New sacral neuromodulation lead for percutaneous implantation using local anesthesia: Description and first experience
New sacral neuromodulation lead for percutaneous implantation using local anesthesia: Description and first experience
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DOI：
10.1097/01.ju.0000092634.64580.9a
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发表时间：
2003-11-01
影响因子：
6.6
通讯作者：
Malaguti, S
中科院分区：
文献类型：
--
作者：
Spinelli, M;Giardiello, G;Malaguti, S
目的：在当今的功能性泌尿外科中，骶神经的慢性刺激已成为最被接受的刺激治疗方法之一。许多研究已经描述了在植入最终系统之前进行测试刺激的优势，以实现有效的患者选择。我们研究了一种方法，旨在提高铅锚定通过开发一个自阻断电极与一个简单的放置程序，在创建一个2阶段的方法，以充分经皮植入，允许在第一个临时stimulation.Materials和Methods的筛选期长的过程中：一个新的cardiac铅是专门设计的，以允许微创经皮导线放置，无需切口，无需额外的筋膜锚定。从2001年9月至2002年11月，连续15例患者（3例男性和12例女性）27至70岁（平均年龄49岁）接受了该手术，并进行了前瞻性评价。结果：12例患者在第一阶段筛选阶段植入植入式脉冲发生器（IPG），3例对测试刺激无反应者（神经源性排尿功能障碍、急迫性尿失禁和神经源性急迫性尿失禁各1例）未植入IPG，局麻下拔除IPG电极。在筛选期间（平均38.8天）或IPG植入病例随访期间（平均11个月，范围5至19），我们没有观察到任何电极导线移位。结论：我们的研究结果表明，新的骨锚定系统是一种可靠的方法，可以真正微创放置慢性电极导线。
Purpose: In functional urology today chronic stimulation of the sacral nerves has become one of the most accepted methods of stimulation treatment. Many studies have described the advantage of test stimulation prior to implanting the definitive system to enable effective patient selection. We studied a method aimed at improving lead anchoring by developing a self-blocking electrode with a simple placement procedure, in the process creating a 2-stage approach to full percutaneous implantation that allows a long screening period during the first temporary stimulation stage.Materials and Methods: A new tined lead was specifically designed to allow minimally invasive percutaneous lead placement requiring no incision and no additional fascial anchoring. From September 2001 to November 2002, 15 consecutive patients (3 males and 12 females) 27 to 70 years old (mean age 49) underwent this procedure and were prospectively evaluated. No PNE test was performed.Results: Following the first stage screening phase 12 patients were implanted with the implantable pulse generator (IPG), while 3 who did not respond positively to test stimulation (neurogenic voiding dysfunction, urge incontinence and neurogenic urge incontinence in 1 each) did not undergo IPG implantation and had the tined lead removed under local anesthesia. We did not observe any lead displacement during the screening period (average 38.8 days) or during followup of IPG implanted cases (average 11 months, range 5 to 19).Conclusions: Our results show that the new tined anchoring system is a reliable way to allow truly minimally invasive placement of the chronic lead.