Revision sheet

Sacral neuromodulation: S3 lead placement

6 steps, each one the authored title and caption from the interactive animation, with the frame captured from that step. Read it before the case, or print it and work through the steps in order.

Teaching only, not for diagnosis or treatment decisions. The text on this sheet is the animation's own step copy, reproduced verbatim.

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UrOops3D · UroRef · © Nity G

  1. 01

    Surface landmarks

    Sacral neuromodulation: S3 lead placement. Step 1: Surface landmarks. Captured frame from the interactive animation.
    • The S3 foramen sits approximately 2 cm lateral to the sacral midline, at the level of the sacroiliac joints and the upper border of the greater sciatic notch.
    • Marks are placed bilaterally before draping.
  2. 02

    Needle insertion at S3

    Sacral neuromodulation: S3 lead placement. Step 2: Needle insertion at S3. Captured frame from the interactive animation.
    • The foramen needle enters the mark and advances along the foramen axis, angled anteriorly and laterally 45 to 60 degrees, to lie beside the S3 root.
  3. 03

    Test stimulation

    Sacral neuromodulation: S3 lead placement. Step 3: Test stimulation. Captured frame from the interactive animation.
    • S3 is the preferred target: look for pelvic-floor bellows with plantar flexion of the first and second toes and an appropriate sensory response when it can be reported.
    • S2 produces outward leg or foot rotation; S4 produces bellows without a toe response and may be appropriate in selected cases.
  4. 04

    Lead placement

    Sacral neuromodulation: S3 lead placement. Step 4: Lead placement. Captured frame from the interactive animation.
    • Pass a directional guide through the tested needle, exchange the needle for the dilator and introducer sheath, then insert and test the tined lead.
    • Hold the final lead position while the sheath and stylet withdraw so the tines deploy in tissue.
  5. 05

    Stage 1 trial

    Sacral neuromodulation: S3 lead placement. Step 5: Stage 1 trial. Captured frame from the interactive animation.
    • For the advanced staged trial, the tined lead and its connection remain buried.
    • A separate percutaneous extension is tunnelled to a remote exit and connected to the external trial stimulator; the symptom diary decides success.
  6. 06

    Stage 2 pocket

    Sacral neuromodulation: S3 lead placement. Step 6: Stage 2 pocket. Captured frame from the interactive animation.
    • When the trial succeeds, the permanent implantable pulse generator sits in a subcutaneous pocket in the upper buttock, clear of the belt line and bony prominences, and the lead is tunnelled to it.

Derived from SnmScene.tsx at build time: every step title and caption above is the authored ProcedureDef text, reproduced verbatim, and this page shares its readable-points renderer with the animation itself. 6 of 6 steps have a captured frame.

Text fingerprint e58588958432696a. A caption edit without a re-capture fails the production check, so the sheet and the animation cannot drift apart silently.