Laparoscopic endopelvic sacral implantation of a Brindley controller for recovery of bladder function in a paralyzed patient.
BACKGROUND
A number of techniques are being investigated to accomplish bladder control recovery in paralyzed patients using the neurostimulation, but currently, all techniques are based on the dorsal implantation of the electrodes using a laminectomy.


METHODS
On 27 April 2006 we performed a laparoscopic implantation of a Finetech-Brindley bladder controller on the endopelvic sacral roots in a Th8 completely paralyzed woman who had previously undergone the removal of a Brindley controller due to an arachnoiditis after extrathecal implantation with intradural sacral deafferentation.


RESULTS
We required about 3.5 h for the entire surgical procedure; no complications occurred and the patients went home on 5th postoperative day. The patient is now able to void empty her bladder and her rectum using the controller without further need for self-catheterisation.


CONCLUSIONS
The presented new technique of laparoscopic implantation of electrodes on the endopelvic portion of the sacral nerve roots is an option to be considered in all paralyzed patients with further wish for electrical induced miction/defecation after previous deafferentation.
Possover
M
M
Department of Gynecology and Obstetrics, St Elisabeth Hospital, Cologne, Germany. marcpossover@aol.com
Baekelandt
J
J
Kaufmann
A
A
Chiantera
V
V
D003672:Defecation; D004599:Electric Stimulation Therapy / Q000379:methods*; D004567:Electrodes, Implanted; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000295:instrumentation / Q000379:methods; D010264:Paraplegia / Q000150:complications* / Q000503:physiopathology; D017060:Patient Satisfaction; D010388:Pelvis / Q000033:anatomy & histology / Q000601:surgery; D012187:Retroperitoneal Space / Q000033:anatomy & histology / Q000601:surgery; D012447:Sacrum / Q000033:anatomy & histology / Q000601:surgery; D013119:Spinal Cord Injuries / Q000150:complications* / Q000503:physiopathology; D013126:Spinal Nerve Roots / Q000503:physiopathology / Q000601:surgery*; D016896:Treatment Outcome; D001743:Urinary Bladder / Q000294:innervation / Q000503:physiopathology / Q000601:surgery; D001750:Urinary Bladder, Neurogenic / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D014554:Urination