V3-06: A New Technique for Removal of Chronically Implanted Neuromodulator Leads
VideoIntroductions and Objectives
We describe a simple and effective technique to completely remove chronically implanted tined lead wires in patients with implanted pulse generator.
We performed a retrospective review of 18 patients who had chronically implanted pulse generators. The simple surgical technique was developed and performed by one surgeon (GG) in all cases. Patients’ demographics, indications, installation and removal complications were recorded and analyzed.
18 patients were included with the mean age of 60.2 years (32-84). Primary indications for sacral nerve stimulation (SNS) were overactive bladder in 10 (55.5%), mixed incontinence in 5 (27.8%), urinary retention in 2 (11.2%), and interstitial cystitis 1 (5.5%). All patients presenting an infection at time of lead wire removal were excluded. Mean implant duration was 22.5 months (8-55 months). In nine patients (50%) the old tined lead was removed and replaced by a new one and a complete removal of the unit in the other nine patients (50%). 17 (94.4%) underwent successful lead removal with no perioperative or postoperative complications. Mean procedure duration ranged from 40 min to 60 min.
This novel technique is simple, safe, and effective way to remove the tined leads in one complete piece._x000D_ _x000D_ Multiple Choice Question:_x000D_ What distance and how many tines make up the tined region the stage II lead wire?_x000D_ a) 3 tines, 3 cm_x000D_ b) 4 tines, 4 cm_x000D_ c) 3 tines, 1.5 cm_x000D_ d) 4 tines, 1.5 cm*_x000D_ _x000D_ The distance of 1.5 cm is just long enough to span the entire range of the fascia. The fascia becomes more engaged with the tines throughout the length of the implanted lead wire stabilizing the electrode placement, but making it challenging for removal.