Method of Use

Methods:
When the ureteral stent is inserted, the attached string should be left connected to the stent and a loop should be created in the string at the point where the string exits the urethra (see figure 1 & 2, videos below). This loop will self-retract into the urethra where it comes to rest in the bulbous urethra or anterior urethra and it is not symptomatic. At time of removal, after the instillation of an urethral anesthetic lubricant, the snare is passed into a man’s urethra until the bulbous portion. Rotating the snare, the loop at the end of the string is hooked by the snare and then gently pulled out (see figure 3). Occasionally more than one pass is required. If multiple passes do not allow the snare to hook the string loop, it is possible that that the loop could have retracted into the bladder and cystoscopic removal is required. In women, the hook of the snare may grab the string or the stent itself (see figure 4). If the snare misses, repeat passes, or US supervision can be used to locate the stent. In men who have a stent and a string was not left in place, cystoscopic removal is the way to remove the stent. In men, the snare should not be passed beyond the bulbous urethra.

Click figure to enlarge

 

Patient Having Stent Removed With A Stent Removing Snare

How To Create A “Loop” In The String Attached To The Stent To Facilitate Stent Removal

Cavernotome

Original Cavernotome

The cavernotome has a simple, yet ingenious design, which helps the surgeon control the cutting and shaving action of the dilator within the confines of the corpora. The cavernotome incorporates a 1 mm cutting blade, which rises from a beveled surface within the circumference of the dilator and does not exceed this perimeter, for a precise and controlled cut or shaving action.

Details

Key Benefits

Cuts and Shaves Fibrotic Tissue
Peronie’s disease, sickle cell, priapism, prolonged intracavernosal therapy, redos, subcapsular space creation in eroded prosthesis
Improves and Shortens the Dilation Process
Avoids multiple corporatomies
Avoids false passages
Controls the Depth of the Internal Cut by its Design
Represents a significant improvement over existing instruments

Method of Use

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  • Entry to the fibrotic corpora needs to be accessed by scalpel and extended both proximally and distally to allow entry to the cavernotome
  • The working element should be directed laterally initially
  • If tissue does not respond to the cutting process the cavernotome can be rotated or moved in an oscillating fashion to create a shaving action that removes fibrotic tissue and at the same time propels the cavernotome forward
  • The cavernotomes are used in succession until the desired size is attained
  • Can be used in normal corpora for a speedier dilation
  • Can be used as a measuring tool

Features

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  • The cavernotomes are designed of top grade surgical steel
  • Cavernotomes can be resterilized
  • Velcro case included

Technical Aspects

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  • The original set consists of 5 cavernotomes with diameters between 6, 7, 9, 11, and 13 mm.
  • Length: 23 cm.
  • 1 cm long, rounded and tapered head to protect the ends of the corpora.
  • The working element is 6 cm long, and starts 1 cm from the tip.
  • The height of the blade is 1 mm and does not exceed the circumference of the cavernotome to avoid cutting beyond this perimeter.
  • The cavernotomes are graded in centimeters and can be used as a measuring tool.
  • A 4 cm flat beveled surface is placed about 7 cm from the cutting element on the same plane as the beveled surface of the blade to let the operator know how the cavernotome is oriented, if the blade is buried and not visible.
  • The original cavernotomes were designed for use in both moderately fibrotic corporas as well as virgin implants.
Description: 1 Set
SKU #: 9901
Advanced System Set: $2299
Shipping, Insurance: $50

Leasing options are available at the price of $395/set per procedure plus shipping.


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