Needle Placement And Test Stimulation - Axonics 1201 Mode D'emploi

11. Arrange sterile drapes to allow visualization of the pelvic floor to verify an appropriate motor response to
stimulation.
12. Ensure that the motor response of the toes and/or soles of the feet can also be observed.

Needle placement and test stimulation

Needle placement adjacent to the sacral nerve is assisted by anatomical landmarks and/or fluoroscopy and confirmed
using test stimulation
Note: For instructions on using the CP, refer to the Axonics Clinician Programmer Manual.
1. Using bony landmarks and/or fluoroscopy to guide placement, insert a foramen needle into the sacral foramen
with an approximate 60-degree insertion angle relative to the skin.
Notes: The foramen needle has depth markings to aid in needle placement. The depth markings are 1 cm apart.
2. Place the needle into the foramen at an approximate 60-degree angle to the bony surface. The nerve lies
along the superior-medial aspect of the foramen (Figure 7).
Caution: The number of needle insertions into the foramen and the implant depth should be limited. Stop the
needle insertion at the point where the desired stimulation response usually occurs, usually about 2.5 to 4.0 cm (1.0
to 1.5 in) in depth. The needle tip should be at the anterior surface of the sacral foramen for initial stimulation. A low
opening threshold of less than 2 mA indicates close proximity to the nerve and this threshold should be the goal for
initial needle placement.
3. Attach the clip end of the needle test stimulation cable to the non-insulated section of the foramen needle
(just below hub and above the triple dash mark on the foramen needle) (Figure 8).
Figure 8. Connect needle test stimulation cable to the foramen needle.
PROPOSED AXONICS FIGURE
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Figure 7. Insert the foramen needle at a 60-degree angle.
Figure 7: Insert needle into S3 foramen
PROPOSED AXONICS FIGURE
Figure 8: Connecting the foramen needle
Place mini-clip
above triple mark
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