Technique for implanting intramuscular electrodes in the diaphragm by videolaparoscopy in pigs

Abstract

PURPOSE:To describe a novel approach for implanting intramuscular electrodes in the diaphragm through videolaparoscopy. METHODS:We used twelve pigs for this videolaparoscopic technique, which permits at the same time to explore the diaphragm, to locate its motor points and to fix the electrodes in the diaphragm bilaterally. In this technique we used three trocars: one portal for a 10-mm 0° viewing angle laparoscope, one portal for the manipulation of structures and another for electrode implantation. RESULTS:All animals survived the procedure without pneumothorax/capnothorax or other complication. Implanted electrodes provided an appropriate interface between the muscle and the electrical current generator, and electroventilation was satisfactorily generated in all animals. CONCLUSION:This videolaparoscopic technique with three trocars enables the exploration and identification of motor points and an efficient fixation of one or two electrodes in each hemidiaphragm.

Proposal of a New Electrode and Modality of Electrical Stimulation for Diaphragmatic Pacemakers

“…Videolaparoscopy was used to implant 68 electrodes in the abdominal portion of the diaphragm. The preparation of the animals, the anesthetic protocol, and the surgical technique are described elsewhere [7].…”

“…The only intramuscular diaphragmatic pacemaker currently used in clinical practice consists of 4 current generators with 2 wires in each channel (2 channels in each hemidiaphragm) [7]. In our model, we successfully achieved an effective muscle contraction in both hemidiaphragms at the same time by using an unpolarized electric current with only a single channel.…”