- 20 -
I
nsert
c
ylInders
AMS has preplaced a traction suture through the distal tip of each cylinder .
Depending on surgeon preference, either after or before inserting the cylinder
into the crus, complete the following steps:
1 . Use the Furlow Insertion Tool
(Figure 4-11)
and Keith Needle to help
introduce cylinders into the corpora cavernosa .
2 . Check function of Furlow Insertion Tool by withdrawing obturator to
locking groove, for the “retracted” position and then fully insert
obturator until tip appears at end .
Note: Lightning Bolt Keith Needles are included in the AMS 700 Accessory Kit.
3 . Withdraw obturator to “retracted” or “locked” position . Pass both ends
of cylinders traction suture (approximately 10 cm) through the eye of a
Lightning Bolt Keith Needle
(Figure 4-12)
.
4 . Load the blunt end of this needle into the Furlow Insertion Tool
(Figure 4-13)
and place suture into into slot of the tool .
5 . Completely retract suture into slot and fully draw needle into barrel of
tool .
6 . Hold the four strands of suture against the tool and insert tool into distal
portion of corporal body until front tip is beneath glans .
Note: It is imperative that patient’s penis is aligned symmetrically with his
body and that location of puncture through glans is satisfactorily identified
before pushing needle through glans. The Furlow Insertion Tool should be in
the ipsilateral corpora at the distal tip.
Note: If you cross over through the intro-cavernosal septum to contralateral
side, remove, place dilator into contralateral side and reposition cylinder on
ipsilateral side. No repair is necessary.
7 . Place the penis on a mild stretch; push needle through glans by fully
inserting obturator into barrel .
8 . Grasp needle with a needle holder or mosquito hemostat, and pull it
completely through glans .
9 . Detach the needle from suture, and remove it from the area to prevent
any accidental puncture of cylinders .
10 . Attach a tubing-covered hemostat to the traction sutures to prevent
inadvertent retraction through glans .
11 . Insert front tip of cylinder into the corporotomy .
12 . Gently push cylinder distally into place from the corporotomy .
Note: Use the traction suture to guide the cylinder until the front tip is placed
well under the glans. Take care not to twist cylinder as it is being placed.
13 . Carefully assess front tip position of cylinder beneath glans to verify
proper cylinder placement .
Note: Take care to leave the traction suture in place through the glans to
allow the cylinder to be repositioned. If repositioning or more dilation is
required, the cylinder should simply be pulled out of corporal body.
Figure 4-11. Furlow Insertion Tool
Figure 4-13. Load Keith Needle
Figure 4-12. Insert Traction Suture into
Keith Needle
Surgical Procedures
(continued)