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Sacral nerve stimulation for fecal incontinence.
| Content Provider | Semantic Scholar |
|---|---|
| Author | Takano, Shota Boutros, Marylise Wexner, S. D. |
| Copyright Year | 2013 |
| Abstract | Diseases of the Colon & ReCtum Volume 56: 3 (2013) this video demonstrates the technique of sacral nerve stimulation for fecal incontinence (fi) and highlights key technical tips (see Supplemental Digital Content 1, http://links.lww.com/DCR/a105). the goal of stage 1 is to implant a tined lead in the third sacral foramen (s3) under fluoroscopic guidance. the awake patient is placed in the prone position; antibiotic prophylaxis is administered, the skin is sterilized, and an antimicrobial, adhesive drape (ioban, st. Paul, mn) is placed. to find the optimal lead position, the target sites for s3 are bilaterally marked and infiltrated with local anesthesia. test needles are placed in the medial aspects of s3 at a 60° angle from the skin. after the best motor and sensory response is obtained, the skin incision is enlarged and a quadripolar lead is placed by using a seldinger technique. the most superficial electrode is first positioned at the anterior cortex; then, the lead is carefully withdrawn until the optimal position is confirmed by good sensory and motor responses, preferably in all 4 electrodes (minimum 2/4), with the least voltage. a subcutaneous pocket (at a preoperatively marked location) is created, and the lead is tunneled into the deep medial aspect. a temporary extension is connected to the lead, ensuring dry and complete contact, which is then tunneled to a superolateral exit site and is connected to an external pulse generator. if, during the following test period, the patient experiences a 50% or greater reduction in episodes of fi and/or Wexner fi score, the permanent stimulator (medtronic inc, minneapolis, mn) is implanted (stage 2). With the patient in the prone position, under sedation, the incision is reopened, and the temporary extension is removed. the stimulator is connected to the permanent lead and placed in the subcutaneous pocket, such that the lead rests beneath the stimulator and is protected. intraoperative programming is undertaken and the pocket is closed. scott steele, m.D., Section Editor |
| Starting Page | 384 |
| Ending Page | 384 |
| Page Count | 1 |
| File Format | PDF HTM / HTML |
| DOI | 10.1097/DCR.0b013e3182809129 |
| PubMed reference number | 23392155 |
| Journal | Medline |
| Volume Number | 56 |
| Issue Number | 3 |
| Alternate Webpage(s) | http://www.doiserbia.nb.rs/(A(k5NRg3ji0gEkAAAANzMwNTJmZDMtYjRkNi00NDE4LTkwZGQtZGM0OGYzNDY4NGRlhtIDR9AnwmNpfgL1GGKXfdJWSVE1))/img/doi/0354-950X/2010/0354-950X1003067M.pdf |
| Alternate Webpage(s) | https://doi.org/10.1097/DCR.0b013e3182809129 |
| Journal | Diseases of the colon and rectum |
| Language | English |
| Access Restriction | Open |
| Content Type | Text |
| Resource Type | Article |
