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Adoption of continuous intraoperative neural monitoring (C-IONM) in endoscopic thyroid surgery is limited due to the uneasy application of C-IONM electrode. Feasibility for transcutaneous vagal nerve stimulation was tested. Vagus nerve (VN) and recurrent laryngeal nerve (RLN) were mapped and stimulated in different neck sites by (1) transcutaneous monopolar intermitted stimulation; (2) prototype for continuous transcutaneous stimulating electrodes (TSEs), that is, suction ball C-IONM electrode remodeled; (3) stimulation subsequently to neck CO insufflation; (4) direct stimulation of surgical exposed nerves. Electromyographic (EMG) parameters were compared. Six anterior neck locations evoked EMG signals of VNs and RLNs. Location Nos. 3 and 6 according to our scheme were over the VNs, confirmed by ultrasonography and subsequent dissection. Other locations did not correspond to nerves sites. Transcutaneous thresholds were higher than surgical exposed ones to produce a consistent and satisfactory EMG response. TSE recorded solely in location No. 5 with amplitude values 256-9 μV. It was not possible to stimulate and monitor the RLN and VN after neck CO insufflation. Transcutaneous C-IONM is unfeasible for endoscopic thyroidectomy.
This article was published in the following journal.
Name: Journal of laparoendoscopic & advanced surgical techniques. Part A
We performed this study to assess the feasibility and efficacy of intraoperative neural monitoring (IONM) in remote access robotic and endoscopic thyroidectomy.
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Comparison of endoscopic thyroidectomy, robotic thyroidectomy and conventional open surgery, the safety of the operation, the timing of the operation and the complications.
Simultaneous and continuous monitoring of several parameters during sleep to study normal and abnormal sleep. The study includes monitoring of brain waves, to assess sleep stages, and other physiological variables such as breathing, eye movements, and blood oxygen levels which exhibit a disrupted pattern with sleep disturbances.
The continuous measurement of physiological processes, blood pressure, heart rate, renal output, reflexes, respiration, etc., in a patient or experimental animal; includes pharmacologic monitoring, the measurement of administered drugs or their metabolites in the blood, tissues, or urine.
Studies to determine the advantages or disadvantages, practicability, or capability of accomplishing a projected plan, study, or project.
An empirical investigation which pertains to the development of prototypes or models that demonstrate the feasibility of novel concepts, ideas, principles, schema or their practical application.
Continuous measurement of the movement and forces of blood in the CARDIOVASCULAR SYSTEM.
The thyroid is a butterfly-shaped gland in the neck, just above thecollarbone and is an endocrine gland that make hormones. These Thyroid hormones control the rate of many activities in the body, including how fast the body burns calories and how fast th...
Surgery is a technology consisting of a physical intervention on tissues. All forms of surgery are considered invasive procedures; so-called "noninvasive surgery" usually refers to an excision that does not penetrate the structure being exci...