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Delayed gastric emptying is a common problem that is seen by both gastroenterologists and general surgeons. Poor gastric emptying from outlet obstruction or diabetic, post-surgical, and idiopathic gastroparesis can be difficult to treat. This video demonstrates four surgical options for treatment. Gastric stimulator, duodenojejunostomy, pyloroplasty, and distal gastrectomy are shown demonstrating technique, and indications for each are discussed.