Hamdi Hussein, Spatola Giorgio, Lagarde Stanislas, McGonigal Aileen, Paz-Paredes Armando, Bizeau Alain, Bartolomei Fabrice, Carron Romain
Department of Functional and Stereotactic Neurosurgery, Timone University Hospital, Marseille, France.
Aix Marseille Univ, APHM, INSERM, INS, Inst Neurosci Syst, Timone Hospital, Marseille, France.
Oper Neurosurg. 2020 May 1;18(5):487-495. doi: 10.1093/ons/opz227.
Vagal nerve stimulation (VNS) is an approved treatment for epilepsy and depression. Wrapping the helical electrodes around the nerve can prove technically challenging. However, a quick and efficient method to slightly elevate the nerve can highly facilitate this part of the procedure.
To provide useful surgical tips to facilitate the procedure.
Based on experience of more than 150 adult cases for mainly epilepsy (primary lead implant), the authors share their surgical technique to provide the experienced surgeons or newcomers to the field of VNS with some useful tips. All patients signed informed consent according to the local ethics committee guidelines.
The article consists of a detailed step-by-step description of the whole procedure illustrated through high-resolution colored photographs of the surgical field. Special reference is made to the usefulness of polyvinyl alcohol (PVA) sponge cubes to elevate the nerve instead of the commonly used silicon vessel loops.
The use of surgical microscope and PVA sponge cubes to elevate the nerve constitute key points to make VNS an easy surgery.
迷走神经刺激术（VNS）是一种已获批准用于治疗癫痫和抑郁症的方法。将螺旋电极缠绕在神经上在技术上可能具有挑战性。然而，一种快速有效的方法来稍微抬高神经可以极大地便利该手术的这一部分操作。
提供有助于手术操作的实用技巧。
基于150多例主要为癫痫患者（初次植入电极）的成人病例经验，作者分享他们的手术技术，为VNS领域的经验丰富的外科医生或新手提供一些实用技巧。所有患者均根据当地伦理委员会指南签署了知情同意书。
本文通过手术视野的高分辨率彩色照片，对整个手术过程进行了详细的分步描述。特别提到了使用聚乙烯醇（PVA）海绵方块抬高神经的实用性，而非常用的硅胶血管环。
使用手术显微镜和PVA海绵方块抬高神经是使VNS手术变得简单的关键点。
