Publication

Video-assisted sacral nerve stimulation

Journal Paper/Review - Jul 1, 2006

Units
PubMed
Doi

Citation
Hetzer F, Hahnloser D, Clavien P, Demartines N. Video-assisted sacral nerve stimulation. Techniques in coloproctology 2006; 10:121-3; discussion 123-4.
Type
Journal Paper/Review (English)
Journal
Techniques in coloproctology 2006; 10
Publication Date
Jul 1, 2006
Issn Print
1123-6337
Pages
121-3; discussion 123-4
Brief description/objective

BACKGROUND: Sacral nerve simulation (SNS) is an accepted therapy for patients with urinary or bowel dysfunction. However, infection rates are as high as 20% and can result in removal of the expensive device. We present a new video-assisted technique minimizing the risk of infection. METHODS: Between April and July 2005, six consecutive women of median age 68 years (range, 60-74), with faecal incontinence (4 patients) and idiopathic constipation (2 patients) underwent video-assisted electrode implantation for SNS. The motor response of the pelvic floor during percutaneous nerve evaluation and implantation of the permanent lead was monitored by a video optic (same as that normally used for laparoscopic or endoscopic procedures) placed between the legs of the patients. The video optic and the perianal area were completely covered with drapes, separating them from the operating field. RESULTS: All but one screening was successful, and no wound infections at the electrode or at the pocket of the stimulator were noted (mean postoperative follow-up, 8 weeks). CONCLUSIONS: With the use of a video optic, the anus and the implantation site can be completely separated and contamination during the operation becomes unlikely. Furthermore, the response of the pelvic floor to the stimulation is better visualized. We routinely recommend the use of video equipment for SNS electrode implantation.