In the case of the Atrostim and Mark IV devices, several surgical techniques may be used. Surgery is generally achieved by way of setting an electrode across the phrenic nerve, both inside the neck (i.E., cervically; an older method), or in the chest (i.E., thoracically; more present day). This electrode is attached to a radiofrequency receiver that’s implanted just below the skin. An outside transmitter sends radio alerts to the device by an antenna which is worn over the receiver. For the cervical surgical technique, the phrenic nerve is approached via a small (~5 cm) incision slightly above, and midline to, the clavic. The phrenic nerve is then isolated under the scalenus anticus muscle. For the thoracic surgical technique, a small (~5 cm) incisions over the 2nd or 3rd intercostal area. The electrodes are positioned across the phrenic nerves alongside the pericardium. Use of a thorascope permits for this technique to be executed in a minimally-invasive manner.
In the case of the NeuRx device, a sequence of four incisions are made in the abdominal pores and skin. Several equipment which include a laparoscope and probe are used to locate the first-rate 4 locations on the diaphragm to connect four electrodes, that have connections outside the body. A 5th electrode is placed simply under the skin within the same vicinity. All those connect to the device.