Universal Compatibility In Intraoperative Neuromonitoring Devices: A Comprehensive Clinical Assessment

EMG Tube Electrodes: reliable and cost-effective RLN monitoring devices that are universally compatible.

December 1, 2021

Universal Intraoperative Neuromonitoring

The Importance of Universal Intraoperative Neuromonitoring

As surgical techniques continue to advance and integrate innovative procedures, there is a growing demand for intraoperative neuromonitoring (IONM) products. These products are designed to identify and monitor vital nerves in real time during surgery, minimizing the risk of nerve damage. Neurovision Medical Products (NMP) has been a pioneer in the field of intraoperative neuromonitoring (IONM) since 1973, with a strong focus on creating innovative products that are universally compatible. NMP's product innovation ranges from commercializing atraumatic laryngeal electrodes to integrating standard ET Tubes with patented atraumatic EMG electrodes to create universal IONM products. Through their commitment to creating technology that can be used interchangeably and universally, hospitals and surgeons are not constrained by a "one brand only" product monopoly. With the ability to interchange technology between brands, hospitals, and surgeons are no longer constrained to a single product. The reliability and superiority of NMP products are evident in the experiences of clinicians who work with them every day. In this blog post, we'll discuss the latest advancements in medical device interoperability and NMP's commitment to patient safety and surgeon needs.

Expert Opinion on NMP IONM Products: A Comparative Study on Functionality and Compatibility in the Operating Room

Universal Compatibility Intraoperative Neuromonitoring Surgical Devices, EMG Electrodes for Thyroid Surgery
EMG Electrodes, Cobra and Dragonfly, RLN Monitoring are Universal Neuromonitoring Surgical Devices

Meet Mike Demarco, R. EP T., CNIM, an exceptional clinician with over 30 years of experience in intraoperative neuromonitoring and neuro-diagnostic healthcare. Over the course of his career, Mr. Demarco has monitored more than 6,000 procedures and has worked at some of the most distinguished medical centers in the country, including Cedars Sinai Medical Center.

As a seasoned neurophysiologist, Mr. Demarco has firsthand experience with many different intraoperative nerve monitoring products, and he has found Neurovision Medical Products EMG electrodes and IONM surgical devices to be superior in function and compatibility. In fact, he recently participated in a study that highlighted how the universal design of NMP products is easy to use, reliable, and safe for nerve monitoring uring surgical procedures.

Mr. Demarco's testament to Neurovision's IONM products speaks volumes to their quality and effectiveness in the operating room. As an experienced clinician with over 30 years of practice in nerve monitoring and neuro-diagnostic healthcare, his expert opinion carries weight. When it comes to intraoperative neuromonitoring, it's crucial to trust the advice of experienced professionals like Mr. Demarco. Neurovision Medical Products delivers proven and effective IONM devices that meet the needs of surgeons, with confidence in the quality and effectiveness of our products.

Importance of Interoperability in Medical Devices: Clinical Insights, IONM with Universal EMG Electrodes 

Mr. Demarco's positive assessment of Neurovision Medical Products' IONM solutions is further supported by his observations of their seamless integration into his clinical routine in the operating room. Specifically, he notes that using the Cobra ET Tube or any other NMP device did not require any updates to his current practices. He also commends NMP's innovative technology for its exceptional performance alongside other intraoperative neuromonitoring machines, including the Cadwell Cascade and the Medtronic Nerve Integrity Monitor (NIM) 2.0. He even has over a decade of experience with intermittent use of Medtronic NIM Spine and some minor experience with Medtronic NIM 3.0.

It is worth noting that interoperability between medical device platforms and accessories is not uncommon in other clinical modalities, such as electrosurgery and laser probes. These devices may be produced by different manufacturers than the primary platform vendor, yet still integrate seamlessly with the system. Bausch and Lomb (Synergetics) and Alcon (Infinitec) are examples of companies that have successfully demonstrated universal interoperability with HGM and Coherent lasers, respectively. The universal compatibility of Neurovision Medical Products' IONM devices is consistent with Mr. Demarco's experiences and those of other clinicians who have used their devices and accessories across various nerve monitoring systems.

Read The Full Case Study

The atraumatic electrodes were safe and effective on any platform and provided optimal ET tube placement for reliable RLN nerve monitoring”

– Mike Demarco, R. EP T., CNIM. (2019)

Cobra 3-Plate EMG Tube, NMP Continues Their Legacy In Universal Compatibility

Neurovision Medical Products' commitment to patient safety and surgeon needs is evident in the constant upgrades and advancements in IONM technology. One of the recent upgrades is the Cobra 3-Plate EMG ET Tube, which is part of the Cobra EMG electrodes used by Mr. Demarco. This redesigned EMG tube is equipped with color-coded wires that identify the lateral and posterior plates, and it features an increased surface area for improved contact with the vocal cords, even in longer airways or larger patients.

The Cobra 3-Plate EMG tube is available in sizes 6, 7, and 8 mm and offers the same functional abilities as an ET Tube with integrated IONM technology to lower the risk of nerve damage and elevate surgeon capabilities. The Cobra 3 Plate is a universal design with proven compatibility with the most common single-channel and multi-channel nerve monitoring systems, making it a versatile and reliable tool in the operating room. With these advancements, NMP continues to lead the way in IONM EMG electrode technology, providing clinicians with innovative tools to improve patient outcomes.

  1. Schneider R, Randolph GW, Dionigi G, et al. International neural monitoring study group guideline 2018 part I: Staging bilateral thyroid surgery with monitoring loss of signal. Laryngoscope 2018;128 Suppl 3:S1-17. [Crossref] [PubMed]


Universal EMG electrode for intraoperative neuromonitoring of the vocal cords. Monitor RLN activity while maintaining an open airway for ventilation.