Atrotech Atrostim PNS Anwenderhandbuch Seite 22

Atrostim PNS
Possible variations
An alternative technique has been developed where suturing of the strips is avoided. Once
the nerve is freed from the ground and a tunnel has been created large enough to permit
smooth passing of the electrode strip behind the nerve, subpleural pockets are created from
each incision in the direction away from the nerve. One pocket is needed on the bridge side
of the electrode, two pockets on the side where the free flaps are to be placed (Exner G.
pers.com.1997). Sutures are placed on the tips of the flaps. The suture of the flap to be
placed behind the nerve is gently pulled through the tunnel behind the nerve and is used to
pull the flap into its pocket. The suture may then be cut or used to fix the flap to the
surrounding tissue. The flap in front of the nerve is then pulled into its pocket by aid of its
suture. Now the bridge part of the electrode is placed into its pocket. If the pockets are
created in the right place and are of the right size, fixing sutures can be omitted (Exner G.
pers.com. 1997). The pockets should be large enough to contain the matrix of the electrode.
Do not stretch
the nerve!
April 2008
Fig. 9. Fixation of the 4-pole Teflon
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Surgical procedure
pleura incisions
back strip
TM
electrode.
front strip