Fifteen years of sacral nerve stimulation: from an open procedure to a minimally invasive technique

Aim This historical review describes the development of InterStim (TM) therapy from an open procedure to a minimally invasive technique for the treatment of pelvic floor disorders. The latest technological and surgical evaluations of sacral nerve stimulation (SNS) are presented with their impact on the therapy's success and safety. Method A search for relevant literature on SNS in the PubMed database was carried out for this review, which focuses on technical modifications and related clinical outcomes. Results InterStim (TM) therapy for faecal incontinence was introduced in Europe in 1995. Since its introduction, technical improvements in devices and leads have progressed SNS from an open one-stage procedure to a minimally invasive two-stage technique. A smaller neurostimulator and particularly the new tined lead allow InterStim (TM) therapy to be performed under local anaesthesia and in an outpatient setting. Additionally, the use of the self-anchoring tined lead has reduced the number of technical failures and improved the test phase significantly, from 60% to 80%. The new smaller-in-size neurostimulator facilitates the implant procedure and further improves patient comfort. Conclusion By using new technical achievements over the past 15 years, InterStim (TM) therapy has become a highly effective and safe procedure for selected patients with faecal incontinence.