Intraoperative neurophysiological monitoring of the phrenic nerve in videothoracoscopic surgeries

Intraoperative neurophysiological monitoring of the phrenic nerve in videothoracoscopic surgeries. Authors: Dr. Grossi Matias, Dr. Piñero Santiago, Dr. Zurita Perea Santos Nicolas, Dr. Perrote Federico.1 1Neurology Service, Intraoperative Neurophysiology Unit, Hospital Privado Universitario de Córdoba, Argentina. OBJECTIVE: Demonstrate the usefulness of intraoperative neurophysiological monitoring for phrenic nerve in videothoracoscopic surgeries. METHODS: Videothoracoscopic surgeries performing monitoring and nerve mapping techniques to avoid phrenic nerve injuries. Monitoring: Stimulation electrodes: subcutaneous bipolar needle electrodes placed on the neck. Recording electrodes: Bipolar subcutaneous needles placed in diaphragm. Mapping: Stimulation electrodes: Monopolar stimulator adapted to endoscopic probe. Recording electrodes: same as for monitoring recording. Alarm criteria: Drop of more than 50% of the amplitude. Prolongation of latency greater than 10%. RESULTS: Monitoring: Amplitude: 186uV. Latency: 20ms. Mapping: Amplitude: 202 uV. Latency: 13ms. CONCLUSIONS: It would be impressive to be a safe and reliable monitoring method to ensure the integrity of nervous structures. REREFENCES: 1.Situación actual de la cirugía video-toracoscópica EDGAR GUTIÉRREZ, Revista colombiana de cirugía 2013. 2. Monitorización neurofisiológica intraoperatoria del nervio frénico utilidad y descripción de la técnica. Alberto Grande-Martín [1] ; Agustina Martínez-Moreno [1] ; Rosa María Sánchez-Honrubia [1] ; José Manuel Pardal-Fernández [1] Hospital Universitario General de Albacete. Cirugía española: ISSN 0009-739X, Vol. 97, Nº. 2 (febrero), 2019, págs. 103-107. 3. Thymectomy Masayoshi Inoue 1, Hiroaki Tsunezuka, Kyobu Geka 2019 Sep. 4. Grande-Martín, A., Martínez-Moreno, A., Sánchez-Honrubia, R. M., & Pardal-Fernández, J. M. (2019). Intraoperative neurophysiological monitoring of the phrenic nerve: utility and descriptions of the technique. cirugía española. https://doi.org/10.1016/j.ciresp.2018.11.002 5. Lucente, G., Martinez-Barenys, C., Ramos-Fransi, A., Almendrote-Muñoz, M., López de Castro, P., Deletis, V., Coll-Canti, J., & Martínez-Piñeiro, A. (2021). A New Methodology for Intraoperative Monitoring of the Functional Integrity of the Phrenic Nerve During Cardiothoracic Surgery. Journal of Clinical Neurophysiology. https://doi.org/10.1097/WNP.0000000000000677.