BONEBRIDGE BCI 602 Implant Surgery | MED-EL — Transcript

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1. 0:00Medel BCI 602 implantation.
2. 0:05The following medical illustrations are
3. 0:07for demonstration purposes only and can
4. 0:09differ from a patient's individual
5. 0:11anatomy.
6. 0:13Please refer to the Bonebridge BCI 602
7. 0:16surgical guide for more information.
8. 0:19BCI 602 implant kit and BCI 602 sizer
9. 0:24kit.
10. 0:26The BCI 602 implant kit consists of
11. 0:29several parts. There's the BCI 602
12. 0:32implant itself, which comprises of a
13. 0:34holding magnet, the receiver coil, and
14. 0:37the transducer, known as the BCFMT.
15. 0:41Two regular self-drilling cortical
16. 0:43screws and one emergency screw, which is
17. 0:46slightly bigger in diameter, are
18. 0:48delivered with the implant to fix it to
19. 0:50the bone.
20. 0:51A single-use surgical screwdriver for
21. 0:53tightening the screws is also part of
22. 0:55the kit.
23. 0:58The BCI 602 sizer kit consists of three
24. 1:01parts.
25. 1:03The footprint sizer, which represents
26. 1:05the footprint of the whole implant,
27. 1:07the transducer sizer, which is used to
28. 1:10drill the bone bed for the BCFMT,
29. 1:13and the handle, which ensures easy
30. 1:15handling of the sizers.
31. 1:18Preparation and incision.
32. 1:22Once the area is sterile, place the
33. 1:24footprint sizer behind the ear.
34. 1:27The best position for the coil section
35. 1:29of the implant is posterior and superior
36. 1:32to the ear canal, angled at
37. 1:34approximately 45°.
38. 1:37Mark the correct position of the implant
39. 1:39on the skin around the rim of the
40. 1:41footprint sizer.
41. 1:47Mark the incision at least 5 mm away
42. 1:50from the desired implant position to
43. 1:52minimize the risk of device extrusion.
44. 1:55Create an incision behind the pinna.
45. 1:59Preparing the periosteal pocket.
46. 2:03Using the footprint, prepare a tight
47. 2:05periosteal pocket to accommodate the
48. 2:07coil section of the BCI 602.
49. 2:12Check the size and position of the
50. 2:13periosteal pocket with a footprint
51. 2:15sizer.
52. 2:19For proper signal transmission and
53. 2:21fixation of the audio processor, the
54. 2:23flap must not exceed a thickness of 7
55. 2:25mm.
56. 2:27Evaluate the thickness of the flap over
57. 2:29the coil section, for example, by using
58. 2:32the skin flap gauge 7.
59. 2:36Creating the bone bed.
60. 2:38The BCFMT is the only part of the
61. 2:41implant which needs a bone bed.
62. 2:44To recess the whole BCFMT,
63. 2:46a drilling depth of 4.5 mm is required.
64. 2:51The two standard screws delivered with
65. 2:53the implant are 5 mm in length and 1.6
66. 2:56mm in diameter.
67. 2:59When fixing the implant, they won't
68. 3:01penetrate the bone deeper than the
69. 3:03transducer of the implant.
70. 3:06Attach the handle to the transducer
71. 3:08sizer.
72. 3:13And use it to mark the position of the
73. 3:15BCFMT on the skull.
74. 3:22Drilling is performed with standard
75. 3:24autologic burs.
76. 3:26While drilling, use the transducer sizer
77. 3:29together with a handle to check whether
78. 3:31sufficient bone has been removed.
79. 3:34When the transducer sizer can be placed
80. 3:36fully into the bone bed, the drilling is
81. 3:39sufficient.
82. 3:41Once the required depth has been
83. 3:43drilled, check whether the screw wings
84. 3:45are in flat contact with bone.
85. 3:49This is done by connecting the
86. 3:50transducer sizer to the footprint-sizer
87. 3:53and handle.
88. 3:55For easy handling,
89. 3:56the entire tool can be held like this.
90. 4:01A surgical needle is used to check flat
91. 4:03contact to the bone.
92. 4:06Fixation of the BCI 602.
93. 4:10Remove the implant from its sterile
94. 4:12package and place it in the surgical
95. 4:14field.
96. 4:16If BCI 602 lifts are being used, attach
97. 4:19them to the implant now by pushing them
98. 4:21onto the fixation wings.
99. 4:24For optimal coil positioning, the
100. 4:26implant can be bent at its transition.
101. 4:32In a horizontal plane, it is possible to
102. 4:35bend it plus or minus 90°
103. 4:37and in a vertical plane, minus 30°.
104. 4:43First, insert the coil section of the
105. 4:45implant under the skin and place the
106. 4:47BCFMT in the prepared bone bed.
107. 4:52Use the two self-drilling cortical
108. 4:54screws and the single-use surgical
109. 4:56screwdriver to fix the BCFMT to the
110. 4:59skull bone.
111. 5:01Initially, tighten both screws loosely.
112. 5:07Then, fully countersink them to properly
113. 5:09secure the implant.
114. 5:12Closure.
115. 5:14Before closing the wound in layers,
116. 5:17palpate the BCFMT to ensure it is fixed
117. 5:20properly.
118. 5:21Then, close the wound and apply a wound
119. 5:24dressing.