9
NOTE: Common sites for IPG implantation are along the midaxillary line, in the upper
buttock along the posterior axillary line (taking care to avoid the belt line), and in the area
over the abdomen just below the lowermost rib. To ensure a flat area is selected, you can
mark a flat area prior to the surgical procedure while the patient is in a sitting position.
CAUTION: Do not place the IPG deeper than 4.0 cm (1.57 in) because the clinician
programmer may not communicate effectively with the IPG.
2.
Create the pocket so that the IPG is parallel to the skin surface and no deeper than 4.0 cm
(1.57 in) below the skin surface.
3.
Insert and remove the pocket sizer to ensure that the pocket is large enough to
accommodate the IPG, allowing enough extra room for a strain relief loop for each lead or
extension.
Connecting a Lead or Extension to the IPG
The following steps outline the suggested guidelines to connect a lead or extension to the IPG:
WARNING: To avoid harming the patient or damaging the neurostimulation system,
ensure that any electrosurgery procedures are completed before connecting the leads
or extensions to the IPG.
CAUTION: Do not connect a lead or extension with body fluid or saline residue on its
contacts because corrosion can occur and cause failure of the system.
1.
If any of the lead or extension contacts came in contact with body fluid or saline, thoroughly
clean the contacts with sterile deionized water or sterile water for irrigation and dry them
completely.
2.
To help ensure that the lead or extension can be fully inserted into the IPG header, insert the
torque wrench through the septum on the IPG header, turn the torque wrench clockwise to
tighten the setscrew until the torque wrench clicks, and then loosen the setscrew again by
turning the wrench counterclockwise about 2.5 times.
CAUTION: Use only the torque wrench included in the extension, IPG, or torque
wrench kit. If you need to loosen the setscrew, turn the setscrew (in quarter turns
counterclockwise) just enough to insert or remove the lead or extension from the IPG
header. Retracting the setscrew too far may cause it to come loose and fail to secure
the lead or extension to the IPG.
CAUTION: To avoid sharply bending and damaging the lead or extension when
performing the following step, insert the lead or extension parallel with the header port.
Additionally, try grasping the lead or extension about 5 mm at a time from the opening
of the header port while inserting.
3.
Using clean gloves, carefully slide the proximal end of the lead or extension into the IPG
header until it stops. Confirm that the lead or extension is correctly inserted by following
these visual indicators and referring to the corresponding figures that follow:
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For IPGs that connect to Abbott Medical leads or extensions, the first contact band (at
the tip) of the lead or extension extends slightly past the first header contact and is
visible, the windows between each of the header contacts are clear, and the ninth
contact band of the lead or extension is not visible.
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For IPGs with compatible headers, the windows between each of the header contacts
are clear and none of the contact bands are visible.