C2 Xplore offers improved patient safety thanks to neuromonitoring in colorectal surgery

Colorectal surgery carries an increased risk of post-operative damage

The extremely complex nerve structures of the autonomic nervous system in the minor pelvis pose a considerable risk during interventions in colorectal surgery. Statistics of post-operative anorectal and urogenital disorders indicate that a large proportion of patients suffer from incontinence and sexual dysfunction after minor pelvic surgery.*
^{*Lent V., Junginger T., Nervenstörungen der Harnblasen- und Sexualfunktionen nach Rektumresektionen und -extirpationen, Chirurgische Allgemeine Zeitung, 12 (2012)}

inomed’s pioneering method for pelvic monitoring

More than 12 years of clinical research have resulted in a novel technology for locating and monitoring the complex autonomic nervous system in the minor pelvis. inomed’s pelvic Intraoperative Neuromonitoring (pIOM), which is patented in Germany, can be used for a variety of interventions in the field of colorectal surgery.

pIOM^® technology can help preserve functions

The EMG signals of the internal and external anal sphincter and bladder pressure are monitored intraoperatively by the pIOM^® technology. This technology can thus help to preserve the functions of the monitored structures inside the minor pelvis after surgery despite the invasive nature of the therapy.** The stimulation sites in the minor pelvis are the hypogastric plexus and the pelvic splanchnic nerves.

The simple application of the procedure supports the surgeon’s workflow without causing any substantial surgical delay.***

^{** Kauff D.W., Kneist W., Risk Factor Analysis for Newly Developed Urogenital Dysfunction after Total Mesorectal Excision and Impact of Pelvic Intraoperative Neuromonitoring - a Prospective 2-Year Follow-Up Study, Journal of Gastrointestinal Surgery, 6 (2017)
*** Wałęga P. et al. “Intraoperative neuromonitoring of hypogastric plexus branches during surgery for rectal cancer - preliminary report,” Polski przeglad chirurgiczny, 89/2 (2017)}

Measurement mode in colorectal surgery

• The placement of needles in the internal and external anal sphincter or a rectal electrode in the anal canal allow real-time monitoring of anorectal function
• Monitoring of the urinary function with the help of a pressure sensor attached to the catheter
• Specially developed manual probe for stimulation of the pelvic nerves and to locate functional structures during open, laparoscopic and robotic assisted interventions
• Optical and acoustic notification if activity occurs
• Recorded signals are processed and displayed in the form of colour bars
• At the same time, the electrical current flow is continuously indicated acoustically during stimulation