Minimally invasive surgical techniques for implanting devices that deliver stimulant to the nervous system

摘要

Devices are currently implanted in patients to treat pain and other conditions including incontinence by delivering stimulants to the nervous system. Surgical methods are improved for implanting the devices. The soft tissues of the body are dilated above the site of device implantation, for example, above the sacrum, to create an annulus of dilated soft tissues. The tissues are dilated by introducing into the soft tissue sequentially larger cannulated dilating devices. A tubular retractor is then passed over the largest introduced dilating device and at least a number of the dilating devices are retracted. This establishes a tubular device insertion corridor through the dilated soft tissues to the site of implantation, for example, the foramen of the sacrum. The device to be implanted, such as an electrical lead, is then inserted through the corridor. The device is tested in situ. Finally, such other method steps are performed, including closing the corridor, as implantation requires. As preferred, when establishing a corridor through the tissues, a corridor is established sufficient in size for insertion of an endoscope; and the endoscope is inserted and utilized for visual imaging as needed. Also as preferred, the nervous system of the body is tested for appropriate reaction to the stimulant through insertion and manipulation of testing implements through the corridor before performing other method steps. As further preferred, the device to be implanted is anchored through insertion and manipulation of anchoring implements through the corridor. The device is also connected to associated equipment, such as an implantable pulse generator, by tunneling through the soft tissues and passing an extension, a cable, from the lead to the site of implantation of the other equipment, such as in the abdomen.