Atrotech Atrostim PNS Anwenderhandbuch Seite 21

Surgical procedure
black color band
Fig. 8. Top view of the 4-pole Teflon
of the electrode contact that is active during the corresponding combination
(working as the cathode).
Either one of the strips is pulled through behind the nerve. This 'back' strip is
allowed to settle easily in place so that no pressure of edges or other structures to the
nerve is apparent, see Fig. 9.
The front strip is then arranged in place using the same precautions as for the back
strip. No empty space should be left between nerve and electrode buttons. At this
stage a proper function of the electrode is tested. Reposition the strips if necessary.
The back strip is then fixed with single sutures to the surrounding tissue. The sutures
to the uniting part of the electrode arrangement are applied, thereafter those to the
free part of the strip, see Fig. 9.
The electrode wires are directed away from the nerve. The wire lead is fixed by aid
of its lugs to the tissue with non-absorbable sutures. This is to prevent possible
transfer of mechanical stress from the wire lead to the electrode. No part of the
electrode wires nor the wire lead should contact the nerve.
The free flaps of the electrode strips may be shortened appropriately and should be
covered thereafter by surrounding tissue. This will provide additional fixation which
helps to prevent mechanical stress to the nerve. In the thorax, the free flaps may be
situated into pockets under the pleura, and the pleura may be sutured in a way to
maximize the areas covered by pleura.
Cut corner indicates
electrode contact #1
TM
12
2 1
electrode. Numbers indicate the location
Atrostim PNS
April 2008