Sacral neuromodulation update in 2024: Insights from the ICS workshop 2023

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Purpose:This review is based on the International Continence Society (ICS) Workshop on Hands-On Sacral Neuromodulation (SNM)- Ideal Lead Placement presented at the Annual Congress in 2023. This workshop briefly reviewed appropriate patient selection, focused most of the time on hands on skills to teach appropriate needle and lead placement techniques. Six very experienced experts worked with attendees on lifelike models to teach them how to achieve lead placement efficiently and appropriately. Tips and tricks for getting the best responses were reviewed. Materials and methods: The review follows the structure adopted by workshop, where SNM-Ideal Lead Placement is discussed in four sections: main/extended indications and ideal patient profile, sacral neuromodulation techniques included basic evaluation (PNE), advanced evaluation, ideal lead placement and novel technology. Results:The learning objectives were achieved at the end of the workshop. These were: understanding the role of sacral neuromodulation, recognize the latest technological developments, their clinical implications and getting the best outcome with SNM, stress the importance of patient selection process and current SNM indications, reviewing standard surgical technique for optimal lead placement and gain understanding of choices for recharge versus fixed battery (as well as use in neurological disease). Conclusions:Hands-on training workshops on sacral neuromodulation is efficient training modules to ensure learning objectives for participants. Accurate needle/temporary lead placement, lead placement with permanent lead, smart programming with programmers are the main parts of hands-on training session with using realistic phantom and 3D printed models in workshop.