Pelvines intraoperatives Neuromonitoring – Update und Pilotstudie zum Telementoring

Zusammenfassung

Das pelvine intraoperative Neuromonitoring (pIONM) gewinnt zunehmend an Bedeutung als Instrument zur Verbesserung funktioneller Ergebnisse nach Rektumchirurgie. Diese Arbeit fasst aktuelle Erkenntnisse zum pIONM zusammen, darunter Ergebnisse der multizentrischen, randomisierten NEUROS-Studie, die signifikante Vorteile für urogenitale und ano-(neo-)rektale Funktionen belegt. Zudem wird die Rolle des Telementorings als Schlüssel für die standardisierte Einführung des robotisch assistierten pIONM untersucht. Eine Pilotserie demonstriert bei drei Operationen den geringen kognitiven Aufwand für Chirurgen während des telemedizinisch unterstützten Monitorings, gemessen mittels NASA-TLX-Fragebogen (TLX-Score Spannweite von 5.0 bis 24.3). Die Ergebnisse unterstreichen das Potenzial des pIONM, Nervenverletzungen zu vermeiden und die Lebensqualität von Patienten zu steigern, während Telementoring die Verbreitung der Methode erleichtern könnte.

Abstract

Pelvic intraoperative neuromonitoring (pIONM) is emerging as a key tool to enhance functional outcomes following rectal cancer surgery. This paper synthesizes current evidence on pIONM, including findings from the multicenter, randomized NEUROS trial, which demonstrated significant benefits for urinary, sexual, and ano-(neo-)rectal functions. Additionally, the role of telementoring as a catalyst for standardized robotic assisted pIONM adoption is explored. Three case studies illustrate the low cognitive burden on surgeons during telemedicine-assisted monitoring, assessed via the NASA-TLX questionnaire (TLX-score varied from 5.0 to 24.3). The results highlight pIONM’s potential to prevent nerve damage and improve patient quality of life, with telementoring poised to facilitate broader implementation.

Schlüsselwörter

pelvines Neuromonitoring - Rektumkarzinom - Telemonitoring - funktionelle Ergebnisse - chirurgische Weiterbildung

Keywords

pelvic neuromonitoring - rectal cancer - telementoring - functional outcomes - surgical education

Publication History

Received: 17 April 2025

Accepted after revision: 12 June 2025

Article published online:
08 August 2025

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