This was explanted and a new prime advanced generator was prepared. The pouch housing the existing generator was entered. A wide area of the right lateral flank region surrounding her existing scar was prepped and draped in standard fashion and infiltrated with 0.5% Marcaine with 1:200,000 epinephrine. Sedation was induced and a dose of IV antibiotics was administered. The patient was brought to the operating room and positioned on the table in the left lateral decubitus position. PROCEDURE IN BRIEF: After extensive preoperative counseling, informed consent was obtained. On this basis, revision of the device was offered and accepted. The device was interrogated approximately a week prior to this procedure and no telemetry was obtained, indicating a breakdown of the battery. Her current device has a complication in which it began malfunctioning approximately a month prior to this procedure and she has gradually noticed declining effectiveness. INDICATIONS: This woman has a dorsal column stimulator in place and has benefited from the therapy. IMPLANTS: Medtronics prime advanced nonreconstructable generator. ESTIMATED BLOOD LOSS: Less than 5 ml SPECIMENS: None. ATTENDING: John Smith, MD ANESTHESIA: Monitored anesthetic coverage with local. PROCEDURE PERFORMED: Replacement of dorsal column stimulator generator. POSTOPERATIVE DIAGNOSIS: Dorsal column stimulator generator malfunction. CASE 6 PREOPERATIVE DIAGNOSIS: Dorsal column stimulator generator malfunction.
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