2. Mark a tunneling route from the location of the IPG pocket to the incision superior to the ear
near the Lead Boots.
3. Administer appropriate local anesthetic along the tunneling route.
Caution: Be careful not to puncture or damage the DBS Lead or other components when
administering the local anesthetic.
4. If desired, bend the Tunneling Tool to an appropriate shape.
Caution: Do not bend locking joints.
5. Create a subcutaneous tunnel from the incision above the ear, along the tunneling path to the
IPG pocket.
6
Be careful not to puncture or damage important structures along the tunneling
Warning:
path, such as the brachial plexus and jugular vein, as this may cause patient
harm.
6. Once the tip of the Tunneling Tool is completely exposed, unscrew and remove the handle of
the Tunneling Tool (Figure 28).
Figure 28. Removing the Handle of the Tunneling Tool
7. Grasp the tip of the Tunneling Tool firmly with one hand and, while holding the Straw in place
with the other hand, pull the Shaft out of the Straw.
8. Push the proximal ends of the Lead Extension(s) through the Straw, then withdraw the Straw.
9. Withdraw the Tunneling Tool Straw.
10. Optional: Secure the Lead Extension Connector to the fascia using Sutures and/or Suture
Sleeves.
Caution: Do not use polypropylene Sutures as they may damage the Suture Sleeve. Do not
suture directly onto the Lead Extension or use a hemostat on the body of the Lead
Extension. This may damage the insulation of the Lead Extension.
6 Tunneling has been tested utilizing 46 cm, 61 cm, and 70 cm Integra Reusable Peritoneal Shunt Introducers
(models 901218, 901224, 9MD270) with Replacement Peritoneal Shunt Sheaths (models 901118, 901124,
9MN170). Data on file.
Implanting the DBS System
Surgical Implant Manual
92495783-02
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