Medtronic launches intraoperative nerve integrity monitors for surgeons

9 October 2009

Medtronic (NYSE: MDT) has launched the NIM-Response 3.0 and NIM-Neuro 3.0 intraoperative nerve integrity monitors designed for a variety of surgeons, including ear, nose, and throat (ENT); endocrine; general; and peripheral surgeons.

During minimally invasive or traditional open surgery, Medtronic’s Nerve Integrity Monitor (NIM) systems enable surgeons to identify and confirm motor nerve function and monitor major motor nerves throughout the body, such as cranial nerves in a patient’s head, face and neck.

If there is a change in nerve function, the NIM system provides visual and audible warnings to alert the surgeon and operating room staff. This helps reduce the risk of nerve damage during surgery, improving safety and peace-of-mind for patients and surgeons.

“Medtronic has 20 years of innovation, experience and leadership in nerve monitoring combining our experience with that of our customers,” said Carla Pagotto, product manager for Intraoperative Monitoring with the Ear, Nose and Throat (ENT) division at Medtronic. “Our new NIM systems expand monitoring capabilities in the operating room to help improve patient safety. We bring exciting new features to our customers and make the systems significantly easier to use with redesigned software.”

The NIM 3.0 systems fully enable:

•  Simultaneous monitoring during bipolar cautery;
•  Artifact detection software that distinguishes artifacts (false signals) from true nerve signals;
•  Stim Bur technology that combines stimulation with Medtronic’s electric Visao® High-Speed Otologic Drill;
•  Real-time continuous monitoring of nerve function via APS™ (Automatic Periodic Stimulation) that provides early warning of a change in nerve function.

With completely redesigned software, the new NIM 3.0 systems are easier to use and more convenient for the operating room than prior models. Users can navigate easily and quickly between three simple modes: Setup, Monitoring and Reports, and use default or custom settings. In addition, the new systems include multiple reporting options that can be easily saved for patient records.

The NIM-Response 3.0 monitors up to four channels of nerve-muscle combinations at a time and is frequently used in skull-based and head and neck procedures. With the NIM-Neuro 3.0, neurotologists and neurosurgeons can monitor up to eight channels of nerve-muscle combinations during complex and delicate surgeries, such as glomus tumor removals. In the future, Medtronic expects a new microscope overlay for the NIM-Neuro 3.0 will help bring monitoring within the surgical field by importing the NIM signal through a high-end microscope as the surgeon operates.

Nerve injury during ENT, head and neck surgery, and other surgery

By stimulating and directing all voluntary muscular movement, motor nerves perform a critical function. Cranial motor nerves from the brain control muscles in the head, face, and neck. At times, these nerves are hard to identify during surgery due to disease, a previous operation, or normal anatomical variations.

Patients can suffer temporary or permanent damage if a nerve is irritated or injured. For example, during skull-based surgery, the facial nerve is commonly exposed and at risk for injury. Since this nerve controls all movements and expressions of the face, damaging this nerve can have devastating physical and emotional results.

Sometimes minor irritation or stretching of the facial nerve can lead to temporary or permanent symptoms of nerve damage, such as facial weakness, numbness, or twitching. Severing the facial nerve, although rare, causes facial paralysis that resembles the effects of a stroke.

Similarly, the recurrent laryngeal nerve, a branch of the vagus nerve, is one of the nerves at risk during neck dissections, including thyroid surgery. Damaging this nerve can severely impact an individual’s ability to speak, swallow, and aspirate.

Medtronic’s NIM system helps surgeons locate and identify the nerve, monitor and control manipulation effects on the nerve, and confirm nerve integrity prior to completing the surgery.

“We are very excited about the launch of our new NIM systems and expanding nerve monitoring to more patients and applications,” said Bob Blankemeyer, president of the Surgical Technologies business and senior vice president at Medtronic.

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