Application of a rubber band with hooks on both ends for vagus nerve stimulator implantation.

Application of a rubber band with hooks on both ends for vagus nerve stimulator implantation.

World Neurosurg. 2017 Dec 28;:

Authors: Hosoyama H, Hanaya R, Otsubo T, Sato M, Kashida Y, Sugata S, Katagiri M, Iida K, Arita K

Abstract
BACKGROUND: Vagus nerve stimulation (VNS) is a valuable therapeutic option for many types of drug-resistant epilepsy. Muscle hooks and carotid endarterectomy rings have been used for cervical delamination preceding the implantation of stimulation electrodes. The attachment on both sides of a rubber band of Kamiyama-style hanging needles, as are used for scalp and dural retraction during craniotomy, yields a useful tool for VNS implantation. Here we report our experience with this method.
METHODS: We present our method using a rubber band-plus-hooks and a review of 21 consecutive patients who underwent VNS implantation using our rubber band-plus-hooks method.
RESULTS: None of the 21 patients experienced intra- or perioperative complications. Hooks placed in connective tissue around the common carotid artery and jugular vein raised the vagus nerve by elevating the carotid sheath. A single surgeon was able to perform all cervical manipulations under a surgical microscope; the average operation time in this series of 21 patients was 137 min.
CONCLUSIONS: The use of hooks attached to both sides of a rubber band rendered VNS implantation safer by lifting the vagus nerve and standardizing the procedure.

PMID: 29289803 [PubMed - as supplied by publisher]

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