• Vyacheslav Makler, Erin D'Agostino, and David F Bauer.
• Section of Neurological Surgery, Department of Surgery, Dartmouth-Hitchcock Medical Center, Lebanon. Electronic address: vyacheslav.i.makler@hitchcock.org.
• World Neurosurg. 2018 Sep 1; 117: 377-381.

BackgroundVagal nerve stimulators (VNs) have been in use in the United States since the 1990s as a palliative treatment option for drug-resistant epilepsy. Over time, the electrode coils wrapped around the vagus nerve become encapsulated by extensive scar tissue, making complete electrode removal challenging. We present a case series of lead revision surgeries with a unique way to remove the scar tissue around the vagus nerve, demonstrating a technique for complete electrode removal.MethodsThis was a case series of 9 consecutive patients who underwent complete removal of an existing VNs electrode using needle tip monopolar electrocautery.ResultsComplete removal of the entire VNs electrode array was achieved in all patients with no permanent complications seen at postoperative follow-up at 3 months.ConclusionsComplete VNs electrode array removal can be safely achieved by using needle tip monopolar electrocautery.Copyright © 2018 Elsevier Inc. All rights reserved.

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