This invention relates to a closing instrument utilized in penile prosthesis implant surgery and, more particularly, to an instrument for assisting in closing an incision in the penis after insertion of an inflatable penile prosthesis therein.
Penile prosthesis products have been developed for use in treatment of chronic, organic male erectile dysfunction (impotence) in men who are suitable candidates for implantation surgery. Currently, there are several different penile prosthesis units that can be utilized. An example is the AMS 700.TM. inflatable penile prosthesis manufactured by American Medical Systems, Inc. The prosthesis includes two generally cylindrical members or cylinders which are inflatable. The size of the inflatable cylinders are chosen to be of the size which will fit within the corpus cavernosum of the patient. The cylinders are typically made of solid silicone, are very soft, and capable of being inflated by a fluid preferably liquid. Each cylinder has a fluid tube connected thereto between the ends at a position spaced further from the distal end and closer to the proximal end thereof. A pump is disposed in the scrotum, and an abdominal reservoir is provided. The cylinders are inflated as fluid is pumped from the reservoir, and are deflated as fluid is transferred back to the reservoir. This inflation and deflation allows the patient to control whether his penis is erect or flaccid.
During the surgical operation of inserting the cylinders, an incision is made in each corpus cavernosum in a position which corresponds generally to the position of the fluid tube. The portion of the cylinder forwardly of the fluid tube is fed into the corpus cavernosum through the incision and is pulled forwardly into the major portion of the corpus cavernosum which extends forwardly of the incision. When the forward portion has reached its proper position, the tube is bent at the position adjacent the fluid tube and the rear end is then inserted into the rearward portion of the corpus cavernosum, completing the insertion of the cylinder. The process is repeated for the other cylinder.
Instruments have been developed to assist in closing an incision made for the purpose of inserting the prosthesis. An example of such an instrument is shown in FIG. 1. The instrument 10 includes a very short arcuate spoon-like element 12 welded on its convex side to a rigid, rod-shaped element 14. The rod-shaped element 14 extends rearwardly from the spoon-like element 12 and is formed with an angular turn. Element 14 is connected to the instrument handle 16. The distal end of the rod-shaped element 14, which is welded to the spoon-like element 12 has a V-shaped notch 18 formed in the exterior thereof. The notch 18 enables a suture needle (not shown) to extend therethrough during a suturing operation to close the incision.
The instrument 10 has been found difficult to use since it is difficult to coordinate or align the V-shaped notch with the suture needle during the incision closing procedure. Consequently, there exits a need to provide an implant incision closing instrument which is more convenient to use and otherwise overcomes the disadvantages of the instruments of the prior art.