DATABASE-RESEARCH | GROUP OF CLINICAL PATIENT RESEARCH | ||||||
Bruno ROCHE | Head of group CV | Research subject | Members of the group |
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Dr. B. ROCHE HUG/ Dpt Chirurgie Serv Chirurgie Viscerale Rue Gabrielle-Perret-Gentil 4 1211 Genève 14 Bruno.Roche.@hcuge.ch Tel.: 022 372 79 34 Fax: 022 372 79 09 Comments Pages updated the 17.11.2015 |
Reseach's subject
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Group's publications
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Electrode Implantation in Sacral Nerve Stimulation
Optimizing Electrode Implantation in Sacral Nerve Stimulation - An Anatomical Cadaver Study Controlled by a Laparoscopic camera
N. C. Buchs, M.D., J.-C. Dembe, M.D., J. Robert-Yap, B. Roche,J. Fasel. BACKGROUND AND AIM: Sacral nerve stimulation is the therapy of choice in patients with neurogenic faecal and urine incontinence, constipation and some pelvic pain syndromes. The aim of this study is to determine the best insertion angles of the electrode under laparoscopic visualization of the sacral nerves. METHODS: Five fresh cadaver pelvises were dissected through an anterior approach of the presacral space, exposing the ventral sacral roots. Needles and electrodes were inserted into the S3 foramen. Both right and left sides were used, with the traditional percutaneous procedure. The validation was done by a laparoscopic camera controlling the position of the needle and electrode on the nerve. The angles were assessed with a goniometer, and were confirmed in 2 living patients. RESULTS: The mean angle of insertion in the sagittal plane was 62.9+/- 3 degrees (range: 59-70). In the axial plane, the mean angle for the left side was 91.7+/- 13.5 degrees (range: 80-110) and 83.2+/-7.7 degrees for the right side (range: 75-95). These angles resulted in the optimal placement of the leads along the S3 sacral root, in all these cases. CONCLUSIONS: This study allows direct visualization during the placement of the needle and electrode, thus permitting accurate calculations of the best angle of approach during the surgical procedure in sacral nerve stimulation. These objective findings attempt to standardize this technique, which is often performed with the aid of intra-operative fluoroscopy but still leaving a lot to chance. These insertion angles should help to find more consistent and reproducible results and thus improved outcome in patients. Group's publications Measure of the voluntary contraction of the puborectal sling as a predictor of successful sphincter repair in the treatment of anal incontinence. DISEASES OF THE COLON & RECTUM 2009 vol. 52(4) pp. 704-710 ZUFFEREY G, PERNEGER T, ROBERT-YAP J, RUBAY R, LKHAGVABAYAR B, ROCHE B Optimizing electrode implantation in sacral nerve stimulation--an anatomical cadaver study controlled by a laparoscopic camera. INTERNATIONAL JOURNAL OF COLORECTAL DISEASE 2008 vol. 23(1) pp. 85-91 BUCHS NC, DEMBE JC, ROBERT-YAP J, ROCHE B, FASEL J Sacral neuromodulation for refractory lower urinary tract dysfunction: results of a nationwide registry in Switzerland EUROPEAN UROLOGY : OFFICIAL ORGAN OF THE EUROPEAN ASSOCIATION OF UROLOGY 2007 vol. 51(5) pp. 1357-1363 KESSLER THOMAS M. The posterior approach for low retrorectal tumors in adults INTERNATIONAL JOURNAL OF COLORECTAL DISEASE 2007 vol. 22 pp. 381-385 BUCHS, N, TAYLOR, S, ROCHE, B Complete closure of cancer-related anovaginal and anoperineal fistulas in locally advanced anal canal carcinomas by upfront intra-arterial chemotherapy followed by combined radiochemotherapy: report o f two cases DISEASES OF THE COLON & RECTUM 2006 vol. 49(12) pp. 1927-1930 ROSSET L, ALLAL AS, MOREL P, ROCHE B, ROTH AD Research's domains |