Name of the Procedure:

Microporous Collagen Implantable Tube (NeuraGen Nerve Guide), per centimeter length

Summary

In layman's terms, this procedure involves implanting a small, tube-shaped device made of a special substance called microporous collagen to help repair damaged nerves.

Purpose

This procedure is designed to address nerve damage, particularly in peripheral nerves. It aims to provide a scaffold that supports and guides the growth of new nerve cells, helping to restore function and reduce pain or loss of sensation associated with nerve injuries.

Indications

• Peripheral nerve injuries or gaps
• Symptoms like numbness, tingling, or muscle weakness due to nerve damage
• Patients who qualify include those with nerve damage from trauma, surgery, or certain medical conditions.

Preparation

• Pre-procedure instructions: Patients may need to fast for several hours before the procedure if anesthesia is used.
• Medication adjustments: Some medications may need to be paused temporarily.
• Diagnostic tests: Prior to the procedure, patients might undergo imaging studies like MRI or nerve conduction studies to assess the extent and location of nerve damage.

Procedure Description

1. After administering appropriate anesthesia, the surgeon makes an incision at the site of the nerve injury.
2. The damaged nerve ends are prepared, and the microporous collagen tube is cut to the appropriate length.
3. The tube is then carefully positioned around the nerve ends, creating a bridge.
4. The incision is closed and dressed.

Tools and Equipment:

• Microporous collagen tube (NeuraGen Nerve Guide)
• Surgical instruments for incision and suturing
• Anesthesia equipment

Anesthesia:

• Local, regional, or general anesthesia, depending on the extent and location of the nerve damage.

Duration

The procedure typically lasts between 1 to 2 hours, but the exact time can vary based on the complexity of the nerve injury.

Setting

The procedure is usually performed in a hospital or a specialized surgical center.

Personnel

• Surgeon specializing in nerve repair
• Surgical nurses
• Anesthesiologist or nurse anesthetist

Risks and Complications

• Common risks: Infection, bleeding, and scarring
• Rare risks: Implant rejection, incomplete nerve regeneration, and allergic reactions to materials used
• Complications management involves antibiotics for infections and further surgical interventions if necessary.

Benefits

• Promotes the regeneration of damaged nerves
• Potential restoration of sensation and motor function
• Pain reduction and improved quality of life

Recovery

• Patients might need to keep the surgical site clean and dry.
• Post-procedure care includes follow-up appointments to monitor healing.
• Expected recovery time varies; full nerve regeneration might take several months.
• Restrictions could include limited use of the affected area to allow proper healing.

Alternatives

• Direct nerve repair (neurorrhaphy)
• Nerve grafting
• Pros: Direct repair or grafting might be more suitable for certain types of nerve injuries.
• Cons: These alternatives can be more invasive and might have different recovery times and success rates.

Patient Experience

• During the procedure: Patients won't feel pain if anesthesia is properly administered.
• After the procedure: Some discomfort, managed with pain medications, and a feeling of numbness or tingling as the nerve starts to regenerate.
• Comfort measures include pain management plans and guidance on mobility and daily activities.