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Thoracoscopic Placement of Phrenic Nerve Electrodes for Diaphragmatic Pacing in Children |
As published in the Journal of Pediatric Surgery1, physicians from the CHildren's Hospital of Los Angeles, report the establishment of bilateral diaphragmatic pacing using thoracoscopic placement of phrenic nerve electrodes.
"Diaphragmatic pacing can provide chronic ventilatory support for children who suffer from congenital central hypoventilation syndrome (CCHS) or cervical spinal cord injury."
"During diaphragm pacing, diaphragmatic contraction results from direct electrical stimulation of the phrenic nerves. Candidates for this technique must have intact phrenic nerves and diaphragmatic muscles."
"Between 1997 and 2000, 9 children ranging in age from 5 to 15 years and suffering from these disorders underwent thoracoscopic placement ofbilateral phrenic nerve electrodes. A 3- or 4-trocar technique was used to dissect the phrenic nerve in the midchest and suture a phrenic nerve electrode (Avery Laboratories I-110A, Commack, NY) into place. The electrode was tunneled to a subcutaneous pocket in the upper abdomen and attached to an implanted pacing unit."
"Phrenic nerve electrodes can be implanted thoracoscopically and allow the successful use of diaphragmatic pacing therapy. Avoidance of thoracotomy with its associated perioperative morbidity and scarring may encourage wider utilization of diaphragmatic pacing in children."
1 Shaul DB, Danielson PF, McComb JG, Keens TG. "Thoracoscopic Placement of Phrenic Nerve Electrodes for Diaphragmatic Pacing in Children." J.Pediatr.Surg. Vol. 37, No.7, pp.974-978 (2002).
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