Neuromonitoring of critical nerve pathways during surgery provides valuable additional information enabling the surgeon to make informed decisions. The technique is used in a wide range of procedures including thyroid surgery, rectal surgery and perineal anal reconstruction.
Neuromonitoring in surgery, particularly in thyroid surgery >>, is already used as the standard procedure in most clinics. The technique is also becoming very important for the complex TME >> (total mesorectal excision) technique.
The technique and application of neuromonitoring in these procedures is gentle and safe for the patient.
Mechanical irritation of nerves is a frequent occurrence resulting in complications for surgical interventions on the thyroid. With continuous monitoring of nerve function during surgery, the surgeon hears and sees any change in neural activity caused by the surgical manipulation of motor nerves. Needles or surface electrodes (EMG) measure the muscle contractions and transmit signals to the equipment resulting in an audio output (sound) and visual display of the motor action potential (waveform). The information from the nerve monitor provides the surgeon with additional and important information of the overall condition of the nerve structures in the operating field. The surgeon is able to adjust the surgical approach resulting in improved outcomes for patients.
The monitoring process is further enhanced by the use of hand held stimulation probe allowing the surgeon to map the nerve structures in the surgical field more accurately.
Diseases of the thyroid or the rectum >> affect millions of patients worldwide; the additional risk of neurological incidents can be largely avoided by the use of intraoperative neuromonitoring. This is especially the case when performing a partial removal of the thyroid and more particularly with the complete removal of the thyroid.
Pelvic intraoperative neuromonitoring >> can help prevent neural damage in pelvic surgery. Thereby the risk of urogential dysfunction could be reduced significantly (see D. Kauff et al., „Comparison of urogenital function following TME with and without pelvic intraoperative neuromonitoring.”, DGCH 2016).
For a perineal pull-through operation in neonates, the sphincter can be tested for its functionality. This is achieved by using transcutaneous stimulation in the pre-operative anal atresia on an ambulatory basis.