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[Pelvic Intraoperative Neuromonitoring - Update and Pilot Study on Telementoring].

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Summary

Pelvic intraoperative neuromonitoring (pIONM) improves urinary, sexual, and rectal functions after rectal cancer surgery. Telementoring aids in adopting this nerve-preserving technique, enhancing patient quality of life.

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Area of Science:

  • Oncology
  • Surgical Innovation
  • Neuroscience

Background:

  • Rectal cancer surgery poses risks to pelvic nerve function.
  • Pelvic intraoperative neuromonitoring (pIONM) is a developing technique to mitigate these risks.
  • Standardization of pIONM, especially with robotic assistance, is needed.

Purpose of the Study:

  • To review current evidence on pIONM in rectal cancer surgery.
  • To assess the impact of pIONM on functional outcomes.
  • To explore the role of telementoring in pIONM adoption.

Main Methods:

  • Synthesis of existing literature and evidence.
  • Analysis of data from the multicenter, randomized NEUROS trial.
  • Evaluation of telementoring in robotic-assisted pIONM through case studies and NASA-TLX questionnaire.

Main Results:

  • The NEUROS trial showed significant improvements in urinary, sexual, and ano-(neo-)rectal functions with pIONM.
  • Telementoring demonstrated a low cognitive burden on surgeons (TLX-scores 5.0-24.3).
  • pIONM effectively helps prevent nerve damage during surgery.

Conclusions:

  • pIONM is a valuable tool for improving functional outcomes and quality of life in rectal cancer patients.
  • Telementoring can facilitate the standardized implementation of robotic-assisted pIONM.
  • Wider adoption of pIONM is recommended to preserve nerve function and enhance patient recovery.