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A simplified method of implanting a neuromodulator device
Ananias C Diokno1, Patrick B Leu, David B Konstandt
1Deaprtment of Urology, William Beaumont Hospital, Royal Oak, Michigan, USA.
The Journal of Urology
|March 12, 2003
Summary
This study presents a modified 2-stage approach for InterStim neuromodulator implantation, reducing incisions to one. This technique simplifies the procedure, potentially lowering infection risk for patients with refractory urinary incontinence.
Area of Science:
- Urology
- Minimally Invasive Surgery
- Medical Devices
Background:
- The InterStim neuromodulator is indicated for refractory urge incontinence, urinary frequency/urgency, and nonobstructive urinary retention.
- Traditional 2-stage implantation involves two separate incisions.
Purpose of the Study:
- To present a modified 2-stage approach for InterStim neuromodulator implantation.
- To reduce the number of incisions from two to one.
- To decrease operative time and potentially reduce infection risk.
Main Methods:
- A single paramedian incision is used for sacral foramen lead placement.
- The lead and extension wire are tunneled subcutaneously.
- Stage 2 involves implantation or removal through the original or a new incision.
Main Results:
- 20 procedures were performed with an average Stage 1 implant time of 72 minutes.
- Median pulse generator implant time was 36 minutes; median lead explant time was 21 minutes.
- No infections or adverse events were reported.
Conclusions:
- The modified approach is simple, efficient, and safe for urologists.
- Reducing incisions minimizes skin barrier violation and infection risk.
- Stage 2 generator implantation may benefit from undisturbed tissue, further reducing infection risk.