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Surgical procedure for pediatric patients
If separation of the two electrode strips is planned, they should be cut now. However,
it should be remembered to keep the minimum distance of 4 mm between the
electrode strips. Practically, there is no upper limit for the distance.
Application of the matrix
The special pediatric electrode with an extension lead system is designed for
pediatric patients. The direction of the matrix is determined by the surgeon from the
surgical point of view. Once the electrode is fixed the direction of the cut corner is
checked and recorded (whether it is positioned cephalad or caudal). The numbers in
Fig. 7 correspond to the numbers of electrode combinations in the programming
module. It is very important to know the position of the electrodes in relation to the
nerve for possible later trouble shooting. Therefore the position of the cut edge of the
strip should be clearly stated in the Registration Form B. This way it is easy to
determine which strip to reposition in case of a poor or unstable stimulus response.
Fig. 7. Top view of the 4-pole Teflon
of the electrode contact that is active during the corresponding combination
(working as the cathode).
One of the strips is pulled through behind the nerve. Don't touch the silicone rubber
parts with instruments! The "back" strip is allowed to settle easily in place so that no
pressure occurs to the nerve by edges of the strip or other structures, see Fig. 8.
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 proper function of the electrode is tested. Reposition the strips if necessary.
Cut corner indicates
electrode contact #1
black color band
TM
electrode. Numbers indicate the location
10
Atrostim PNS
2
1
April 2008
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