Atrotech Atrostim PNS Anwenderhandbuch Seite 33

Surgical procedure for pediatric patients
1. The pediatric electrode (Fig. 2), which is implanted onto the
phrenic nerve. It consists of two joined strips of Teflon
The conductive surface of each of the four nerve contacts is made of
platinum. Two platinum electrode buttons are mounted into each
strip. The strips cross the nerve at opposite sides at a certain distance
from each other in longitudinal direction. The electrode wire lead
consists of four multifilament stainless steel wires, which are
insulated by a 4-lumen tube made of silicon elastomer. The wires are
attached to the ears of the electrode buttons. The difference between
the two electrodes is in the size of the platinum buttons and the
Teflon
In active patients, like children with CAH, the electrodes should be
implanted onto the phrenic nerves in the thorax only.
2. The extension lead (Fig. 3) is used together with a pediatric
electrode. It has a plug at one and a receptacle at the other end.
The receptacle fits to its electrode counterpart in the thorax.
3. The compound connector (Fig. 4) for the four-fold electrode
wire lead which connects the nerve electrode to the implanted
stimulator (receiver). Connector elements of the receptacle are made
of stainless steel. The connector array is molded into a flat sleeve of
silicon elastomer, which supports the array. The electrode wires are
attached to male type connectors made of titanium, which are
insulated by silicon rubber. The plug/receptacle system forms a
water tight insulation, which prevents creation of any electrolytic
pathway between the connectors and from the connectors to outside
tissue. No special tool or material is required for plugging of the
connectors. However, use of a special tool is recommended for
unplugging.
4. The implant stimulator (receiver) (Fig. 5), which is implanted
under the skin. It consists of a hermetically sealed hybrid
microcircuit, an external pick-up coil and a 4-contact wire lead
receptacle. The implant stimulator capsule is made of titanium
and is completely coated with implant grade silicon elastomer. The
implant stimulators are usually implanted in the subclavicular
region, anterolaterally over the lower ribs or in the abdominal wall. It
is essential to keep a distance of 15 cm between the inner borders of
the implant stimulators to prevent cross talk between both sides
during energy transfer. The location has to be chosen according to
the patients size and distribution of subcutaneous fat.
5. The energy transfer coil (antenna coil) (Fig. 6), which is placed
on the skin of the patient as close as possible to the implanted
stimulator.
TM
fabric matrix.
2
Atrostim PNS
TM
fabric.
April 2008