Buttock placement of the implantable pulse generator: A new implantation technique for sacral neuromodulation - A multicenter study

Objective: In the standard operation procedure for sacral neuromodulation, the implantable pulse generator (IPG) is implanted in a subcutaneous pocket at the lower part of the anterior abdominal wall. This procedure requires a long operation time and three incisions. With the IPG in the abdominal wa ll, some patients complain of displacement or pain at the IPG site postoper atively. By modifying the technique of placement of the IPG, these disadvan tages are overcome. Methods: Between August 1999 and July 2000, 39 patients underwent a buttock implant of the IPG. In 2 of these patients the position of the IPG was cha nged from abdominal region to the buttock. During follow-up, complications concerning the operation and location of the IPG were compared to the publi shed literature. Results: Operation time is reduced in all patients by approximately 1 h. No repositioning of the patient is required during surgery. Only a short subc utaneous tunnel is required to connect the lead to the IPG. Pain at the lev el of the IPG was noted in 10% of the patients, which needed no further tre atment. No infections were seen and the IPG did not displace postoperativel y. Conclusion: Buttock placement of the IPG in sacral nerve stimulation leads to shorter operation time; only two incisions are needed instead of three a nd a shorter subcutaneous tunnel is needed. Using this technique there are less complications and a lower re-operation rate. Copyright (C) 2001 S. Kar ger AG, Basel.