The transition from training to clinical practice can be a difficult process. Dr. Stepan will discuss tips and tricks to help with a smooth transition into clinical practice. He will also discuss strategies for incorporating and increasing peripheral nerve volume in your practice.
Peripheral nerve surgery is inherently unpredictable. In this lecture, Dr. Miller will review how monopolar and bipolar intraoperative nerve stimulation can make facial nerve surgery more predictable. He will dive deeper into patient selection and surgical techniques for facial reanimation procedures introduced in Part I. Dr. Miller will discuss how to optimize outcomes in selective denervation (aka neurolysis), depressor anguli oris excision, free gracilis muscle transfer, cross-face nerve graft, and 5-7 nerve transfer.
Dr. Miller will review how monopolar nerve stimulation can facilitate safe nerve dissection in common facial plastic and head and neck procedures such as parotidectomy, facial nerve exploration, and deep plane facelift. He will review common facial reanimation procedures such as 5-7 nerve transfer, gracilis free tissue transfer, cross face nerve graft, and selective denervation (aka selective neurolysis). Dr. Miller will discuss the benefits of monopolar and bipolar nerve stimulation for each of these procedures.
This NERVE MASTER virtual lecture discussed Checkpoint Surgical’s newest products to support surgical decision making and improve clinical outcomes: CHECKPOINT GEMINI® Bipolar Nerve Stimulator and CHECKPOINT NEUROSHIELD® Chitosan Membrane. Dr. Shah reviewed his clinical applications of bipolar and monopolar nerve stimulation in peripheral nerve surgery, including fascicular identification during nerve transfers, brachial plexus, and nerve decompressions. Dr. Niedermeier discussed the benefits of chitosan for peripheral nerve injuries and review his clinical applications of Checkpoint NeuroShield, including nerve decompression and reconstruction.
This DECISION POINT discussed emerging concepts of intraoperative nerve assessment to support surgical decision making. Dr. Koehler reviewed the clinical use of the CHECKPOINT GUARDIAN™ and CHECKPOINT GEMINI™ nerve stimulators to support intraoperative nerve assessment. He also discussed clinical application of both monopolar and bipolar stimulation and the importance of isolated stimulation in peripheral nerve surgery.
RLN preservation is of critical importance in thyroid and parathyroid surgery. Functional assessment during thyroidectomy is frequently used to ensure RLN preservation. RLN EMG monitoring has become widely practiced but is associated with issues of technical complexity and reliability, including EMG Loss of Signal (LOS). Dr. Fahey will review a safe and reliable method for RLN functional assessment that can be used to verify false LOS with EMG monitoring or be adapted into routine practice. Adding this method into practice can enhance patient care and overcome technical hurdles associated with EMG monitoring in thyroidectomy surgery.
Thomas Freier, a foremost expert in the development of biomaterials and polymers for medical device applications, gives an overview of chitosan, a promising biomaterial in nerve repair surgery. The session reviews preclinical and clinical studies supporting chitosan’s use in nerve repair and other medical applications.
Until recently, the surgical techniques of amputation have not changed significantly since the Civil War era. Dr. Roubaud will review MD Anderson’s multidisciplinary approach and standard of care to manage post-amputation neuroma and phantom limb pain. Dr. Roubaud will discuss how the management of nerves with targeted muscle reinnervation (TMR) at the time of amputation improves pain outcomes and is becoming a new standard of care.
Nerve transfers have revolutionized the way surgeons treat peripheral nerve injuries in the upper extremity. In this presentation, Dr. Ko will discuss the use of intraoperative nerve stimulation to determine the use of end-to-end or reverse (supercharged) end-to-side nerve transfers to maximize motor outcomes in injuries from the shoulder to the fingertips.
Dr. Rhee reviews his experience and surgical techniques to manage upper motor neuron injuries as a result of brain and spinal cord injuries. The lecture includes a discussion of intraoperative motor nerve assessment utilizing nerve stimulation to enhance surgical outcomes. A live interactive question and answer session follows the prepared presentation.
Dr. Ian Valerio and Dr. Margaret Roubaud reviewed utilization of TMR in the oncologic patient for the reduction of post-amputation neuroma and phantom limb pain in major limb amputations. The presenters reviewed recent clinical data comparing TMR to standard practice (nerve relocation and bury into muscle) in the oncologic and trauma patient populations. Considerations for the utilization of TMR in the oncologic patient population, procedure overview and tips for getting started with TMR were discussed. The session concluded with an interactive question and answer session.
Dr. Jacques Hacquebord and Dr. Michael Barfield reviewed utilization of TMR in the vasculopathic patient for the reduction of post-amputation neuroma and phantom limb pain in major limb amputations. They reviewed recent clinical data comparing TMR to standard practice (nerve relocation and bury into muscle) in the trauma and oncologic patient populations. Considerations for the utilization of TMR in the vasculopathic patient population, procedure overview and tips for getting started with TMR were discussed. The session concluded with an interactive question and answer session.
Dr. Kyle Chepla reviewed his experience and techniques for optimizing outcomes after hand and upper extremity tendon transfers. The lecture included a review of the literature, patient evaluation, surgical planning and treatment, and clinical case studies. An interactive question and answer session followed the prepared presentation.
Drs. Eberlin, Loeffler and Echo present considerations for adding TMR to your surgical practice, including patient selection and education, assembling a care team, and immediate vs delayed TMR.