narrow focus is the reason patients drive in from across Pinellas and Florida rather than defaulting to the nearest general surgeon. You can read Dr. Grandhige’s full training and background for the complete picture.

His training runs through Johns Hopkins University, a medical degree from the University of Michigan, and a general surgery residency plus a fellowship in foregut and minimally invasive surgery at Yale-New Haven Hospital. He is a founding member of the American Foregut Society, a member of SAGES, and one of a handful of surgeons in Tampa Bay who performs G-POEM. Across his broader foregut practice he has performed more than 600 fundoplications, more than 600 LINX procedures, and more than 200 TIF procedures, which is the kind of volume that builds judgment about when to operate and when not to. His board certification and Florida medical license can be verified independently through the American Board of Surgery and the Florida Department of Health. For deeper reading on reflux, testing, and foregut conditions, see our blog.

FAQS

Yes. G-POEM is a real foregut operation performed under general anesthesia, done endoscopically through the mouth rather than through cuts in the abdomen. Incisionless does not mean minor. The internal cut in the pylorus still needs to heal, so diet and activity restrictions apply during recovery.

You are a possible candidate if a gastric emptying study confirms delayed emptying, testing points to the pylorus as the problem, and your symptoms have not responded to diet and medication. Patients whose gastroparesis followed a viral infection, or who are currently on opioids, usually need a different plan or further steps first. Candidacy is decided after testing, not from symptoms alone.

The practice is at 1315 South Howard Avenue in South Tampa, about a 25 to 35 minute drive from central St. Petersburg depending on traffic and where you start. All surgeries are performed at HCA South Tampa Hospital.

No. When possible, the team arranges for diagnostic testing to be done closer to your home in the St. Petersburg area and consolidates studies onto as few days as possible, so you are not making repeated trips across the bay.

Published research shows roughly 60 to 70 percent one-year clinical success depending on the cause, with postsurgical gastroparesis at the higher end and idiopathic at the lower end. Patients with nausea and vomiting as their main symptom tend to respond better than those with pain as the main symptom. Dr. Grandhige gives you an honest read on your specific odds during the consultation.

Most patients go home within a day or two. Diet progresses on a set schedule from liquids to soft foods to regular textures over several weeks while the pylorus heals. Because there are no abdominal incisions, most people are back to light activity quickly.

If testing shows the pylorus is not the cause, Dr. Grandhige will tell you before operating rather than proceed anyway. If a procedure helps only partially, he sets that expectation in advance and coordinates next steps, including referrals to other specialists for symptoms that are not coming from gastroparesis.

Often, yes. Delayed emptying and reflux frequently occur together, and gastroparesis is commonly mistaken for GERD. As a foregut specialist, Dr. Grandhige evaluates both, confirms which symptoms come from which problem, and builds a single plan rather than treating them in isolation.

Getting to the practice from St. Petersburg

Tampa Bay Reflux Institute is at 1315 South Howard Avenue, Suite 101, Tampa, FL 33606, in the yellow brick building next to Sally O’Neill’s Pizza, with parking behind Sally O’Neill’s. It is about a 25 to 35 minute drive from central St. Petersburg, and surgeries are performed at HCA South Tampa Hospital. Office hours are 9 AM to 6 PM, Monday through Friday. Phone: 813.922.2920. To have your records reviewed before your visit, email them to info@tampareflux.com.

If gastroparesis is running your life and diet and medication have stopped working, the next step is a workup that tells you whether the pylorus is the cause and whether G-POEM can help.

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An endoscopy cannot tell you if you have reflux. It can only tell you if you have complications of GERD. 

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If you have a hiatal hernia and fit one of these categories, you should know your options. 

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NOT increased acid production

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