Purpose <p>More than half of patients treated with neuromodulation experience inconveniences related to the implantable pulse generator (IPG). Despite their significance, there is an absence of standardized guidelines and recommendations minimizing and/or preventing these issues, reinforcing the continuous burden posed by IPG-related inconveniences. This study aims to provide evidence- and experience-based recommendations for preoperative counselling, implantation site, surgical technique, and management strategies, improving IPG-related inconveniences, by combining a comprehensive literature review with insights gathered from global expert meetings on the topic.</p> Methods <p>In this evidence-and experience-based consensus study, a literature analysis was performed using the PubMed, MEDLINE, and EMBASE databases. Experts’ insights on the topic were systematically collected during various expert-based meetings. Recommendations were developed through an integration of literature evidence and clinical expertise, with the aim of preventing and reducing IPG-related inconveniences. The level of evidence for each recommendation has been assessed using the GRADE system and the degree of consensus was evaluated using an independent expert-analysis.</p> Results <p>A total of 26 articles, published between 2001 and 2024, were included in the literature search. Twenty-six recommendations were formulated. Outcomes emphasized the importance of thorough preoperative counseling, strategic implant site selection, well-considered surgical technique, and tailored postoperative management in reducing the incidence and severity of IPG-related issues. The level of evidence was low to moderate, while the degree of consensus was high for most of the recommendations proposed in this study.</p> Conclusions <p>Given the impact of IPG-related inconveniences, clear and practical recommendations are essential for consistent and effective neuromodulation practice.</p> Graphical Abstract <p></p>

错误:搜索内容不能为空,请输入英文关键词
错误:关键词超出字数限制,请精简
高级检索

Troubles in the Pocket: Evidence- and Experience-Based Multidisciplinary Expert Consensus Recommendations for Implantable Pulse Generator Placement and Management of Associated Inconveniences

  • Linda Kollenburg,
  • Inge Arnts,
  • Caro Edelbroek,
  • Colette Milliner,
  • Georgios Matis,
  • Alaa Abd-Elsayed,
  • Jan Willem Kallewaard,
  • Erkan Kurt

摘要

Purpose

More than half of patients treated with neuromodulation experience inconveniences related to the implantable pulse generator (IPG). Despite their significance, there is an absence of standardized guidelines and recommendations minimizing and/or preventing these issues, reinforcing the continuous burden posed by IPG-related inconveniences. This study aims to provide evidence- and experience-based recommendations for preoperative counselling, implantation site, surgical technique, and management strategies, improving IPG-related inconveniences, by combining a comprehensive literature review with insights gathered from global expert meetings on the topic.

Methods

In this evidence-and experience-based consensus study, a literature analysis was performed using the PubMed, MEDLINE, and EMBASE databases. Experts’ insights on the topic were systematically collected during various expert-based meetings. Recommendations were developed through an integration of literature evidence and clinical expertise, with the aim of preventing and reducing IPG-related inconveniences. The level of evidence for each recommendation has been assessed using the GRADE system and the degree of consensus was evaluated using an independent expert-analysis.

Results

A total of 26 articles, published between 2001 and 2024, were included in the literature search. Twenty-six recommendations were formulated. Outcomes emphasized the importance of thorough preoperative counseling, strategic implant site selection, well-considered surgical technique, and tailored postoperative management in reducing the incidence and severity of IPG-related issues. The level of evidence was low to moderate, while the degree of consensus was high for most of the recommendations proposed in this study.

Conclusions

Given the impact of IPG-related inconveniences, clear and practical recommendations are essential for consistent and effective neuromodulation practice.

Graphical Abstract