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J Thorac Cardiovasc Surg 2003;126:582-583
© 2003 The American Association for Thoracic Surgery

Brief communication

Endoscopic, robotically assisted implantation of phrenic pacemakers

^a Department of Surgery, Division of Cardiothoracic Surgery,, College of Physicians and Surgeons, Columbia University, New York, NY, USA
^b Department of Surgery, College of Physicians and Surgeons, Columbia University, New York, NY, USA

Received for publication December 11, 2002; revisions received December 30, 2002; revisions received January 16, 2003; accepted for publication February 11, 2003.

^* Address for reprints: Jeffrey A. Morgan, MD, Columbia University, College of Physicians and Surgeons, 177 Fort Washington Ave, Room 17-415, New York, NY 10032, USA
Jm2240@columbia.edu

The first 20% of the full text of this article appears below.

Diaphragmatic pacing is a technique that was pioneered by Dr William Glenn, who began clinical experiments in 1966 and reported his experience in 1968.¹ It is most commonly performed for patients with quadriplegia and central alveolar hypoventilation. Phrenic pacing can eliminate the requirement for ventilatory support.^2,3 Other indications include intractable hiccups (singultus) and phrenic nerve injury.

This procedure is typically performed with an open technique through a cervical approach requiring multiple neck incisions, a thoracic approach requiring multiple bilateral 5- to 7-cm anterior thoracotomy incisions, or a sternotomy.⁴ An endoscopic approach minimizes the number and size of incisions to three 1-cm incisions. In the thorax, the phrenic nerve is a continuous single trunk. With a thoracic approach, full potential of phrenic nerve stimulation can be achieved.

Patients and methods

During the course of 1 year, 6 patients underwent implantation of phrenic nerve pacemakers (Avery Laboratories, Dobelle Institute, Commack, NY) through an endoscopic approach with robotic assistance. Mean age was 40.2 ± 24.2 years (range 16-81 years), with 3 male and 3 female patients. The indications were quadriplegia . . . [Full Text of this Article]

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