Beacon Memorial Hospital, 621 Memorial Drive. Suite 302, South Bend, IN, 46601, USA.
Int Urogynecol J. 2021 Mar;32(3):661-663. doi: 10.1007/s00192-020-04539-3. Epub 2020 Oct 7.
Describe a novel technique for retrieval of the Interstim lead in part based on techniques used in massage therapy.
Retrospective review of patients (single surgeon) identified by CPT code 64585 over 10 years. Exclusion criteria included patients who (1) had explantation for active infection or (2) did not proceed with a stage 2 implant (in the event of a staged procedure). To effect removal, the surgeon applies a focused massage with firm deliberate pressure in deep circular motions to the insertion site and surrounding tissue. At the same time, gentle steady traction is applied to the lead (from the IPG pocket) by the surgeon.
Sixty women were identified. Mean implant duration was 24 (6-60) months. There were three lead fractures at retrieval (5%). In all three occurrences, the inner conductor wire was removed despite leaving the tined fragment in place. The author did not perform a cutdown to retrieve the retained fragment. There were no peri- or postoperative complications.
Lead removal is safely accomplished in a matter of a few minutes with the presented technique without the need for a cutdown. Lead breakage was 5% and similar to more invasive techniques.
描述一种基于按摩疗法技术的新型 Interstim 导丝取出技术。
回顾性分析了 10 年来按 CPT 代码 64585 识别的患者（单外科医生）。排除标准包括：（1）因活动性感染而进行取出术的患者；（2）未进行二期植入术（分期手术）的患者。为了实现取出，外科医生在插入部位和周围组织上施加集中的按摩，以深圆形运动施加有力的刻意压力。同时，外科医生对导线（从 IPG 口袋）施加温和稳定的牵引力。
共确定了 60 名女性。平均植入时间为 24 个月（6-60）。在取出时发生了 3 例导线断裂（5%）。在所有 3 例中，尽管留下了叉形碎片，但内导体线已被取出。作者未进行切开术以取出残留的碎片。没有围手术期并发症。
使用所提出的技术，无需切开术，即可在数分钟内安全地完成导线取出，成功率为 100%。导线断裂率为 5%，与更具侵入性的技术相似。
