Surgical Procedures 48
RNS
®
System User Manual
13. Select the desired amplifier (sensing) channels on the MONTAGE tab (under CONFIGURE
SETTINGS) of the programmer. Program the information into the neurostimulator.
14. View real-time ECoG signals on the R
EAL-TIME ECOGS tab (under REVIEW DATA tab) and
measure lead impedance(s) (under M
EASUREMENTS tab) to ensure proper connection
between the neurostimulator and the leads. An acceptable range for lead impedance is
250 - 3500 ohms.
15. If impedance measurements are abnormal or real-time ECoG signals are not adequate,
remove the connector cover and flush the connector area. Fully reinsert the leads into the
connector cover and repeat the impedance measurements. Refer to the Troubleshooting
section if impedance measurements remain abnormal.
16. Use the lead caps (provided) to cap the proximal ends of any unconnected leads. Secure the
lead caps with a suture if desired.
17. Situate all capped, unconnected leads adjacent to the neurostimulator to facilitate easy
connection to the neurostimulator in the future.
18. Place any excess lead length in a sub-galeal pocket near the craniectomy away from the
incision line.
19. Close the incision.
20. After the incision closure, interrogate the neurostimulator again using the programmer.
Confirm that the impedance measurements and real-time ECoG signals are normal.
Note: It is common for the neurostimulator to reset if electrocautery is used near the
neurostimulator or leads. To recover from a neurostimulator reset, perform the
following:
1. Document all error messages.
2. Proceed with the interrogation.
3. Go to the P
ROGRAM SETTINGS tab and select program.
4. Synchronize the programmer with PDMS (post-operatively).
5. If problems persist, refer to the Troubleshooting section of this manual.
REPLACING / EXPLANTING THE RNS
®
SYSTEM
When explanting any part of the RNS
®
System, the following disposal guidelines are suggested:
• Return the explanted neurostimulator to NeuroPace. Contact NeuroPace to obtain shipping
containers.
• Dispose of all product not returned to NeuroPace by adhering to local governing agency
recommendations.
• Do not incinerate or cremate the neurostimulator. Explosion may occur when exposed to
extreme heat.
Replacing the RNS
®
Neurostimulator with a New Neurostimulator
1. Using the programmer, disable detection and therapy.
2. Verify the position of the leads to avoid damaging the leads during incision. Verification can
be performed using prior x-ray or CT imaging.
3. Make an incision in the scalp at the incision line used for the initial neurostimulator implant.
Note: It is not necessary to explant the implanted ferrule when replacing the
neurostimulator; however, the ferrule clamp may be replaced.
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