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World Journal of Surgery

Published in:

01-01-2018 | Original Scientific Report

Development of a Novel Detachable Magnetic Nerve Stimulator for Intraoperative Neuromonitoring

Authors: Eui-Suk Sung, Jin-Choon Lee, Sung-Chan Shin, Sung-Won Choi, Da-Woon Jung, Byung-Joo Lee

Published in: World Journal of Surgery | Issue 1/2018

Abstract

Background

Recurrent laryngeal nerve (RLN) palsy is a serious complication of thyroid surgery. During intraoperative neuromonitoring (IONM) of the RLN in thyroid surgery, repeated shifting between surgical instruments and the nerve stimulator is cumbersome and time-consuming. Therefore, we developed a simple detachable magnetic nerve stimulator that may be connected to all metallic surgical instruments. This study aimed to investigate the feasibility and efficacy of this detachable magnetic nerve stimulator for IONM in a porcine model and humans.

Methods

Eight RLNs in four pigs and thirteen in nine patients that underwent thyroidectomy were examined. We developed a detachable nerve stimulator that combined surgical instruments with the nerve-stimulating probe. We evaluated the electromyography (EMG) amplitudes of the RLNs in pigs and patients using conventional nerve probes and surgical instruments with the novel detachable magnetic nerve stimulator attached.

Results

The EMG amplitudes of the eight RLNs in pigs and thirteen in patients were analyzed. The detachable magnetic nerve stimulator was feasible and safe. There was no significant difference in the EMG amplitude between instruments (P = 0.423 in animals, P = 0.446 in humans).

Conclusions

The application of stimulating dissection using a detachable magnetic nerve stimulator during thyroidectomy with IONM is simple, convenient, and effective. It provides surgeons with real-time feedback of the EMG response during intermittent IONM. We propose that this novel device could be an essential guide for most surgeons, especially for less experienced head and neck surgeons.

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Title: Development of a Novel Detachable Magnetic Nerve Stimulator for Intraoperative Neuromonitoring
Authors: Eui-Suk Sung
Jin-Choon Lee
Sung-Chan Shin
Sung-Won Choi
Da-Woon Jung
Byung-Joo Lee
Publication date: 01-01-2018
Publisher: Springer International Publishing
Published in: World Journal of Surgery / Issue 1/2018
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-017-4159-4

At a glance: The STEP trials

Springer Medicine

Development of a Novel Detachable Magnetic Nerve Stimulator for Intraoperative Neuromonitoring

Abstract

Background

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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