US20220323223A1 - Furlow insertion device - Google Patents
Furlow insertion device Download PDFInfo
- Publication number
- US20220323223A1 US20220323223A1 US17/809,163 US202217809163A US2022323223A1 US 20220323223 A1 US20220323223 A1 US 20220323223A1 US 202217809163 A US202217809163 A US 202217809163A US 2022323223 A1 US2022323223 A1 US 2022323223A1
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- US
- United States
- Prior art keywords
- elongate barrel
- obturator
- disposed
- insertion device
- needle
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
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Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/26—Penis implants
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/34—Trocars; Puncturing needles
- A61B17/3468—Trocars; Puncturing needles for implanting or removing devices, e.g. prostheses, implants, seeds, wires
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B17/0469—Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B17/0483—Hand-held instruments for holding sutures
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/34—Trocars; Puncturing needles
- A61B17/3417—Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating
- A61B2017/3454—Details of tips
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/06—Measuring instruments not otherwise provided for
- A61B2090/061—Measuring instruments not otherwise provided for for measuring dimensions, e.g. length
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/06—Measuring instruments not otherwise provided for
- A61B2090/062—Measuring instruments not otherwise provided for penetration depth
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/08—Accessories or related features not otherwise provided for
- A61B2090/0807—Indication means
Definitions
- This disclosure relates generally to devices for insertion of bodily implants and, more specifically, to insertion devices for bodily implants, such as penile prostheses.
- a penile prosthesis that mechanically erects the penis.
- Such prostheses can have different physical constructions (e.g., materials, mechanical structure and function, etc.) and configurations (e.g., physical dimensions, etc.).
- a penile prosthesis can be in the form of a cylinder (e.g., malleable, inflatable, etc.) that is selected based on the physical requirements of an intended recipient (a patient).
- an appropriate penile prosthesis can be implanted within a corpus cavernosum (corpus cavernosa) of a patient's penis by medical personnel that are trained and knowledgeable regarding the implantation and use of penile prostheses.
- Insertion devices can be used to facilitate the insertion of a penile prosthesis into the corpus cavernosum of a patient.
- Such furlow insertion devices can be used for measurement of an insertion length within the corpus cavernosum, as well as for facilitating insertion of a penile prosthesis by deploying a suture-carrying needle, where the needle and/or suture are used to introduce (draw, pull, insert, implant, etc.) the prosthesis into the corpus cavernosum.
- a needle used in the insertion of a penile prosthesis can be, at least partially, prematurely deployed from (e.g., come out of, fall out of, etc.) a corresponding insertion device, which can result in a tip of the needle piercing (e.g., damaging, injuring, etc.) the corpus cavernosum before the insertion device is fully inserted to the intended position for deploying the needle (e.g., through a glans of the penis).
- a tip of the needle piercing e.g., damaging, injuring, etc.
- improper measurement of insertion depth can occur due to occlusion of the insertion device (e.g., by blood, etc.) when it is inserted into a body of a patient.
- Such improper measurement can result in selection of an improperly sized prosthesis for a patient.
- accessibility to an insertion point for the insertion device can be compromised in some instances. For instance, in procedures being performed on heavy-set patients, body mass of the patient can inhibit (interfere with, etc.) medical personnel's access to an insertion point (e.g., an incision site) for the insertion device.
- furlow insertion devices are sterilized after each use, and then reused in subsequent patient procedures. It can, however, be difficult to clean and sterilize such devices due to, at least, a slot in the insertion device that can be used for threading sutures along a length of the device and/or an interior of the insertion device, where incomplete or inadequate sterilization could lead to patient infections.
- an insertion device can include an elongate barrel, where a distal end of the elongate barrel has an opening defined therein.
- the insertion device can also include a lumen defined within the elongate barrel, the lumen being accessible through the opening.
- the insertion device can further include an obturator disposed within the lumen of the elongate barrel.
- the obturator can be movable within the lumen between a proximal position in the elongate barrel and a distal position in the elongate barrel.
- the obturator, in its distal position in the elongate barrel can be configured to receive a needle via the opening.
- the obturator, in its proximal position in the elongate barrel can be configured to secure the needle within the elongate barrel.
- the obturator can include a collet disposed at a distal end of the obturator.
- the collet can have a plurality of tags.
- the plurality of tags can be biased to receive the needle when the obturator is in its distal position in the elongate barrel.
- the plurality of tags can be compressed to secure the needle when the obturator is in its proximal position in the elongate barrel.
- the lumen of the elongate barrel can include a flared portion disposed at the distal end of the elongate barrel.
- the flared portion can be configured to allow the plurality of tags to bias to receive the needle when the collet is disposed within the flared portion.
- the lumen of the elongate barrel can include a cylindrical portion disposed proximal to the flared portion.
- the cylindrical portion can be configured to compress the plurality of tags when the collet is disposed within the cylindrical portion.
- a diameter of the flared portion of the lumen can be greater than a diameter of the cylindrical portion of the lumen.
- the insertion device can include a biasing spring that can be axially disposed around at least a portion of the obturator and disposed within the lumen of the elongate barrel.
- the biasing spring can be configured to bias the obturator in its proximal position.
- the insertion device can include a measurement scale disposed on an exterior surface of the elongate barrel and a measurement ring that is slidable along the elongate barrel to indicate an insertion depth of the elongate barrel.
- the elongate barrel can include a groove or a slot that is defined therein. The groove or slot can extend along the elongate barrel.
- the measurement ring can be slidable along the groove or the slot.
- the measurement scale can be inscribed on an exterior surface of the elongate barrel.
- the elongate barrel can be aligned along a first longitudinal axis
- the insertion device can include a housing disposed at a proximal end of the elongate barrel.
- the housing can include an elbow portion coupled with the elongate barrel and a straight portion coupled with the elbow portion.
- the straight portion can be aligned along a second longitudinal axis.
- the second longitudinal axis can define an angle with the first longitudinal axis. The angle can be between ninety degrees and one-hundred-eighty degrees.
- the housing can have a lumen disposed therethrough.
- the insertion device can include an actuator disposed at a distal end of the housing and a flexible connecting rod having a first portion disposed within the lumen of the housing and a second portion disposed within the lumen of the elongate barrel.
- the flexible connecting rod can be disposed between the actuator and the obturator.
- the actuator and the flexible connecting rod can be configured, in response to movement of the actuator by a user, to move the obturator from its proximal position to its distal position.
- the insertion device can include a handle coupled with the housing.
- the handle can be aligned along a third longitudinal axis
- the third longitudinal axis can be parallel with, non-parallel with, and/or offset from the first longitudinal axis.
- the insertion device can include a housing disposed at a proximal end of the elongate barrel and coupled with the elongate barrel, where the housing has a lumen disposed therethrough.
- the insertion device can include an actuator disposed at a distal end of the housing and a connecting rod having a first portion disposed within the lumen of the housing and a second portion disposed with the lumen of the elongate barrel.
- the connecting rod can be disposed between the actuator and the obturator.
- the actuator and the connecting rod can be configured, in response to movement of the actuator by a user, to move the obturator from its proximal position to its distal position.
- the connecting rod can be a flexible connecting rod.
- the actuator can include at least one of a plunger, a squeeze lever, or a rotating knob disposed in the housing.
- the insertion device can include a locking mechanism that is configured to selectively lock the obturator in its distal position.
- the insertion device can include an indexing mechanism configured to, in response to actuation of the insertion device, alternate between a first fixed position and a second fixed position.
- the indexing mechanism When the indexing mechanism is in its first fixed position, the obturator can be fixed in its distal position in the elongate barrel.
- the obturator When the indexing mechanism is in its second fixed position, the obturator can be fixed in its proximal position in the elongate barrel.
- a method for inserting a penile prosthesis can include making a penoscrotal or an infrapubic incision in a body of a patient, capturing a needle in an obturator of an insertion device to secure the needle within an elongate barrel of the insertion device and pulling a suture inserted in an eye of the needle into a slot in the elongate barrel.
- the method can also include, using a handle of an insertion device to manipulate the insertion device to perform an insertion of the elongate barrel, via the incision, into a corpus cavernosum of a penis of the patient.
- the method can further include attaching a penile prosthesis to the suture and actuating the insertion device to deploy at least a portion of the needle through a glans of the penis.
- the method can still further include withdrawing the elongate barrel from the corpus cavernosum and the incision, and implanting the penile prosthesis in the corpus cavernosum by pulling the prosthesis through the incision and into to the corpus cavernosum by pulling the needle and suture through the glans.
- capturing the needle in the obturator can include capturing the needle with tags of a collet disposed at a distal end of the obturator.
- the insertion of the elongate barrel can be a second insertion
- the method can include, prior to performing the second insertion, using the handle of the insertion device, manipulating the insertion device to, via the incision, perform a first insertion of the elongate barrel of the insertion device into the corpus cavernosum.
- the method can include sliding a ring disposed on the barrel proximate the incision, withdrawing the elongate barrel from the corpus cavernosum and the incision, and determining, based on a measurement scale inscribed on the elongate barrel and position of the ring on the elongate barrel, a depth of insertion of the elongate barrel in the corpus cavernosum.
- the penile prosthesis can be selected based on the depth of insertion.
- Sliding the ring can include sliding the ring along a groove in the elongate barrel or the slot in the elongate barrel.
- FIGS. 1A, 1B and 1C schematically illustrate a furlow insertion device that can be used for insertion of a penile prosthesis according to an embodiment.
- FIG. 1D schematically illustrates a needle, a suture and a penile prosthesis according to an embodiment.
- FIG. 2 illustrates a furlow insertion device that can be used for insertion of a penile prosthesis according to another embodiment.
- FIG. 3 illustrates a cross-sectional view of the furlow insertion device of FIG. 2 according to an embodiment.
- FIG. 4 illustrates a collet that can be included in a furlow insertion device according to an embodiment.
- FIG. 5 is a partial cross-sectional view of a furlow insertion device illustrating a needle secured within the collet of FIG. 4 according to an embodiment.
- FIGS. 6A and 6B are partial cross-sectional views of housing of a furlow insertion device in which a locking mechanism can be implemented according to an embodiment.
- FIGS. 7A and 7B are views of an indexer of a locking mechanism according to an embodiment.
- FIG. 7C is a cross-sectional view of the indexer of FIGS. 7A and 7B according to an implementation.
- FIG. 8A is a plunger for actuating a furlow insertion device that can operate in conjunction with the indexer of FIGS. 7A-7C in the housing of FIGS. 6A and 6B according to an embodiment.
- FIG. 8B is a cross-sectional view of the plunger of FIG. 8A according to an embodiment.
- FIGS. 9A, 9B and 9C are diagrams illustrating a locking mechanism according to an embodiment.
- FIGS. 10A and 10B are cross-sectional views of another furlow insertion device according to an embodiment.
- FIGS. 11A and 11B are cross-sectional views of yet another furlow insertion device according to an embodiment.
- FIG. 12 is a flowchart of a method for inserting a penile prosthesis according to an embodiment.
- the embodiments are directed to medical devices such as insertion devices for penile prostheses or other bodily implants.
- the term patient may hereafter be used for a person who benefits from the medical device or the methods disclosed in the present disclosure.
- the patient can be a person whose body is implanted using the medical device or benefits from the methods disclosed for operating the medical devices of the present disclosure.
- the patient may be a human male, a human female, or any other mammal.
- proximal and distal described in relation to various devices, apparatuses, and components as discussed in the subsequent text of the present disclosure are referred to using a point of reference.
- the point of reference is a perspective of a person who uses the disclosed insertion devices to implant a bodily implant, such as a penile prosthesis.
- the person may be a surgeon, a physician, a nurse, a doctor, a technician, and the like who may perform the implantation procedure.
- proximal refers to an area or portion that is closer or closest to the person during the implantation procedure.
- distal refers to an area or portion that is farther from, or farthest from the person.
- the embodiments discussed herein may provide improvements to penile prosthesis insertion devices (e.g., furlow insertion devices, furlow insertion tools, insertion tools, devices, tools, etc.).
- penile prosthesis insertion devices e.g., furlow insertion devices, furlow insertion tools, insertion tools, devices, tools, etc.
- such insertion devices can be configured to self-load and secure a needle in a barrel of the insertion device, which can prevent premature deployment of the needle (e.g., prevent the needle from inadvertently coming out of the tool).
- such insertion devices can be produced using low-cost bio-compatible materials, such as bio-compatible plastics, or otherwise, as compared with tools constructed using primarily surgical grade metals, for example. Accordingly, in certain embodiments, an insertion device such, as those described herein, can be cost-effective as a single-use device, where the insertion device can be provided in sterile packaging and then disposed of after use in performing a single implantation procedure on a patient, which can reduce the risk of patient infection from reuse and eliminate the need for sterilization of the insertion device.
- a furlow insertion device can be ergonomically arranged to facilitate easier access to an implantation site (e.g., incision site) for some patients, such as heavy-set patients by allowing for manipulation of the device at a distance that is farther away from the patient's body than in some current insertion devices.
- an insertion device can include a locking mechanism that facilitates ease of loading of a needle (e.g., a Keith needle) and suture in the insertion device.
- FIGS. 1A, 1B and 1C schematically illustrate a furlow insertion device (device) 100 that can be used for insertion (implantation, etc.) of a penile prosthesis in a penis of a patient according to an embodiment.
- FIG. 1D schematically illustrates a needle 180 , a suture 185 and a penile prosthesis 190 that can be used in conjunction with the insertion tool 100 according to an embodiment.
- the needle 180 , the suture 185 and the penile prosthesis 190 can be used in conjunction with other insertion tools, such as those described herein.
- the device 100 can include an elongate barrel 110 that is aligned (arranged, situated, etc.) along a longitudinal axis L 1 .
- the elongate barrel 110 can have a measurement scale 120 that is disposed on an outer surface of the elongate barrel 110 .
- the measurement scale 120 can be inscribed, printed, engraved, etc. on the outer surface of the elongate barrel 110 .
- the elongate barrel 110 can also include a measurement indicator 130 .
- the measurement indicator 130 can be a measurement ring that is axially disposed around the elongate barrel 110 .
- the measurement indicator 130 can slide along the elongate barrel 110 (along the axis L 1 ) in a groove or slot 140 (referred to hereafter as slot 140 ) that is included in the elongate barrel 110 .
- the slot 140 can also be used to receive a suture that is attached to (threaded in) a needle that can be inserted in the elongate barrel 110 of the device 100 , such as described herein.
- the measurement indicator 130 can be used, in conjunction with the measurement scale 120 , to determine an insertion depth of the elongate barrel 110 , e.g., when the elongate barrel 110 is inserted in a corpus cavernosum of a patient. This insertion depth can be used to select an appropriately sized penile prosthesis for implantation in the patient.
- the device 100 can also include a housing 150 that is coupled with the elongate barrel 110 .
- the elongate barrel 110 and the housing 150 can be included in a unitary (monolithic) structure.
- the elongate barrel 110 and the housing 150 can be separate structures that are coupled (attached, etc.) to each other, such as using an adhesive, being press-fit together, welded together, and so forth.
- the housing 150 can have at least a portion that is aligned along a second longitudinal axis L 2 .
- the axis L 1 of the elongate barrel 110 and the axis L 2 of the housing 150 can define (form, etc.) an angle.
- the angle defined by the axis L 1 and the axis L 2 can be between ninety degrees and one-hundred-eighty degrees.
- the device 100 also includes an actuator 160 that is coupled (operationally coupled, etc.) with the housing 150 .
- the actuator 160 can, depending on the particular implementation, take a number of forms, such as those described herein.
- the actuator 160 can be used to operate the device 100 during the implantation of a penile prosthesis (e.g., to configure and/or operate the device 100 for loading, capturing and deploying a needle, such as a Keith needle, used for penile prosthesis implantation).
- the device 100 can also include a handle 170 that is coupled with the housing 150 .
- the handle 170 can be aligned along a third longitudinal axis L 3 .
- the axis L 3 of the handle 170 can be parallel with the axis L 1 of the elongate barrel 110 .
- the axis L 3 of the handle 170 can be non-parallel or offset with respect to the axis L 1 of the elongate barrel 110 .
- the arrangement of the elongate barrel 110 , the housing 150 and/or the handle 170 in the device 100 can, as was noted above, facilitate easier access to an implantation site (e.g., an incision site) for some patients, such as heavy-set patients, by allowing for manipulation of the device 100 at a distance away from the patient's body, which can prevent interference by body mass of the patient when a user is attempting to utilize the device 100 during the procedure for implantation of a penile prosthesis.
- an implantation site e.g., an incision site
- FIG. 1B schematically illustrates further aspects (elements) of the elongate barrel 110 of the device 100 shown in FIG. lA according to an embodiment.
- the elements shown in FIG. 1B can be implemented and/or included within the elongate barrel 110 of the insertion device 100 .
- the elongate barrel 110 can include an obturator 115 , a biasing spring 125 and a connecting rod 135 , which can be disposed within a lumen 145 that is defined in the elongate barrel 110 .
- the lumen 145 can extend along the axis L 1 of the elongate barrel and can extend from a distal end of the elongate barrel 110 to a proximal end of the elongate barrel 110 (e.g., can be a through-lumen extending the length of the elongate barrel 110 ).
- the obturator 115 can be configured to, based on operation of the device 100 using the actuator 160 , receive, capture and deploy a needle for implanting a penile prosthesis.
- the biasing spring 125 can be axially disposed around the obturator 115 (or can be disposed between the obturator 115 and the connecting rod 135 ).
- the biasing spring 125 can apply a force to the obturator 115 and/or the connecting rod 135 to bias the obturator 115 to a fixed position within the lumen 145 of the elongate barrel.
- the biasing spring 125 can bias the obturator 115 to a fixed proximal position in the lumen 145 .
- the obturator 115 can be configured, when in its fixed proximal position to retain (hold, secure, etc.) a needle within the lumen 145 , and can prevent the needle from being prematurely deployed from (e.g., exiting) the elongate barrel 110 during the implantation of a penile prosthesis.
- the actuator 160 when manipulated by a user, can cause the obturator 115 (along with the connecting rob 135 ) to move distally along the axis L 1 , from its proximal position to a distal position in the lumen 145 while compressing the biasing spring 125 .
- a locking mechanism can be included that can secure (lock) the obturator 115 in its distal position (e.g., after a user releases the actuator 160 ), preventing the compressed biasing spring 125 from decompressing and biasing the obturator 115 back to its fixed proximal position.
- the obturator 115 can be configured, when in its distal position (fixed or non-fixed) to receive a needle to be secured by the obturator in its proximal position within the lumen 145 , and to deploy the needle (e.g., through a glans of a patient's penis) during a process for implanting a penile prosthesis.
- FIG. 1C schematically illustrates aspects (elements) of the housing 150 of the device 100 shown in FIG. 1A according to an embodiment.
- the elements shown in FIG. 1C can be implemented and/or included within the housing 150 of the insertion device 100 .
- the housing 150 can include at least a portion of the connecting rod 135 .
- a first portion of the connecting rod 135 can be disposed within the elongate barrel 110 and a second portion of the connecting rod 135 can be disposed within the housing 150 .
- the housing 150 can also include a locking mechanism 155 .
- the locking mechanism 155 could, alternatively, be included in the elongate barrel 110 .
- the locking mechanism 155 can be an indexing mechanism (such as the mechanism described with respect to FIGS. 6A-6B, 7A-7C, 8A-8B and 9A-9C ).
- the locking mechanism 155 in response to actuation of the device 100 with the actuator 160 , can alternate between a first position and a second position, which can be a first fixed position and a second fixed position.
- the locking mechanism 155 , the biasing spring 125 and/or the connecting rod 135 can cause the obturator 115 to be fixed (locked) in its proximal (needle securing) position.
- the locking mechanism 155 , the biasing spring 125 and/or the connecting rod 135 can cause the obturator 115 to be fixed (locked) in its distal (needle receiving and deploying) position.
- the connecting rod 135 and the locking mechanism 155 can be disposed within a lumen 157 that is defined in the housing 155 .
- the lumen 157 which can be coaxial with the lumen 145 of the elongate barrel, can extend from a distal end of the housing 150 to a proximal end of the housing 150 (e.g., can be a through-lumen).
- the actuator 160 can be disposed at the proximal end of the housing 150 and can, when manipulated by a user, affect movement of the obturator 115 along the axis L 1 in the elongate barrel 100 (e.g., distal movement) by applying a force to the connecting rod 135 that is communicated to the obturator 115 (via movement of the connecting rod in the lumen 157 and/or the lumen 145 ), such that the biasing spring 125 is compressed, and the obturator 115 moves distally in the lumen 145 .
- the needle 180 e.g., a Keith needle
- the suture 185 and the penile prosthesis of FIG. 1D can be used in conjunction with the device 100 , or other insertion devices, such as those disclosed herein, for implanting the penile prosthesis 190 in a corpus cavernosum of a patient's penis.
- An example method for performing such an implantation is illustrated in FIG. 12 and described below.
- FIG. 2 illustrates a furlow insertion device (device) 200 that can be used for insertion of a penile prosthesis according to another embodiment.
- the device 200 can, however, implement the device 100 of FIG. 1 .
- the device 200 includes an elongate barrel 210 , a measurement indicator (measurement ring 230 ), an actuator 260 , a housing 250 that is coupled with (or integrated monolithically with) the elongate barrel 210 , and a handle 270 .
- a section line 9 A- 9 A is also shown in FIG. 2 , which illustrates a cut line through the housing corresponding with the cross-sectional view illustrated in FIG. 9A .
- the elongate barrel 210 can include a measurement scale 220 that is disposed on an outer surface of the elongate barrel 210 .
- the measurement scale 210 can be inscribed, printed, engraved, etc. on the elongate barrel 210 .
- the elongate barrel 210 can also include a slot (or groove) 240 that is disposed along an underside of the elongate barrel 210 and, therefore, not explicitly shown in FIG. 2 .
- the measurement ring 230 can slide along the slot 240 .
- the measurement ring 230 after inserting the elongate barrel 210 into the body of a patient (e.g., to a depth of a corpus cavernosum), can be slid, guided by the slot 240 , along the elongate barrel 210 , until the measurement ring 230 is proximate with an insertion site for the elongate barrel 210 .
- the position of the measurement ring 230 on the measurement scale 220 can be used to determine the insertion depth.
- a suture such as the suture 185 of FIG. 1D , can be pulled into the slot 240 when performing an implantation process using the device 200 , such as in accordance with the method 1200 illustrated in FIG. 12 .
- the housing 250 includes a curved portion 252 that curves away from a central axis of the elongate barrel 210 , the central axis of the elongate barrel being arranged along the axis L 1 .
- the housing 250 also includes a straight portion 254 that extends along the axis L 2 , where the axis L 1 of the elongate barrel 210 and the axis L 2 of the straight portion 254 define an angle between ninety degrees and one-hundred-eighty degrees.
- a locking mechanism can be included in the device 200 , e.g., in the elongate barrel 210 or in the housing 250 , such as in the straight portion 254 of the housing 250 .
- An example locking mechanism that can be included in the device 200 is illustrated below in FIGS. 6A-6B, 7A-7C, 8A-8B and 9A-9C .
- the locking mechanism can be, for instance, an indexing locking mechanism.
- the device 200 of FIG. 2 can further include an actuator 260 , which is implemented as a plunger in the device 200 .
- a user can operate (actuate) the device 200 by depressing the actuator 260 with his or her thumb, while holding the device 200 by the handle 270 , the handle 270 being coupled with the housing 250 .
- the handle 270 can be arranged along the axis L 3 .
- the axis L 3 of the handle 270 can be parallel with, or non-parallel with the axis L 1 of the elongate barrel 210 .
- FIG. 3 illustrates a cross-sectional view of the furlow insertion device 200 of FIG. 2 according to an embodiment.
- the elongate barrel 210 and the housing are shown in cross-section, to illustrated elements of the device 200 that can be disposed within the elongate barrel 210 and the housing 250 , such as the elements of the device 100 illustrated in FIGS. 1B and 1C and described above.
- the device 200 can include an obturator 215 and a biasing spring 225 that are disposed within a lumen 245 that is defined within the elongate barrel 210 .
- the biasing spring 225 can be axially disposed around the obturator and can contact one or more surfaces within the lumen 245 and/or engage with the obturator 215 to bias the obturator 215 in a proximal position, such as is illustrated in FIG. 3 .
- the device 200 can also include a connecting rod 235 , which can be a resilient, flexible connecting rod that has a first portion disposed within the lumen 245 of the elongate barrel and a second portion that is disposed within a lumen 257 of the housing 250 .
- a connecting rod 235 can be a resilient, flexible connecting rod that has a first portion disposed within the lumen 245 of the elongate barrel and a second portion that is disposed within a lumen 257 of the housing 250 .
- the connecting rod 235 can be disposed between the actuator 260 and the obturator 215 .
- depressing the actuator 260 into the lumen 257 of the housing 250 will apply a force on the connecting rod 235 and that force will be communicate to the obturator 215 to move the obturator to a distal position in the lumen 245 of the elongate barrel 210 .
- the force on the connecting rod and the obturator 215 can also compress the biasing spring 225 .
- a locking mechanism can be indexed in response to the actuator 260 being depressed and lock (fix) the obturator 215 in its distal position, with the biasing spring compressed. In such implementations, on a next depression of the actuator 260 , the locking mechanism can index again and allow the biasing spring 225 to decompress and return the obturator 215 to its proximal position, such as shown in FIG. 3 .
- the device 200 may not include a locking mechanism.
- the obturator 215 can be maintained in its distal position by maintaining pressure on the actuator 260 , or keeping the actuator 260 depressed. Releasing the actuator 260 , or removing pressure from the actuator 260 in such implementations can allow the biasing spring 225 to decompress and move the obturator 215 from its distal position to it proximal position.
- the obturator 215 can include a collet 217 disposed at a distal end of the obturator, where the collet 217 is configured to receive a needle 280 (which can be, e.g., a Keith needle) when the obturator 215 is in its distal position, and configured to secure (hold, retain, etc.) the needle in the collet 217 within the elongate barrel 210 when the obturator 215 is in its proximal position.
- a needle 280 which can be, e.g., a Keith needle
- the lumen 245 of the elongate barrel 210 can included a flared portion at a distal end of the elongate barrel 210 and a cylindrical portion 249 that is disposed proximally of the flared portion 247 in the elongate barrel.
- the flared portion 247 and the cylindrical portion 249 of the lumen 245 can operate, in conjunction with collet 217 , to allow the collet 217 , based on a position of the obturator 215 in the lumen 245 , to allow the collet 217 to open to receive or deploy the needle 280 , or to close to retain the needle 280 in the collet 217 .
- An example implementation of the collet 217 is illustrated in FIG. 4
- an example implementation of the flared portion 247 and the cylindrical portion 249 of the lumen 245 , along with the collet 217 is illustrated in FIG. 5 .
- FIG. 4 illustrates an example implementation of the collet 217 of the device 200 of FIGS. 2 and 3 according to an embodiment.
- the collet 217 can be disposed at a distal end of the obturator 215 in the device 200 .
- the collet 217 can include a plurality of tags that can be defined by forming splices 419 in the distal end of the obturator 215 , where a diameter of the collet 217 is greater than a diameter of a shaft 219 of the obturator 215 .
- the splices 419 can create an opening in the collet 217 , e.g., between the tags 417 , that is sized to receive the needle 280 .
- the tags 417 of the collet 217 can be radially disposed around the distal end of the obturator.
- the collet 217 can include, for example, two to six tags.
- FIG. 5 is a partial cross-sectional view of the device 200 . illustrating the needle 280 secured within the collet 217 of FIG. 4 according to an embodiment. That is, FIG. 5 illustrates a cross-sectional view of a distal end of the device 200 , as shown in FIG. 3 , for example.
- the collet 217 and the needle 280 are disposed within the cylindrical portion 249 of the lumen 245 of the device 200 .
- the cylindrical portion 249 of the lumen 245 can have a diameter that is smaller than a diameter of the flared portion 247 of the lumen 245 .
- the diameter of the cylindrical portion 245 can also be smaller than a diameter of the collet 217 .
- the obturator 215 when the obturator 215 is located, e.g., biased by the biasing spring 224 , in a position within the lumen 245 of the elongate barrel 210 such that the collet 217 is within the cylindrical portion 249 , walls of the cylindrical portion 249 will apply inward pressure on the tags 417 .
- This inward pressure on the tags 417 can cause the tags 417 to tighten on the needle 280 , such that the needle 280 is secured within the collet 217 by the tags 417 .
- the needle 280 can be securely held within the elongate barrel 210 of the device 200 by the tags 417 of the collet 217 .
- the obturator 215 can be moved distally, or fixed in a distal position by applying pressure to the actuator 260 , or indexing a locking mechanism with the actuator 260 .
- the tags 417 of the collet 217 can spread, e.g., spring, outward, such than an opening in the splices 419 of the collet 217 can allow for receiving or deploying the needle 280 , e.g., via an opening 510 in the distal end of the elongate barrel 210 , where the opening 510 can be continuous with, or part of the lumen 245 .
- a furlow insertion device can include a locking mechanism, such as an indexing locking mechanism.
- a locking mechanism such as an indexing locking mechanism.
- An example indexing locking mechanism is illustrated in FIGS. 6A-6B, 7A-7C, 8A-8B and 9A-9C .
- FIGS. 6A and 6B illustrate a portion of a housing 650 that includes protrusions 620 and grooves 610 and 630 that can be used in implementing a locking mechanism.
- the protrusions and grooves shown in FIGS. 6A and 6B can be implemented in other portions, or sections of a furlow insertion device, such as in an elongate barrel of a furlow insertion device.
- the housing 650 (or other housing, such as the housing 250 ) can include a cylindrical bore therethrough, and a separate cylindrical piece that includes the protrusions and grooves 610 and 630 can be disposed within the cylindrical bore in the housing 650 (or other housing).
- FIGS. 7A-7C illustrate an indexer 700 that can be included in a locking mechanism of a furlow insertion tool
- FIGS. 8A and 8B illustrate an example implementation of the actuator 260 that includes an end portion 830 that can work cooperatively with the indexer 700 in the housing 650 to implement an indexing locking mechanism.
- Operation of a locking mechanism 900 including the elements of FIGS. 6A-6B, 7A-7C and 8A-8B is illustrated in FIGS. 9A-9C .
- the locking mechanism of FIGS. 6A-6B, 7A-7C, 8A-8B and 9A-9C is described with further reference to FIGS. 1A-1B and 2-5 .
- Furlow insertion devices such as the device 200 , that include such a locking mechanism can provide for easier loading of, and securing of the needle 280 within the collet 217 of the obturator 215 .
- a locking mechanism can lock or fix the obturator in a distal position, such that the collet 217 is disposed within the flared portion 247 of the elongate barrel 210 ′s lumen 245 .
- This locking of the obturator in a fixed distal position allows for a user to load the needle 280 in the open tags 417 of the collet 217 , without the need to maintain pressure on the actuator 260 of the device, e.g., to prevent the biasing spring 225 from decompressing and moving (biasing) the obturator 215 to a proximal fixed position.
- the actuator 260 can be depressed again, causing the locking mechanism to index, which can allow the biasing spring 225 to decompress and move, or bias the obturator 215 to a proximal fixed position, e.g., with the collet 217 disposed within the cylindrical portion 249 of the lumen 245 and the tags 417 pressed inward onto the needle 280 , such that the needle 280 is retained or held in place in the collet 217 by the tags 417 .
- 6A-6B, 7A-7C, 8A-8B and 9A-9C can be activated to lock the obturator 215 in a fixed distal position by depressing the actuator 260 until a mechanical stop (e.g., the indexer 700 reaching an end of a lumen in the housing 650 ), and then releasing the actuator 260 .
- the locking mechanism can then be deactivated to return the obturator 215 to its biased, fixed proximal position by, again, depressing the actuator 260 until the mechanical stop, and then releasing the actuator 260 .
- FIGS. 6A and 6B are partial cross-sectional views of the housing 650 of a furlow insertion device in which a locking mechanism can be implemented according to an example embodiment.
- the views shown in FIGS. 6A and 6B show an inner surface of the housing 650 , which can be used in implementing an indexing locking mechanism.
- the views of FIGS. 6A and 6B are isometric views from two different angles and at two different degrees of magnification, the view of FIG. 6B being enlarged (magnified) and further sectioned, as compared with the view of FIG. 6A .
- the housing 650 can include a plurality of protrusions 620 that are radially disposed around the inner surface of the housing 650 .
- the protrusions 620 can define grooves 610 and grooves 630 on the inner surface, where the grooves 610 and 630 , and the protrusions 620 can alternate around a circumference of the inner surface of the housing 650 , such as in the arrangement shown in FIGS. 6A and 6B , as well as in FIG. 9A . For instance, as is illustrated in FIG.
- the inner surface of the housing 650 can include three grooves 610 and three grooves 630 , as shown the grooves 610 can alternative with the grooves 630 , with protrusions 620 disposed between, the grooves 610 being deeper than the grooves 630 .
- the grooves 610 and 630 , and the protrusions 620 are sized, shaped and located so that they can work cooperatively with protrusions and surfaces of the end portion 830 of the actuator 260 , and protrusions and surfaces of the indexer 700 , to operate as an indexing locking mechanism for device 200 and the obturator 215 , using the example of the device 200 .
- the protrusions 620 can include angled surface 637 that work cooperatively with the indexer 700 to affect indexing of a locking mechanism.
- the inner surface of the housing 650 includes an open area 640 , without protrusions or grooves.
- the open area 640 in this example locking mechanism, can allow the indexer 700 to rotate, in cooperation with the actuator 260 and the housing 650 , to index the locking mechanism between a first position, with the obturator locked or fixed in a distal position, and a second position, with the obturator locked or fixed in a proximal position, such as is described herein.
- FIGS. 7A and 7B are views of an indexer 700 of a locking mechanism according to an embodiment.
- FIG. 7C is a cross-sectional view of the indexer 700 of FIGS. 7A and 7B according to an embodiment.
- FIGS. 7A and 7B are isometric views of the indexer 700 from two different angles, to illustrate different perspectives of the features of the indexer 700 .
- the indexer 700 can include two diametric sections 705 and 725 , which are cylindrical and axially connected.
- the sections 705 and 725 of the indexer can be monolithically formed.
- the section 705 includes a plurality of angled and beveled surfaces 730 that form V-shaped ridges or troughs disposed along an upper circumferential edge of the section 705 .
- a depth of each V-shaped trough ends at an outside diameter or surface 740 of the section 725 of the indexer 705 .
- each alternative apex of the V-shaped troughs of the section 705 has a protrusion 710 , where a width of each protrusion 710 extends from an apex of corresponding V-shaped trough and extends vertically along the length of the section 705 of the indexer.
- the protrusions 710 of the indexer 700 are configured to slide, or ride within the deeper grooves 610 of the housing 650 .
- the protrusion 710 are sized such that they do not slide (will not enter) the shallower grooves 630 of the housing 650 .
- the protrusions 710 are also sized such that the indexer 700 rotates, or indexes in the open area 640 of the housing, such as when the protrusions 710 are outside the grooves 610 of the housing 650 .
- the section 705 of the indexer 700 also includes surfaces 720 that form part of the V-shaped troughs of the section 705 .
- the surfaces 720 of the section 705 are defined, in part, by the protrusions 710 of the section 705 .
- the section 725 of the indexer 700 can be cylindrical with a center bore 750 . In some implementations, the center bore 750 can be eliminated.
- the section 725 includes an outer surface 740 . Section 725 can be sized so that the outer surface 740 fits within a bore defined in the end portion 830 of the actuator 260 , such as the bore shown below in FIG. 8B , which can coaxially align the indexer 700 with the end portion 830 of the actuator 260 .
- FIG. 7C illustrates a cross-sectional view of the indexer 700 , sectioned through a central axis of the indexer 700 . As shown in FIG.
- the indexer 700 can include a counter-bore 760 in the section 705 , where the counter bore 760 can be sized to receive a proximal end of the connecting rod 735 , or a proximal end of the obturator, depending on a specific location of the locking mechanism in the device 200 .
- FIG. 8A is a plunger that can be used to implement the actuator 260 of, for example, the device 200 according to an embodiment.
- the actuator 260 of FIG. 8A can operate in conjunction with the housing 650 of FIGS. 6A and 6B , and the indexer 700 of FIGS. 7A-7C to implement an indexing locking mechanism in a furlow insertion device, such as in the device 200 .
- FIG. 8B is a cross-sectional view of the actuator (plunger) 260 of FIG. 8A according to an embodiment.
- the actuator (plunger) 260 of FIGS. 8A and 8B includes a button 810 that can be used to depress the actuator in the device 200 , e.g., to affect distal movement of the obturator 215 and/or to index a locking mechanism, such as the locking mechanism of the present example.
- the actuator 260 as shown in FIG. 8A , includes a cylindrical section 820 and an end portion 830 , where the end portion 830 can operate in cooperation with the housing 650 and the indexer 700 to implement an indexing locking mechanism.
- the end portion 830 of the actuator 260 of FIGS. 8A and 8B can include a counter bore 839 which can receive the section 725 of the indexer 700 , so that the indexer 700 and the end portion 830 are concentrically aligned.
- the end portion 830 can include V-shaped protrusions 837 which can operate cooperatively with the V-shapes troughs of the indexer 700 in implementing an indexing locking mechanism.
- the end portion 830 of the actuator 260 can include protrusions 835 that are disposed on its outer surface.
- the protrusions 835 of the end portion 835 can be sized to ride in the shallower grooves 620 of the housing 650 .
- the protrusions 835 can allow the actuator 260 of FIGS. 8A and 8B to move axially along the grooves 620 , while preventing the actuator 260 from rotational motion within the housing 650 , which could result in changing alignment of the end portion 830 with indexer 700 , causing improper operation of the locking mechanism of this example.
- the locking mechanism can be configured such that the protrusions 835 do not exit the grooves 620 , even when the actuator 260 is fully depressed.
- the protrusions 835 can be prevent from exiting the grooves 620 due to the indexer 700 contacting a mechanical stop in the housing 650 and preventing axial movement of the protrusions 835 out of the grooves 620 and into the open area 640 of the housing 650 .
- FIGS. 9A, 9B and 9C are diagrams illustrating a locking mechanism 900 according to an embodiment.
- the locking mechanism 900 which can also be referred to as an indexing locking mechanism can be implemented, as was indicated above, using the housing 650 of FIGS. 6A and 6B , the indexer 700 of FIGS. 7A-7C and the actuator (plunger) 260 of FIGS. 8A and 8B . Accordingly, in the discussion of FIGS. 9A-9C , further reference is made to FIGS. 6A and 6B , FIGS. 7A-7C , FIGS. 8A and 8B , and the elements of the housing 650 , the indexer 700 and the actuator 260 (as illustrated in FIGS. 8A and 8B ).
- FIG. 9A is a plan view along the section line 9 A- 9 A in FIG. 2 , illustrating an example arrangement of the elements of the locking mechanism 900 in the housing 650 (or the housing 250 ).
- FIG. 9A illustrates the axial arrangement of the indexer 700 and the end portion 830 of the actuator 260 of FIGS. 8A and 8B within the housing 650 .
- other elements of the device 200 such as the handle 270 , are not shown in FIG. 9A .
- the housing 650 (or 250 ) can be of two-piece construction, including a first housing portion 650 a and a second housing portion 650 b.
- the protrusions 710 can be disposed in, or ride in the deeper grooves 610 of the housing 650 .
- the protrusions 835 of the end portion 830 can be disposed in, or ride in the shallower grooves 630 of the housing 650 .
- the protrusions 620 of the housing 650 are disposed between the grooves 610 and the grooves 630 in an alternating arrangement around a circumference of the inner surface of the housing 650 .
- FIG. 9B is a side view of the locking mechanism 900 in the arrangement shown in FIG. 9A . That is, FIG. 9B illustrates the indexer 700 with its protrusions 710 riding in the grooves 610 of the housing 650 and the end portion 830 of the actuator 260 with its protrusions 835 riding in the grooves 630 . As shown in FIG. 9B , in this arrangement, the V-shaped troughs or protrusions 730 of the indexer 700 are offset from the V-shaped protrusions 837 of the end portion 830 . When pressure is applied to the actuator 260 (e.g., when the actuator 260 is depressed) both the end portion 830 of the actuator 260 and the indexer 700 will slide axially (downward in FIG. 9B ) within their respective grooves of the housing, where the grooves prevent rotational movement of the indexer 700 and the actuator 260 .
- pressure is applied to the actuator 260 (e.g., when the actuator 260 is depressed)
- indexing of the locking mechanism 900 As the indexer 700 rises in response to force from the biasing spring 225 , peaks of its V-shaped protrusions 730 will ride along the angled edges 637 of the protrusions 620 in the housing 650 , which will cause further rotational motion of the indexer 700 , and align the protrusion 710 of the indexer 700 with either the grooves 610 or the grooves 630 of the housing 650 .
- the rotational motion of the indexer 700 resulting from depressing and releasing of the actuator 260 can be referred to as indexing of the locking mechanism 900 .
- the protrusions 710 after indexing of the locking mechanism 900 , are aligned with the deeper grooves 610 , the protrusions 710 of the indexer 700 will ride in the grooves 610 and an obturator, such as the obturator 215 will be biased to its proximal position. If, however, the protrusions 710 , after indexing of the locking mechanism 900 , are aligned with the shallower grooves 630 , the protrusions 710 of the indexer 700 will be prevented from rising by the shallower grooves 620 , the biasing spring 625 will remain compressed, and the obturator of the associated insertion device will be locked, or fixed in its distal position.
- FIGS. 10A and 10B are cross-sectional views of another furlow insertion device 1000 according to an embodiment.
- the device 1000 includes an elongate barrel 1010 that is similar in configuration to the elongate barrel 210 of the device 200 . Accordingly, for purposes of brevity, at least some aspects and features of the elongate barrel 1010 are not described in detail with respect to FIGS. 10A and 10B .
- the device 1000 includes a squeeze handle actuator 1060 that rotates on a pivot (e.g., a pin, an axle, etc.) 1065 .
- the pivot 1065 and the actuator 1060 can be affixed to, or coupled with a handle 1070 of the device 1000 .
- the device 1000 is shown in FIG. 10A with an obturator 1015 in a proximal position.
- the biasing spring 1025 can maintain the obturator 1015 in a fixed, proximal position.
- a collet of the obturator 1015 can be compressed, so as to retain a needle within the collet and within the elongate barrel 1010 .
- the device 1000 is illustrated with the obturator 1015 in a distal position.
- pressure may be applied to the actuator 1060 , so as to apply a force to a connecting rod 1035 to affect distal movement of the obturator 1015 , e.g., to the distal position for loading or deployment of a needle.
- the obturator 1015 as shown in FIG. 10B , can be locked, or fixed in its distal position.
- FIGS. 11A and 11B are cross-sectional views of another furlow insertion device 1100 according to an embodiment.
- the device 1100 includes an elongate barrel 1110 that is similar in configuration to the elongate barrel 210 of the device 200 . Accordingly, for purposes of brevity, at least some aspects and features of the elongate barrel 1110 are not described in detail with respect to FIGS. 11A and 11B .
- the device 1100 includes a rotating knob actuator 1160 that rotates within a housing 1150 .
- the actuator 1160 includes a tab 1165 that contacts a connecting rod 1135 .
- the device 1100 can also include a handle 1170 that is coupled with the housing 1150 .
- the device 1100 is illustrated with an obturator 1115 in a proximal position.
- pressure is not being applied to the actuator 1160 .
- the biasing spring 1125 can maintain the obturator 1115 in a fixed, proximal position.
- a collet of the obturator 1115 can be compressed, so as to retain a needle within the collet and within the elongate barrel 1110 .
- the device 1100 is illustrated with the obturator 1115 in a distal position.
- pressure may be applied to the actuator 1160 , so as to apply a force to the connecting rod 1135 , via the tab 1165 , to affect distal movement of the obturator 1115 , e.g., to a distal position for loading or deployment of a needle.
- the obturator 1115 of the device 1100 can be locked, or fixed in its distal position by the locking mechanism 900 , such as described above with respect to FIGS. 9A-9C .
- FIG. 12 is a flowchart of a method 1200 for inserting a penile prosthesis according to an embodiment.
- a cylindrical (e.g., inflatable, malleable, etc.) penile prosthesis can be implanted (inserted, etc.) in a corpus cavernosum of a patient in accordance with the method 1200 .
- the method 1200 can be implemented using the insertion devices described herein.
- the method 1200 of FIG. 12 is described with further reference to the insertion devices 100 and 200 of FIGS. 1A-1C, 2, 3, 4 and 5 , and the locking mechanism 900 of FIGS. 6, 7, 8 and 9 , as appropriate. Reference is further made to FIG. 1D in the discussion of FIG. 12 .
- the method 1200 can include making a penoscrotal or an infrapubic incision in a body of a patient, wherein the incision is located such that a corpus cavernosum of the patient's penis is accessible through the incision.
- the method 1200 includes manipulating the insertion device 200 , via the handle 270 , to perform a first insertion of the elongate barrel 210 of the insertion device 200 into the corpus cavernosum, the insertion of the elongate barrel 210 being made via the incision of block 1210 .
- the method 1200 can include sliding the measurement ring 230 along the elongate barrel 210 , such that the measurement ring 230 is proximate (adjacent to, touching, in contact with, etc.) the incision.
- the measurement ring 230 can be slid along the groove or slot 240 in the elongate barrel 210 .
- the method 120 can include extracting (withdrawing, removing, etc.) the elongate barrel 210 from the patient (e.g., removing the elongate barrel 210 from the corpus cavernosum via the incision).
- the method 1200 can include reading (determining, etc.) an insertion depth of the elongate barrel 210 in the corpus cavernosum, where the insertion depth is determined based on the measurement scale 220 on the elongate barrel 210 and a position of the measurement ring 230 on the elongate barrel 210 (and the measurement scale 220 ).
- an appropriate penile prosthesis such as the prosthesis 190
- the selected prosthesis can be attached (coupled with, affixed to, etc.) the suture 185 .
- the suture of block 1250 can be threaded into (inserted through) an eye of a needle, such as the Keith needle 280 .
- the method 1200 can include capturing a needle (e.g., the Keith needle 280 ) within the elongate barrel 210 of the insertion device 200 , such as within the tags 417 of the collet 217 .
- capturing the needle 280 in the tags 417 of the collet 217 can include locking the obturator 215 in its distal position, such as by using a locking mechanism (e.g., the locking mechanism 900 ) that can be included in the insertion device 200 .
- the tags 417 of the collet 217 can be biased within the flared portion 247 of the lumen 245 such that the tags are spaced (open, etc.) to receive the needle 280 .
- the needle 280 can then be captured within the elongate barrel 210 by indexing the locking mechanism 900 .
- the locking mechanism 900 can be indexed by actuating the insertion device 200 , causing the biasing spring 225 to bias the obturator 215 to its proximal position, resulting in the tags 417 of the collet 217 being compressed within the cylindrical portion 249 of the lumen 245 , and capturing (grabbing, retaining, holding, etc.) the needle 290 in the collet 217 and within the elongate barrel 210 .
- the method 1200 can include pulling (guiding, etc.) a suture (e.g., the suture 185 ) that is inserted (threaded, etc.) in an eye of the needle 280 along (into, etc.) the slot 240 in the elongate barre 210 .
- a suture e.g., the suture 185
- the method 1200 can include performing a second insertion of the elongate barrel 210 into the corpus cavernosum of the patient via the incision.
- the insertion tool 200 can be actuated (e.g., to lock the obturator in its distal position), causing the needle 280 to, at least partially, exit the patient's body via a glans of the patient's penis.
- the elongate barrel 210 can again be removed (withdrawn, etc.) from the corpus cavernosum of the patient, leaving the needle 280 and the suture 185 in place (e.g., with the needle 280 partially extending out of the glans and the suture 185 extending from an eye of the needle 280 within the corpus cavernosum to the penile prosthesis being implanted).
- the penile prosthesis can be implanted into the corpus cavernosum of the patient by drawing the prosthesis through the incision and into to the corpus cavernosum by pulling the needle 280 and the suture 185 through (out of, etc.) the glans of the patient's penis.
- the insertion tool 200 can be disposed of (e.g. as medical waste).
Abstract
According to a general aspect, an insertion device can include an elongate barrel having an opening defined in a distal end; a lumen defined within the elongate barrel, the lumen being accessible through the opening; and an obturator disposed within the lumen of the elongate barrel. The obturator can be movable within the lumen between a proximal position in the elongate barrel and a distal position in the elongate barrel. The obturator, in its distal position in the elongate barrel, can be configured to receive a needle via the opening. The obturator, in its proximal position in the elongate barrel, can be configured to secure the needle within the elongate barrel.
Description
- This application is a continuation of, and claims priority to, U.S. patent application Ser. No. 16/357,851, filed on Mar. 19, 2019, entitled “FURLOW INSERTION DEVICE”, which claims priority to U.S. Patent Application No. 62/647,272, filed on Mar. 23, 2018, entitled “FURLOW INSERTION DEVICE”, the disclosures of which are incorporated by reference herein in their entirety.
- This disclosure relates generally to devices for insertion of bodily implants and, more specifically, to insertion devices for bodily implants, such as penile prostheses.
- One treatment for chronic, organic, male erectile dysfunction is the implantation of a penile prosthesis that mechanically erects the penis. Such prostheses can have different physical constructions (e.g., materials, mechanical structure and function, etc.) and configurations (e.g., physical dimensions, etc.). For instance, such a penile prosthesis can be in the form of a cylinder (e.g., malleable, inflatable, etc.) that is selected based on the physical requirements of an intended recipient (a patient). For instance, an appropriate penile prosthesis can be implanted within a corpus cavernosum (corpus cavernosa) of a patient's penis by medical personnel that are trained and knowledgeable regarding the implantation and use of penile prostheses.
- Insertion devices (e.g., furlow insertion devices) can be used to facilitate the insertion of a penile prosthesis into the corpus cavernosum of a patient. Such furlow insertion devices can be used for measurement of an insertion length within the corpus cavernosum, as well as for facilitating insertion of a penile prosthesis by deploying a suture-carrying needle, where the needle and/or suture are used to introduce (draw, pull, insert, implant, etc.) the prosthesis into the corpus cavernosum.
- In some existing devices, a needle (e.g., which can be referred to as a Keith needle) used in the insertion of a penile prosthesis can be, at least partially, prematurely deployed from (e.g., come out of, fall out of, etc.) a corresponding insertion device, which can result in a tip of the needle piercing (e.g., damaging, injuring, etc.) the corpus cavernosum before the insertion device is fully inserted to the intended position for deploying the needle (e.g., through a glans of the penis). Also in some existing devices, improper measurement of insertion depth (e.g., for selecting a properly sized prosthesis) can occur due to occlusion of the insertion device (e.g., by blood, etc.) when it is inserted into a body of a patient. Such improper measurement can result in selection of an improperly sized prosthesis for a patient. Further, for some existing devices, accessibility to an insertion point for the insertion device can be compromised in some instances. For instance, in procedures being performed on heavy-set patients, body mass of the patient can inhibit (interfere with, etc.) medical personnel's access to an insertion point (e.g., an incision site) for the insertion device. Still further in some existing devices, furlow insertion devices are sterilized after each use, and then reused in subsequent patient procedures. It can, however, be difficult to clean and sterilize such devices due to, at least, a slot in the insertion device that can be used for threading sutures along a length of the device and/or an interior of the insertion device, where incomplete or inadequate sterilization could lead to patient infections.
- In a general aspect, an insertion device can include an elongate barrel, where a distal end of the elongate barrel has an opening defined therein. The insertion device can also include a lumen defined within the elongate barrel, the lumen being accessible through the opening. The insertion device can further include an obturator disposed within the lumen of the elongate barrel. The obturator can be movable within the lumen between a proximal position in the elongate barrel and a distal position in the elongate barrel. The obturator, in its distal position in the elongate barrel, can be configured to receive a needle via the opening. The obturator, in its proximal position in the elongate barrel, can be configured to secure the needle within the elongate barrel.
- Implementations can include one or more of the following features. For example, in some implementations, the obturator can include a collet disposed at a distal end of the obturator. The collet can have a plurality of tags. The plurality of tags can be biased to receive the needle when the obturator is in its distal position in the elongate barrel. The plurality of tags can be compressed to secure the needle when the obturator is in its proximal position in the elongate barrel.
- In some implementations, the lumen of the elongate barrel can include a flared portion disposed at the distal end of the elongate barrel. The flared portion can be configured to allow the plurality of tags to bias to receive the needle when the collet is disposed within the flared portion. The lumen of the elongate barrel can include a cylindrical portion disposed proximal to the flared portion. The cylindrical portion can be configured to compress the plurality of tags when the collet is disposed within the cylindrical portion. A diameter of the flared portion of the lumen can be greater than a diameter of the cylindrical portion of the lumen.
- In some implementations, the insertion device can include a biasing spring that can be axially disposed around at least a portion of the obturator and disposed within the lumen of the elongate barrel. The biasing spring can be configured to bias the obturator in its proximal position.
- In some implementations, the insertion device can include a measurement scale disposed on an exterior surface of the elongate barrel and a measurement ring that is slidable along the elongate barrel to indicate an insertion depth of the elongate barrel. The elongate barrel can include a groove or a slot that is defined therein. The groove or slot can extend along the elongate barrel. The measurement ring can be slidable along the groove or the slot. The measurement scale can be inscribed on an exterior surface of the elongate barrel.
- In some implementations, the elongate barrel can be aligned along a first longitudinal axis, and the insertion device can include a housing disposed at a proximal end of the elongate barrel. The housing can include an elbow portion coupled with the elongate barrel and a straight portion coupled with the elbow portion. The straight portion can be aligned along a second longitudinal axis. The second longitudinal axis can define an angle with the first longitudinal axis. The angle can be between ninety degrees and one-hundred-eighty degrees.
- In some implementations, the housing can have a lumen disposed therethrough. The insertion device can include an actuator disposed at a distal end of the housing and a flexible connecting rod having a first portion disposed within the lumen of the housing and a second portion disposed within the lumen of the elongate barrel. The flexible connecting rod can be disposed between the actuator and the obturator. The actuator and the flexible connecting rod can be configured, in response to movement of the actuator by a user, to move the obturator from its proximal position to its distal position.
- In some implementations, the insertion device can include a handle coupled with the housing. The handle can be aligned along a third longitudinal axis The third longitudinal axis can be parallel with, non-parallel with, and/or offset from the first longitudinal axis.
- In some implementations, the insertion device can include a housing disposed at a proximal end of the elongate barrel and coupled with the elongate barrel, where the housing has a lumen disposed therethrough. The insertion device can include an actuator disposed at a distal end of the housing and a connecting rod having a first portion disposed within the lumen of the housing and a second portion disposed with the lumen of the elongate barrel. The connecting rod can be disposed between the actuator and the obturator. The actuator and the connecting rod can be configured, in response to movement of the actuator by a user, to move the obturator from its proximal position to its distal position. The connecting rod can be a flexible connecting rod. The actuator can include at least one of a plunger, a squeeze lever, or a rotating knob disposed in the housing.
- In some implementations, the insertion device can include a locking mechanism that is configured to selectively lock the obturator in its distal position.
- In some implementations, the insertion device can include an indexing mechanism configured to, in response to actuation of the insertion device, alternate between a first fixed position and a second fixed position. When the indexing mechanism is in its first fixed position, the obturator can be fixed in its distal position in the elongate barrel. When the indexing mechanism is in its second fixed position, the obturator can be fixed in its proximal position in the elongate barrel.
- In another general aspect, a method for inserting a penile prosthesis can include making a penoscrotal or an infrapubic incision in a body of a patient, capturing a needle in an obturator of an insertion device to secure the needle within an elongate barrel of the insertion device and pulling a suture inserted in an eye of the needle into a slot in the elongate barrel. The method can also include, using a handle of an insertion device to manipulate the insertion device to perform an insertion of the elongate barrel, via the incision, into a corpus cavernosum of a penis of the patient. The method can further include attaching a penile prosthesis to the suture and actuating the insertion device to deploy at least a portion of the needle through a glans of the penis. The method can still further include withdrawing the elongate barrel from the corpus cavernosum and the incision, and implanting the penile prosthesis in the corpus cavernosum by pulling the prosthesis through the incision and into to the corpus cavernosum by pulling the needle and suture through the glans.
- Implementations can include one or more of the following features. For example, in some implementations, capturing the needle in the obturator can include capturing the needle with tags of a collet disposed at a distal end of the obturator.
- In some implementations, the insertion of the elongate barrel can be a second insertion, and the method can include, prior to performing the second insertion, using the handle of the insertion device, manipulating the insertion device to, via the incision, perform a first insertion of the elongate barrel of the insertion device into the corpus cavernosum. The method can include sliding a ring disposed on the barrel proximate the incision, withdrawing the elongate barrel from the corpus cavernosum and the incision, and determining, based on a measurement scale inscribed on the elongate barrel and position of the ring on the elongate barrel, a depth of insertion of the elongate barrel in the corpus cavernosum. The penile prosthesis can be selected based on the depth of insertion. Sliding the ring can include sliding the ring along a groove in the elongate barrel or the slot in the elongate barrel.
-
FIGS. 1A, 1B and 1C schematically illustrate a furlow insertion device that can be used for insertion of a penile prosthesis according to an embodiment. -
FIG. 1D schematically illustrates a needle, a suture and a penile prosthesis according to an embodiment. -
FIG. 2 illustrates a furlow insertion device that can be used for insertion of a penile prosthesis according to another embodiment. -
FIG. 3 illustrates a cross-sectional view of the furlow insertion device ofFIG. 2 according to an embodiment. -
FIG. 4 illustrates a collet that can be included in a furlow insertion device according to an embodiment. -
FIG. 5 is a partial cross-sectional view of a furlow insertion device illustrating a needle secured within the collet ofFIG. 4 according to an embodiment. -
FIGS. 6A and 6B are partial cross-sectional views of housing of a furlow insertion device in which a locking mechanism can be implemented according to an embodiment. -
FIGS. 7A and 7B are views of an indexer of a locking mechanism according to an embodiment. -
FIG. 7C is a cross-sectional view of the indexer ofFIGS. 7A and 7B according to an implementation. -
FIG. 8A is a plunger for actuating a furlow insertion device that can operate in conjunction with the indexer ofFIGS. 7A-7C in the housing ofFIGS. 6A and 6B according to an embodiment. -
FIG. 8B is a cross-sectional view of the plunger ofFIG. 8A according to an embodiment. -
FIGS. 9A, 9B and 9C are diagrams illustrating a locking mechanism according to an embodiment. -
FIGS. 10A and 10B are cross-sectional views of another furlow insertion device according to an embodiment. -
FIGS. 11A and 11B are cross-sectional views of yet another furlow insertion device according to an embodiment. -
FIG. 12 is a flowchart of a method for inserting a penile prosthesis according to an embodiment. - Detailed embodiments are disclosed herein. However, it is understood that the disclosed embodiments are merely examples, which may be embodied in various forms. Therefore, specific structural and functional details disclosed herein are not to be interpreted as limiting, but merely as a basis for the claims and as a representative basis for teaching one skilled in the art to variously employ the embodiments in virtually any appropriately detailed structure. Further, the terms and phrases used herein are not intended to be limiting, but to provide an understandable description of the present disclosure.
- The terms “a” or “an,” as used herein, are defined as one or more than one. The term “another,” as used herein, is defined as at least a second or more. The terms “including” and/or “having”, as used herein, are defined as comprising (i.e., open transition). The term “coupled” or “moveably coupled,” as used herein, is defined as connected, although not necessarily directly and mechanically.
- In general, the embodiments are directed to medical devices such as insertion devices for penile prostheses or other bodily implants. The term patient may hereafter be used for a person who benefits from the medical device or the methods disclosed in the present disclosure. For example, the patient can be a person whose body is implanted using the medical device or benefits from the methods disclosed for operating the medical devices of the present disclosure. For example, in some embodiments, the patient may be a human male, a human female, or any other mammal.
- The terms proximal and distal described in relation to various devices, apparatuses, and components as discussed in the subsequent text of the present disclosure are referred to using a point of reference. The point of reference, as used in this description, is a perspective of a person who uses the disclosed insertion devices to implant a bodily implant, such as a penile prosthesis. The person may be a surgeon, a physician, a nurse, a doctor, a technician, and the like who may perform the implantation procedure. The term proximal refers to an area or portion that is closer or closest to the person during the implantation procedure. The term distal refers to an area or portion that is farther from, or farthest from the person.
- The embodiments discussed herein may provide improvements to penile prosthesis insertion devices (e.g., furlow insertion devices, furlow insertion tools, insertion tools, devices, tools, etc.). For example, such insertion devices can be configured to self-load and secure a needle in a barrel of the insertion device, which can prevent premature deployment of the needle (e.g., prevent the needle from inadvertently coming out of the tool).
- Further, in some embodiments, such insertion devices can be produced using low-cost bio-compatible materials, such as bio-compatible plastics, or otherwise, as compared with tools constructed using primarily surgical grade metals, for example. Accordingly, in certain embodiments, an insertion device such, as those described herein, can be cost-effective as a single-use device, where the insertion device can be provided in sterile packaging and then disposed of after use in performing a single implantation procedure on a patient, which can reduce the risk of patient infection from reuse and eliminate the need for sterilization of the insertion device.
- In some embodiments, a furlow insertion device can be ergonomically arranged to facilitate easier access to an implantation site (e.g., incision site) for some patients, such as heavy-set patients by allowing for manipulation of the device at a distance that is farther away from the patient's body than in some current insertion devices. Also, in certain embodiments, an insertion device can include a locking mechanism that facilitates ease of loading of a needle (e.g., a Keith needle) and suture in the insertion device.
-
FIGS. 1A, 1B and 1C schematically illustrate a furlow insertion device (device) 100 that can be used for insertion (implantation, etc.) of a penile prosthesis in a penis of a patient according to an embodiment.FIG. 1D schematically illustrates aneedle 180, asuture 185 and apenile prosthesis 190 that can be used in conjunction with theinsertion tool 100 according to an embodiment. In some implementations, theneedle 180, thesuture 185 and thepenile prosthesis 190 can be used in conjunction with other insertion tools, such as those described herein. - As shown in
FIG. 1A , thedevice 100 can include anelongate barrel 110 that is aligned (arranged, situated, etc.) along a longitudinal axis L1. Theelongate barrel 110 can have ameasurement scale 120 that is disposed on an outer surface of theelongate barrel 110. In certain implementations, themeasurement scale 120 can be inscribed, printed, engraved, etc. on the outer surface of theelongate barrel 110. Theelongate barrel 110 can also include ameasurement indicator 130. In certain implementations, themeasurement indicator 130 can be a measurement ring that is axially disposed around theelongate barrel 110. Themeasurement indicator 130 can slide along the elongate barrel 110 (along the axis L1) in a groove or slot 140 (referred to hereafter as slot 140) that is included in theelongate barrel 110. In some implementations, theslot 140 can also be used to receive a suture that is attached to (threaded in) a needle that can be inserted in theelongate barrel 110 of thedevice 100, such as described herein. Themeasurement indicator 130 can be used, in conjunction with themeasurement scale 120, to determine an insertion depth of theelongate barrel 110, e.g., when theelongate barrel 110 is inserted in a corpus cavernosum of a patient. This insertion depth can be used to select an appropriately sized penile prosthesis for implantation in the patient. - The
device 100 can also include ahousing 150 that is coupled with theelongate barrel 110. In some implementations, theelongate barrel 110 and thehousing 150 can be included in a unitary (monolithic) structure. In other implementations, theelongate barrel 110 and thehousing 150 can be separate structures that are coupled (attached, etc.) to each other, such as using an adhesive, being press-fit together, welded together, and so forth. As shown inFIG. 1A , thehousing 150 can have at least a portion that is aligned along a second longitudinal axis L2. The axis L1 of theelongate barrel 110 and the axis L2 of thehousing 150 can define (form, etc.) an angle. In some implementations, the angle defined by the axis L1 and the axis L2 can be between ninety degrees and one-hundred-eighty degrees. - The
device 100 also includes anactuator 160 that is coupled (operationally coupled, etc.) with thehousing 150. Theactuator 160 can, depending on the particular implementation, take a number of forms, such as those described herein. In some implementations, theactuator 160 can be used to operate thedevice 100 during the implantation of a penile prosthesis (e.g., to configure and/or operate thedevice 100 for loading, capturing and deploying a needle, such as a Keith needle, used for penile prosthesis implantation). - As illustrated in
FIG. 1A , thedevice 100 can also include ahandle 170 that is coupled with thehousing 150. Thehandle 170 can be aligned along a third longitudinal axis L3. In some implementations, the axis L3 of thehandle 170 can be parallel with the axis L1 of theelongate barrel 110. In other implementations, the axis L3 of thehandle 170 can be non-parallel or offset with respect to the axis L1 of theelongate barrel 110. The arrangement of theelongate barrel 110, thehousing 150 and/or thehandle 170 in thedevice 100 can, as was noted above, facilitate easier access to an implantation site (e.g., an incision site) for some patients, such as heavy-set patients, by allowing for manipulation of thedevice 100 at a distance away from the patient's body, which can prevent interference by body mass of the patient when a user is attempting to utilize thedevice 100 during the procedure for implantation of a penile prosthesis. -
FIG. 1B schematically illustrates further aspects (elements) of theelongate barrel 110 of thedevice 100 shown in FIG. lA according to an embodiment. In some implementations, the elements shown inFIG. 1B can be implemented and/or included within theelongate barrel 110 of theinsertion device 100. As illustrated inFIG. 1B , theelongate barrel 110 can include anobturator 115, a biasingspring 125 and a connectingrod 135, which can be disposed within alumen 145 that is defined in theelongate barrel 110. Thelumen 145 can extend along the axis L1 of the elongate barrel and can extend from a distal end of theelongate barrel 110 to a proximal end of the elongate barrel 110 (e.g., can be a through-lumen extending the length of the elongate barrel 110). - The
obturator 115 can be configured to, based on operation of thedevice 100 using theactuator 160, receive, capture and deploy a needle for implanting a penile prosthesis. The biasingspring 125 can be axially disposed around the obturator 115 (or can be disposed between theobturator 115 and the connecting rod 135). The biasingspring 125 can apply a force to theobturator 115 and/or the connectingrod 135 to bias theobturator 115 to a fixed position within thelumen 145 of the elongate barrel. For instance, in some implementations, the biasingspring 125 can bias theobturator 115 to a fixed proximal position in thelumen 145. Theobturator 115 can be configured, when in its fixed proximal position to retain (hold, secure, etc.) a needle within thelumen 145, and can prevent the needle from being prematurely deployed from (e.g., exiting) theelongate barrel 110 during the implantation of a penile prosthesis. - The
actuator 160, when manipulated by a user, can cause the obturator 115 (along with the connecting rob 135) to move distally along the axis L1, from its proximal position to a distal position in thelumen 145 while compressing the biasingspring 125. In some implementations, a locking mechanism can be included that can secure (lock) theobturator 115 in its distal position (e.g., after a user releases the actuator 160), preventing thecompressed biasing spring 125 from decompressing and biasing theobturator 115 back to its fixed proximal position. Theobturator 115 can be configured, when in its distal position (fixed or non-fixed) to receive a needle to be secured by the obturator in its proximal position within thelumen 145, and to deploy the needle (e.g., through a glans of a patient's penis) during a process for implanting a penile prosthesis. -
FIG. 1C schematically illustrates aspects (elements) of thehousing 150 of thedevice 100 shown inFIG. 1A according to an embodiment. In some implementations, the elements shown inFIG. 1C can be implemented and/or included within thehousing 150 of theinsertion device 100. As illustrated inFIG. 1C , thehousing 150 can include at least a portion of the connectingrod 135. For instance, in some implementations, a first portion of the connectingrod 135 can be disposed within theelongate barrel 110 and a second portion of the connectingrod 135 can be disposed within thehousing 150. - As shown in
FIG. 1C , thehousing 150 can also include alocking mechanism 155. In some implementations, thelocking mechanism 155 could, alternatively, be included in theelongate barrel 110. Thelocking mechanism 155 can be an indexing mechanism (such as the mechanism described with respect toFIGS. 6A-6B, 7A-7C, 8A-8B and 9A-9C ). For instance, thelocking mechanism 155, in response to actuation of thedevice 100 with theactuator 160, can alternate between a first position and a second position, which can be a first fixed position and a second fixed position. In the first fixed position, thelocking mechanism 155, the biasingspring 125 and/or the connectingrod 135 can cause theobturator 115 to be fixed (locked) in its proximal (needle securing) position. In the second fixed position, thelocking mechanism 155, the biasingspring 125 and/or the connectingrod 135 can cause theobturator 115 to be fixed (locked) in its distal (needle receiving and deploying) position. - In the
housing 150 shown inFIG. 1C , the connectingrod 135 and thelocking mechanism 155 can be disposed within alumen 157 that is defined in thehousing 155. Thelumen 157, which can be coaxial with thelumen 145 of the elongate barrel, can extend from a distal end of thehousing 150 to a proximal end of the housing 150 (e.g., can be a through-lumen). In certain implementations, theactuator 160 can be disposed at the proximal end of thehousing 150 and can, when manipulated by a user, affect movement of theobturator 115 along the axis L1 in the elongate barrel 100 (e.g., distal movement) by applying a force to the connectingrod 135 that is communicated to the obturator 115 (via movement of the connecting rod in thelumen 157 and/or the lumen 145), such that the biasingspring 125 is compressed, and theobturator 115 moves distally in thelumen 145. - The needle 180 (e.g., a Keith needle), the
suture 185 and the penile prosthesis ofFIG. 1D can be used in conjunction with thedevice 100, or other insertion devices, such as those disclosed herein, for implanting thepenile prosthesis 190 in a corpus cavernosum of a patient's penis. An example method for performing such an implantation is illustrated inFIG. 12 and described below. -
FIG. 2 illustrates a furlow insertion device (device) 200 that can be used for insertion of a penile prosthesis according to another embodiment. Thedevice 200 can, however, implement thedevice 100 ofFIG. 1 . As shown inFIG. 2 , thedevice 200 includes anelongate barrel 210, a measurement indicator (measurement ring 230), anactuator 260, ahousing 250 that is coupled with (or integrated monolithically with) theelongate barrel 210, and ahandle 270. Asection line 9A-9A is also shown inFIG. 2 , which illustrates a cut line through the housing corresponding with the cross-sectional view illustrated inFIG. 9A . - As shown in
FIG. 2 , theelongate barrel 210 can include ameasurement scale 220 that is disposed on an outer surface of theelongate barrel 210. Depending on the implementation, themeasurement scale 210 can be inscribed, printed, engraved, etc. on theelongate barrel 210. Theelongate barrel 210 can also include a slot (or groove) 240 that is disposed along an underside of theelongate barrel 210 and, therefore, not explicitly shown inFIG. 2 . In theinsertion device 200, themeasurement ring 230 can slide along theslot 240. For instance, themeasurement ring 230, after inserting theelongate barrel 210 into the body of a patient (e.g., to a depth of a corpus cavernosum), can be slid, guided by theslot 240, along theelongate barrel 210, until themeasurement ring 230 is proximate with an insertion site for theelongate barrel 210. After extracting theelongate barrel 210 from the patient, the position of themeasurement ring 230 on themeasurement scale 220 can be used to determine the insertion depth. Further, a suture, such as thesuture 185 ofFIG. 1D , can be pulled into theslot 240 when performing an implantation process using thedevice 200, such as in accordance with themethod 1200 illustrated inFIG. 12 . - In the
device 200, thehousing 250 includes acurved portion 252 that curves away from a central axis of theelongate barrel 210, the central axis of the elongate barrel being arranged along the axis L1. Thehousing 250 also includes astraight portion 254 that extends along the axis L2, where the axis L1 of theelongate barrel 210 and the axis L2 of thestraight portion 254 define an angle between ninety degrees and one-hundred-eighty degrees. In certain implementations, a locking mechanism can be included in thedevice 200, e.g., in theelongate barrel 210 or in thehousing 250, such as in thestraight portion 254 of thehousing 250. An example locking mechanism that can be included in thedevice 200 is illustrated below inFIGS. 6A-6B, 7A-7C, 8A-8B and 9A-9C . The locking mechanism can be, for instance, an indexing locking mechanism. - The
device 200 ofFIG. 2 can further include anactuator 260, which is implemented as a plunger in thedevice 200. A user can operate (actuate) thedevice 200 by depressing the actuator 260 with his or her thumb, while holding thedevice 200 by thehandle 270, thehandle 270 being coupled with thehousing 250. As shown inFIG. 2 , thehandle 270 can be arranged along the axis L3. Depending on the implementation, the axis L3 of thehandle 270 can be parallel with, or non-parallel with the axis L1 of theelongate barrel 210. -
FIG. 3 illustrates a cross-sectional view of thefurlow insertion device 200 ofFIG. 2 according to an embodiment. InFIG. 3 , theelongate barrel 210 and the housing are shown in cross-section, to illustrated elements of thedevice 200 that can be disposed within theelongate barrel 210 and thehousing 250, such as the elements of thedevice 100 illustrated inFIGS. 1B and 1C and described above. - As shown in
FIG. 3 , thedevice 200 can include anobturator 215 and abiasing spring 225 that are disposed within alumen 245 that is defined within theelongate barrel 210. The biasingspring 225 can be axially disposed around the obturator and can contact one or more surfaces within thelumen 245 and/or engage with theobturator 215 to bias theobturator 215 in a proximal position, such as is illustrated inFIG. 3 . Thedevice 200 can also include a connectingrod 235, which can be a resilient, flexible connecting rod that has a first portion disposed within thelumen 245 of the elongate barrel and a second portion that is disposed within alumen 257 of thehousing 250. - As illustrated in
FIG. 3 , the connectingrod 235 can be disposed between the actuator 260 and theobturator 215. In thedevice 200, depressing the actuator 260 into thelumen 257 of thehousing 250 will apply a force on the connectingrod 235 and that force will be communicate to theobturator 215 to move the obturator to a distal position in thelumen 245 of theelongate barrel 210. The force on the connecting rod and theobturator 215 can also compress thebiasing spring 225. In certain implementations, a locking mechanism can be indexed in response to theactuator 260 being depressed and lock (fix) theobturator 215 in its distal position, with the biasing spring compressed. In such implementations, on a next depression of theactuator 260, the locking mechanism can index again and allow thebiasing spring 225 to decompress and return theobturator 215 to its proximal position, such as shown inFIG. 3 . - In certain implementations, the
device 200 may not include a locking mechanism. In such devices, theobturator 215 can be maintained in its distal position by maintaining pressure on theactuator 260, or keeping theactuator 260 depressed. Releasing theactuator 260, or removing pressure from theactuator 260 in such implementations can allow thebiasing spring 225 to decompress and move theobturator 215 from its distal position to it proximal position. - As also shown in
FIG. 3 , theobturator 215 can include acollet 217 disposed at a distal end of the obturator, where thecollet 217 is configured to receive a needle 280 (which can be, e.g., a Keith needle) when theobturator 215 is in its distal position, and configured to secure (hold, retain, etc.) the needle in thecollet 217 within theelongate barrel 210 when theobturator 215 is in its proximal position. As shown inFIG. 3 , thelumen 245 of theelongate barrel 210 can included a flared portion at a distal end of theelongate barrel 210 and acylindrical portion 249 that is disposed proximally of the flaredportion 247 in the elongate barrel. The flaredportion 247 and thecylindrical portion 249 of thelumen 245 can operate, in conjunction withcollet 217, to allow thecollet 217, based on a position of theobturator 215 in thelumen 245, to allow thecollet 217 to open to receive or deploy theneedle 280, or to close to retain theneedle 280 in thecollet 217. An example implementation of thecollet 217 is illustrated inFIG. 4 , while an example implementation of the flaredportion 247 and thecylindrical portion 249 of thelumen 245, along with thecollet 217, is illustrated inFIG. 5 . -
FIG. 4 illustrates an example implementation of thecollet 217 of thedevice 200 ofFIGS. 2 and 3 according to an embodiment. As discussed above, thecollet 217 can be disposed at a distal end of theobturator 215 in thedevice 200. In some implementations, thecollet 217 can include a plurality of tags that can be defined by formingsplices 419 in the distal end of theobturator 215, where a diameter of thecollet 217 is greater than a diameter of ashaft 219 of theobturator 215. Thesplices 419 can create an opening in thecollet 217, e.g., between thetags 417, that is sized to receive theneedle 280. As shown inFIG. 4 , thetags 417 of thecollet 217 can be radially disposed around the distal end of the obturator. Depending on the implementation, thecollet 217 can include, for example, two to six tags. -
FIG. 5 is a partial cross-sectional view of thedevice 200. illustrating theneedle 280 secured within thecollet 217 ofFIG. 4 according to an embodiment. That is,FIG. 5 illustrates a cross-sectional view of a distal end of thedevice 200, as shown inFIG. 3 , for example. - As shown in
FIG. 5 , thecollet 217 and theneedle 280 are disposed within thecylindrical portion 249 of thelumen 245 of thedevice 200. As can be seen inFIG. 5 , thecylindrical portion 249 of thelumen 245 can have a diameter that is smaller than a diameter of the flaredportion 247 of thelumen 245. The diameter of thecylindrical portion 245 can also be smaller than a diameter of thecollet 217. Therefore, when theobturator 215 is located, e.g., biased by the biasing spring 224, in a position within thelumen 245 of theelongate barrel 210 such that thecollet 217 is within thecylindrical portion 249, walls of thecylindrical portion 249 will apply inward pressure on thetags 417. This inward pressure on thetags 417 can cause thetags 417 to tighten on theneedle 280, such that theneedle 280 is secured within thecollet 217 by thetags 417. In other words, in this arrangement, theneedle 280 can be securely held within theelongate barrel 210 of thedevice 200 by thetags 417 of thecollet 217. - As discussed herein, the
obturator 215 can be moved distally, or fixed in a distal position by applying pressure to theactuator 260, or indexing a locking mechanism with theactuator 260. When theobturator 215 is moved to a distal position or a fixed distal position, where thecollet 217 is disposed within the flaredportion 247 of thelumen 245, thetags 417 of thecollet 217 can spread, e.g., spring, outward, such than an opening in thesplices 419 of thecollet 217 can allow for receiving or deploying theneedle 280, e.g., via anopening 510 in the distal end of theelongate barrel 210, where theopening 510 can be continuous with, or part of thelumen 245. - As discussed above with respect to the
devices FIGS. 6A-6B, 7A-7C, 8A-8B and 9A-9C . - For instance,
FIGS. 6A and 6B illustrate a portion of ahousing 650 that includesprotrusions 620 andgrooves FIGS. 6A and 6B , as well as related elements of the locking mechanism, can be implemented in other portions, or sections of a furlow insertion device, such as in an elongate barrel of a furlow insertion device. For instance, in some implementations the housing 650 (or other housing, such as the housing 250) can include a cylindrical bore therethrough, and a separate cylindrical piece that includes the protrusions andgrooves -
FIGS. 7A-7C illustrate anindexer 700 that can be included in a locking mechanism of a furlow insertion tool, whileFIGS. 8A and 8B illustrate an example implementation of theactuator 260 that includes anend portion 830 that can work cooperatively with theindexer 700 in thehousing 650 to implement an indexing locking mechanism. Operation of alocking mechanism 900 including the elements ofFIGS. 6A-6B, 7A-7C and 8A-8B is illustrated inFIGS. 9A-9C . For purposes of illustration and by way of example, the locking mechanism ofFIGS. 6A-6B, 7A-7C, 8A-8B and 9A-9C is described with further reference toFIGS. 1A-1B and 2-5 . - Furlow insertion devices, such as the
device 200, that include such a locking mechanism can provide for easier loading of, and securing of theneedle 280 within thecollet 217 of theobturator 215. For example, as discussed above, such a locking mechanism can lock or fix the obturator in a distal position, such that thecollet 217 is disposed within the flaredportion 247 of theelongate barrel 210′slumen 245. This locking of the obturator in a fixed distal position allows for a user to load theneedle 280 in theopen tags 417 of thecollet 217, without the need to maintain pressure on theactuator 260 of the device, e.g., to prevent thebiasing spring 225 from decompressing and moving (biasing) theobturator 215 to a proximal fixed position. - Once the
needle 280 is loaded in thetags 417 of thecollet 217, theactuator 260 can be depressed again, causing the locking mechanism to index, which can allow thebiasing spring 225 to decompress and move, or bias theobturator 215 to a proximal fixed position, e.g., with thecollet 217 disposed within thecylindrical portion 249 of thelumen 245 and thetags 417 pressed inward onto theneedle 280, such that theneedle 280 is retained or held in place in thecollet 217 by thetags 417. Accordingly, said in other words, the locking mechanismFIGS. 6A-6B, 7A-7C, 8A-8B and 9A-9C can be activated to lock theobturator 215 in a fixed distal position by depressing the actuator 260 until a mechanical stop (e.g., theindexer 700 reaching an end of a lumen in the housing 650), and then releasing theactuator 260. The locking mechanism can then be deactivated to return theobturator 215 to its biased, fixed proximal position by, again, depressing the actuator 260 until the mechanical stop, and then releasing theactuator 260. -
FIGS. 6A and 6B are partial cross-sectional views of thehousing 650 of a furlow insertion device in which a locking mechanism can be implemented according to an example embodiment. The views shown inFIGS. 6A and 6B show an inner surface of thehousing 650, which can be used in implementing an indexing locking mechanism. Further, the views ofFIGS. 6A and 6B are isometric views from two different angles and at two different degrees of magnification, the view ofFIG. 6B being enlarged (magnified) and further sectioned, as compared with the view ofFIG. 6A . - As shown, in
FIGS. 6A and 6B , thehousing 650 can include a plurality ofprotrusions 620 that are radially disposed around the inner surface of thehousing 650. Theprotrusions 620 can definegrooves 610 andgrooves 630 on the inner surface, where thegrooves protrusions 620 can alternate around a circumference of the inner surface of thehousing 650, such as in the arrangement shown inFIGS. 6A and 6B , as well as inFIG. 9A . For instance, as is illustrated inFIG. 9A , in some implementations, the inner surface of thehousing 650 can include threegrooves 610 and threegrooves 630, as shown thegrooves 610 can alternative with thegrooves 630, withprotrusions 620 disposed between, thegrooves 610 being deeper than thegrooves 630. In example implementations, thegrooves protrusions 620 are sized, shaped and located so that they can work cooperatively with protrusions and surfaces of theend portion 830 of theactuator 260, and protrusions and surfaces of theindexer 700, to operate as an indexing locking mechanism fordevice 200 and theobturator 215, using the example of thedevice 200. For instance, theprotrusions 620 can includeangled surface 637 that work cooperatively with theindexer 700 to affect indexing of a locking mechanism. - As further shown in
FIGS. 6A and 6B , the inner surface of thehousing 650 includes anopen area 640, without protrusions or grooves. Theopen area 640, in this example locking mechanism, can allow theindexer 700 to rotate, in cooperation with theactuator 260 and thehousing 650, to index the locking mechanism between a first position, with the obturator locked or fixed in a distal position, and a second position, with the obturator locked or fixed in a proximal position, such as is described herein. -
FIGS. 7A and 7B are views of anindexer 700 of a locking mechanism according to an embodiment.FIG. 7C is a cross-sectional view of theindexer 700 ofFIGS. 7A and 7B according to an embodiment. -
FIGS. 7A and 7B are isometric views of theindexer 700 from two different angles, to illustrate different perspectives of the features of theindexer 700. As shown inFIGS. 7A and 7B , theindexer 700 can include twodiametric sections sections section 705 includes a plurality of angled andbeveled surfaces 730 that form V-shaped ridges or troughs disposed along an upper circumferential edge of thesection 705. As shown inFIGS. 7A and 7B , a depth of each V-shaped trough ends at an outside diameter orsurface 740 of thesection 725 of theindexer 705. - As also shown in
FIGS. 7A and 7B , each alternative apex of the V-shaped troughs of thesection 705 has aprotrusion 710, where a width of eachprotrusion 710 extends from an apex of corresponding V-shaped trough and extends vertically along the length of thesection 705 of the indexer. In this example, when implemented with thehousing 650 in the locking mechanism illustrated inFIGS. 9A-9C , theprotrusions 710 of theindexer 700 are configured to slide, or ride within thedeeper grooves 610 of thehousing 650. Theprotrusion 710 are sized such that they do not slide (will not enter) theshallower grooves 630 of thehousing 650. Theprotrusions 710 are also sized such that theindexer 700 rotates, or indexes in theopen area 640 of the housing, such as when theprotrusions 710 are outside thegrooves 610 of thehousing 650. - The
section 705 of theindexer 700 also includessurfaces 720 that form part of the V-shaped troughs of thesection 705. Thesurfaces 720 of thesection 705 are defined, in part, by theprotrusions 710 of thesection 705. - The
section 725 of theindexer 700 can be cylindrical with acenter bore 750. In some implementations, the center bore 750 can be eliminated. Thesection 725 includes anouter surface 740.Section 725 can be sized so that theouter surface 740 fits within a bore defined in theend portion 830 of theactuator 260, such as the bore shown below inFIG. 8B , which can coaxially align theindexer 700 with theend portion 830 of theactuator 260.FIG. 7C illustrates a cross-sectional view of theindexer 700, sectioned through a central axis of theindexer 700. As shown inFIG. 7C , theindexer 700 can include a counter-bore 760 in thesection 705, where the counter bore 760 can be sized to receive a proximal end of the connecting rod 735, or a proximal end of the obturator, depending on a specific location of the locking mechanism in thedevice 200. -
FIG. 8A is a plunger that can be used to implement theactuator 260 of, for example, thedevice 200 according to an embodiment. Theactuator 260 ofFIG. 8A can operate in conjunction with thehousing 650 ofFIGS. 6A and 6B , and theindexer 700 ofFIGS. 7A-7C to implement an indexing locking mechanism in a furlow insertion device, such as in thedevice 200.FIG. 8B is a cross-sectional view of the actuator (plunger) 260 ofFIG. 8A according to an embodiment. - The actuator (plunger) 260 of
FIGS. 8A and 8B includes abutton 810 that can be used to depress the actuator in thedevice 200, e.g., to affect distal movement of theobturator 215 and/or to index a locking mechanism, such as the locking mechanism of the present example. Theactuator 260, as shown inFIG. 8A , includes acylindrical section 820 and anend portion 830, where theend portion 830 can operate in cooperation with thehousing 650 and theindexer 700 to implement an indexing locking mechanism. - The
end portion 830 of theactuator 260 ofFIGS. 8A and 8B , as shown in the cross-sectional view ofFIG. 8B , can include acounter bore 839 which can receive thesection 725 of theindexer 700, so that theindexer 700 and theend portion 830 are concentrically aligned. As shown inFIGS. 8A and 8B , theend portion 830 can include V-shapedprotrusions 837 which can operate cooperatively with the V-shapes troughs of theindexer 700 in implementing an indexing locking mechanism. As further illustrated inFIGS. 8A and 8B , theend portion 830 of theactuator 260 can includeprotrusions 835 that are disposed on its outer surface. In this example, theprotrusions 835 of theend portion 835 can be sized to ride in theshallower grooves 620 of thehousing 650. For instance, theprotrusions 835 can allow theactuator 260 ofFIGS. 8A and 8B to move axially along thegrooves 620, while preventing the actuator 260 from rotational motion within thehousing 650, which could result in changing alignment of theend portion 830 withindexer 700, causing improper operation of the locking mechanism of this example. For instance, the locking mechanism can be configured such that theprotrusions 835 do not exit thegrooves 620, even when theactuator 260 is fully depressed. Theprotrusions 835 can be prevent from exiting thegrooves 620 due to theindexer 700 contacting a mechanical stop in thehousing 650 and preventing axial movement of theprotrusions 835 out of thegrooves 620 and into theopen area 640 of thehousing 650. -
FIGS. 9A, 9B and 9C are diagrams illustrating alocking mechanism 900 according to an embodiment. Thelocking mechanism 900, which can also be referred to as an indexing locking mechanism can be implemented, as was indicated above, using thehousing 650 ofFIGS. 6A and 6B , theindexer 700 ofFIGS. 7A-7C and the actuator (plunger) 260 ofFIGS. 8A and 8B . Accordingly, in the discussion ofFIGS. 9A-9C , further reference is made toFIGS. 6A and 6B ,FIGS. 7A-7C ,FIGS. 8A and 8B , and the elements of thehousing 650, theindexer 700 and the actuator 260 (as illustrated inFIGS. 8A and 8B ). -
FIG. 9A is a plan view along thesection line 9A-9A inFIG. 2 , illustrating an example arrangement of the elements of thelocking mechanism 900 in the housing 650 (or the housing 250). For instance,FIG. 9A illustrates the axial arrangement of theindexer 700 and theend portion 830 of theactuator 260 ofFIGS. 8A and 8B within thehousing 650. For purposes of clarity, other elements of thedevice 200, such as thehandle 270, are not shown inFIG. 9A . As shown inFIG. 9A , the housing 650 (or 250) can be of two-piece construction, including afirst housing portion 650 a and asecond housing portion 650 b. - As illustrated in
FIG. 9A , in thelocking mechanism 900, theprotrusions 710 can be disposed in, or ride in thedeeper grooves 610 of thehousing 650. As also shown inFIG. 9A , theprotrusions 835 of theend portion 830 can be disposed in, or ride in theshallower grooves 630 of thehousing 650. Further, as illustrated inFIG. 9A , theprotrusions 620 of thehousing 650 are disposed between thegrooves 610 and thegrooves 630 in an alternating arrangement around a circumference of the inner surface of thehousing 650. -
FIG. 9B is a side view of thelocking mechanism 900 in the arrangement shown inFIG. 9A . That is,FIG. 9B illustrates theindexer 700 with itsprotrusions 710 riding in thegrooves 610 of thehousing 650 and theend portion 830 of theactuator 260 with itsprotrusions 835 riding in thegrooves 630. As shown inFIG. 9B , in this arrangement, the V-shaped troughs orprotrusions 730 of theindexer 700 are offset from the V-shapedprotrusions 837 of theend portion 830. When pressure is applied to the actuator 260 (e.g., when theactuator 260 is depressed) both theend portion 830 of theactuator 260 and theindexer 700 will slide axially (downward inFIG. 9B ) within their respective grooves of the housing, where the grooves prevent rotational movement of theindexer 700 and theactuator 260. - As shown in
FIG. 9C , once the actuator has been depressed to move theprotrusions 710 of theindexer 700 out of thegrooves 610 of thehousing 650, and into theopen area 640 of the housing, pressure applied to theactuator 260 and counter-pressure from the biasingspring 225 can cause the V-shapedprotrusions 730 of the indexer to align with the V-shapedprotrusions 837 of theend portion 830, as shown inFIG. 9C . This alignment of theindexer 700 and theend portion 830 of theactuator 260 will affect a slight rotational motion of theindexer 700. When pressure is removed from theactuator 260, the biasing force of thespring 225 will push both theindexer 700 and theactuator 260 distally (upward) in the housing 635. - As the
indexer 700 rises in response to force from the biasingspring 225, peaks of its V-shapedprotrusions 730 will ride along theangled edges 637 of theprotrusions 620 in thehousing 650, which will cause further rotational motion of theindexer 700, and align theprotrusion 710 of theindexer 700 with either thegrooves 610 or thegrooves 630 of thehousing 650. The rotational motion of theindexer 700 resulting from depressing and releasing of theactuator 260 can be referred to as indexing of thelocking mechanism 900. If theprotrusions 710, after indexing of thelocking mechanism 900, are aligned with thedeeper grooves 610, theprotrusions 710 of theindexer 700 will ride in thegrooves 610 and an obturator, such as theobturator 215 will be biased to its proximal position. If, however, theprotrusions 710, after indexing of thelocking mechanism 900, are aligned with theshallower grooves 630, theprotrusions 710 of theindexer 700 will be prevented from rising by theshallower grooves 620, the biasing spring 625 will remain compressed, and the obturator of the associated insertion device will be locked, or fixed in its distal position. -
FIGS. 10A and 10B are cross-sectional views of anotherfurlow insertion device 1000 according to an embodiment. As shown inFIGS. 10A and 10B , thedevice 1000 includes anelongate barrel 1010 that is similar in configuration to theelongate barrel 210 of thedevice 200. Accordingly, for purposes of brevity, at least some aspects and features of theelongate barrel 1010 are not described in detail with respect toFIGS. 10A and 10B . - As illustrated in
FIGS. 10A and 10B , thedevice 1000 includes asqueeze handle actuator 1060 that rotates on a pivot (e.g., a pin, an axle, etc.) 1065. Thepivot 1065 and theactuator 1060 can be affixed to, or coupled with ahandle 1070 of thedevice 1000. Thedevice 1000 is shown inFIG. 10A with anobturator 1015 in a proximal position. For instance, pressure is not being applied to theactuator 1060. Accordingly, thebiasing spring 1025 can maintain theobturator 1015 in a fixed, proximal position. In the proximal position ofFIG. 10A , a collet of theobturator 1015 can be compressed, so as to retain a needle within the collet and within theelongate barrel 1010. - In
FIG. 10B , thedevice 1000 is illustrated with theobturator 1015 in a distal position. For instance, in the arrangement shown inFIG. 10B , pressure may be applied to theactuator 1060, so as to apply a force to a connectingrod 1035 to affect distal movement of theobturator 1015, e.g., to the distal position for loading or deployment of a needle. In certain implementations, if thedevice 1000 includes a locking mechanism, theobturator 1015, as shown inFIG. 10B , can be locked, or fixed in its distal position. -
FIGS. 11A and 11B are cross-sectional views of anotherfurlow insertion device 1100 according to an embodiment. As shown inFIGS. 11A and 11B , thedevice 1100 includes anelongate barrel 1110 that is similar in configuration to theelongate barrel 210 of thedevice 200. Accordingly, for purposes of brevity, at least some aspects and features of theelongate barrel 1110 are not described in detail with respect toFIGS. 11A and 11B . - As illustrated in
FIGS. 11A and 11B , thedevice 1100 includes arotating knob actuator 1160 that rotates within ahousing 1150. Theactuator 1160 includes a tab 1165 that contacts a connectingrod 1135. As shown inFIGS. 11A and 11B , thedevice 1100 can also include ahandle 1170 that is coupled with thehousing 1150. - In
FIG. 11A , thedevice 1100 is illustrated with anobturator 1115 in a proximal position. For instance, pressure is not being applied to theactuator 1160. Accordingly, thebiasing spring 1125 can maintain theobturator 1115 in a fixed, proximal position. In the proximal position ofFIG. 11A , a collet of theobturator 1115 can be compressed, so as to retain a needle within the collet and within theelongate barrel 1110. - In
FIG. 11B , thedevice 1100 is illustrated with theobturator 1115 in a distal position. For instance, in the arrangement shown inFIG. 11B , pressure may be applied to theactuator 1160, so as to apply a force to the connectingrod 1135, via the tab 1165, to affect distal movement of theobturator 1115, e.g., to a distal position for loading or deployment of a needle. In certain implementations, as shown inFIG. 11B , theobturator 1115 of thedevice 1100 can be locked, or fixed in its distal position by thelocking mechanism 900, such as described above with respect toFIGS. 9A-9C . -
FIG. 12 is a flowchart of amethod 1200 for inserting a penile prosthesis according to an embodiment. For instance, a cylindrical (e.g., inflatable, malleable, etc.) penile prosthesis can be implanted (inserted, etc.) in a corpus cavernosum of a patient in accordance with themethod 1200. Further, themethod 1200 can be implemented using the insertion devices described herein. For purposes of illustration, and by way of example, themethod 1200 ofFIG. 12 is described with further reference to theinsertion devices FIGS. 1A-1C, 2, 3, 4 and 5 , and thelocking mechanism 900 ofFIGS. 6, 7, 8 and 9 , as appropriate. Reference is further made toFIG. 1D in the discussion ofFIG. 12 . It is understood that, in some implementations, other insertion tools can be used to perform themethod 1200. Also, in some implementations, the order of the operations of themethod 1200 can vary, additional operations can be added and/or operations shown inFIG. 12 can be omitted, depending on the particular implementation. - As shown in
FIG. 12 , atblock 1210, themethod 1200 can include making a penoscrotal or an infrapubic incision in a body of a patient, wherein the incision is located such that a corpus cavernosum of the patient's penis is accessible through the incision. At block 1220, themethod 1200 includes manipulating theinsertion device 200, via thehandle 270, to perform a first insertion of theelongate barrel 210 of theinsertion device 200 into the corpus cavernosum, the insertion of theelongate barrel 210 being made via the incision ofblock 1210. - At
block 1230, themethod 1200 can include sliding themeasurement ring 230 along theelongate barrel 210, such that themeasurement ring 230 is proximate (adjacent to, touching, in contact with, etc.) the incision. Themeasurement ring 230 can be slid along the groove orslot 240 in theelongate barrel 210. Atblock 1240, themethod 120 can include extracting (withdrawing, removing, etc.) theelongate barrel 210 from the patient (e.g., removing theelongate barrel 210 from the corpus cavernosum via the incision). Also atblock 1240, themethod 1200 can include reading (determining, etc.) an insertion depth of theelongate barrel 210 in the corpus cavernosum, where the insertion depth is determined based on themeasurement scale 220 on theelongate barrel 210 and a position of themeasurement ring 230 on the elongate barrel 210 (and the measurement scale 220). - At
block 1250, an appropriate penile prosthesis, such as theprosthesis 190, can be selected based on the insertion depth measurement ofblock 1240. Also atblock 1250, the selected prosthesis can be attached (coupled with, affixed to, etc.) thesuture 185. Atblock 1260 the suture ofblock 1250 can be threaded into (inserted through) an eye of a needle, such as theKeith needle 280. - At
block 1270, themethod 1200 can include capturing a needle (e.g., the Keith needle 280) within theelongate barrel 210 of theinsertion device 200, such as within thetags 417 of thecollet 217. For instance, capturing theneedle 280 in thetags 417 of thecollet 217 can include locking theobturator 215 in its distal position, such as by using a locking mechanism (e.g., the locking mechanism 900) that can be included in theinsertion device 200. As described herein, when theobturator 215 is in its distal position, thetags 417 of thecollet 217 can be biased within the flaredportion 247 of thelumen 245 such that the tags are spaced (open, etc.) to receive theneedle 280. Theneedle 280 can then be captured within theelongate barrel 210 by indexing thelocking mechanism 900. For instance, thelocking mechanism 900 can be indexed by actuating theinsertion device 200, causing the biasingspring 225 to bias theobturator 215 to its proximal position, resulting in thetags 417 of thecollet 217 being compressed within thecylindrical portion 249 of thelumen 245, and capturing (grabbing, retaining, holding, etc.) the needle 290 in thecollet 217 and within theelongate barrel 210. Also atblock 1270, themethod 1200 can include pulling (guiding, etc.) a suture (e.g., the suture 185) that is inserted (threaded, etc.) in an eye of theneedle 280 along (into, etc.) theslot 240 in theelongate barre 210. - At
block 1280, themethod 1200 can include performing a second insertion of theelongate barrel 210 into the corpus cavernosum of the patient via the incision. Atblock 1290, theinsertion tool 200 can be actuated (e.g., to lock the obturator in its distal position), causing theneedle 280 to, at least partially, exit the patient's body via a glans of the patient's penis. Also atblock 1290, theelongate barrel 210 can again be removed (withdrawn, etc.) from the corpus cavernosum of the patient, leaving theneedle 280 and thesuture 185 in place (e.g., with theneedle 280 partially extending out of the glans and thesuture 185 extending from an eye of theneedle 280 within the corpus cavernosum to the penile prosthesis being implanted). Atblock 1295, the penile prosthesis can be implanted into the corpus cavernosum of the patient by drawing the prosthesis through the incision and into to the corpus cavernosum by pulling theneedle 280 and thesuture 185 through (out of, etc.) the glans of the patient's penis. After completing implantation of the penile prosthesis in accordance with themethod 1200, theinsertion tool 200 can be disposed of (e.g. as medical waste). - While certain features of the described implementations have been illustrated as described herein, many modifications, substitutions, changes and equivalents will now occur to those skilled in the art. It is, therefore, to be understood that the appended claims are intended to cover all such modifications and changes as fall within the scope of the embodiments.
Claims (20)
1. An insertion device comprising:
an elongate barrel, a distal end of the elongate barrel having an opening defined therein;
a lumen defined within the elongate barrel, the lumen being accessible through the opening; and
an obturator disposed within the lumen of the elongate barrel, the obturator being movable within the lumen between a proximal position in the elongate barrel and a distal position in the elongate barrel,
the obturator, in its distal position in the elongate barrel, is configured to receive a needle via the opening, and
the obturator, in its proximal position in the elongate barrel, is configured to secure the needle within the elongate barrel.
2. The insertion device of claim 1 , wherein the obturator includes a collet disposed at a distal end of the obturator, the collet having a plurality of tags,
the plurality of tags being biased to receive the needle when the obturator is in its distal position in the elongate barrel, and
the plurality of tags being compressed to secure the needle when the obturator is in its proximal position in the elongate barrel.
3. The insertion device of claim 2 , wherein the lumen of the elongate barrel includes:
a flared portion disposed at the distal end of the elongate barrel, the flared portion being configured to allow the plurality of tags to bias to receive the needle when the collet is disposed within the flared portion; and
a cylindrical portion disposed proximal to the flared portion, the cylindrical portion being configured to compress the plurality of tags when the collet is disposed within the cylindrical portion.
4. The insertion device of claim 3 , wherein a diameter of the flared portion of the lumen is greater than a diameter of the cylindrical portion of the lumen.
5. The insertion device of claim 1 , further comprising:
a biasing spring axially disposed around at least a portion of the obturator and disposed within the lumen of the elongate barrel, the biasing spring being configured to bias the obturator in its proximal position.
6. The insertion device of claim 1 , further comprising:
a measurement scale disposed on an exterior surface of the elongate barrel; and
a measurement ring that is slidable along the elongate barrel to indicate an insertion depth of the elongate barrel.
7. The insertion device of claim 6 , wherein the elongate barrel includes a groove or a slot defined therein, the groove or slot extending along the elongate barrel, the measurement ring being slidable along the groove or the slot.
8. The insertion device of claim 6 , wherein the measurement scale is inscribed on an exterior surface of the elongate barrel.
9. The insertion device of claim 1 , wherein the elongate barrel is aligned along a first longitudinal axis, the insertion device further comprising:
a housing disposed at a proximal end of the elongate barrel, the housing including:
an elbow portion coupled with the elongate barrel; and
a straight portion coupled with the elbow portion, the straight portion being aligned along a second longitudinal axis, the second longitudinal axis defining an angle with the first longitudinal axis, the angle being between ninety degrees and one-hundred-eighty degrees,
the housing having a lumen disposed therethrough;
an actuator disposed at a distal end of the housing;
a flexible connecting rod having a first portion disposed within the lumen of the housing and a second portion disposed within the lumen of the elongate barrel, the flexible connecting rod being disposed between the actuator and the obturator, the actuator and the flexible connecting rod being configured, in response to movement of the actuator by a user, to move the obturator from its proximal position to its distal position.
10. The insertion device of claim 9 , further comprising:
a handle coupled with the housing, the handle being aligned along a third longitudinal axis.
11. The insertion device of claim 10 , wherein the third longitudinal axis is parallel with the first longitudinal axis.
12. The insertion device of claim 1 , further comprising:
a housing disposed at a proximal end of the elongate barrel and coupled with the elongate barrel, the housing having a lumen disposed therethrough;
an actuator disposed at a distal end of the housing;
a connecting rod having a first portion disposed within the lumen of the housing and a second portion disposed with the lumen of the elongate barrel, the connecting rod being disposed between the actuator and the obturator, the actuator and the connecting rod being configured, in response to movement of the actuator by a user, to move the obturator from its proximal position to its distal position.
13. The insertion device of claim 12 , wherein the connecting rod is a flexible connecting rod.
14. The insertion device of claim 12 , wherein the actuator includes at least one of:
a plunger;
a squeeze lever; or
a rotating knob disposed in the housing.
15. The insertion device of claim 1 , further comprising a locking mechanism that is configured to selectively lock the obturator in its distal position.
16. The insertion device of claim 1 , further comprising an indexing mechanism configured to, in response to actuation of the insertion device, alternate between a first fixed position and a second fixed position, wherein:
when the indexing mechanism is in its first fixed position, the obturator is fixed in its distal position in the elongate barrel, and
when the indexing mechanism is in its second fixed position, the obturator is fixed in its proximal position in the elongate barrel.
17. A method for inserting a penile prosthesis, the method comprising:
making a penoscrotal or an infrapubic incision in a body of a patient;
capturing a needle in an obturator of an insertion device to secure the needle within an elongate barrel of the insertion device;
pulling a suture inserted in an eye of the needle into a slot in the elongate barrel;
using a handle of an insertion device, manipulating the insertion device to perform an insertion of the elongate barrel, via the incision, into a corpus cavernosum of a penis of the patient;
attaching a penile prosthesis to the suture;
actuating the insertion device to deploy at least a portion of the needle through a glans of the penis;
withdrawing the elongate barrel from the corpus cavernosum and the incision;
implanting the penile prosthesis in the corpus cavernosum by pulling the prosthesis through the incision and into to the corpus cavernosum by pulling the needle and suture through the glans.
18. The method of claim 17 , wherein capturing the needle in the obturator includes capturing the needle with tags of a collet disposed at a distal end of the obturator.
19. The method of claim 17 , wherein the insertion is a second insertion, the method further comprising, prior to performing the second insertion:
using the handle of the insertion device, manipulating the insertion device to, via the incision, perform a first insertion of the elongate barrel into the corpus cavernosum;
sliding a ring disposed on the barrel proximate the incision;
withdrawing the elongate barrel from the corpus cavernosum and the incision; and
determining, based on a measurement scale inscribed on the elongate barrel and position of the ring on the elongate barrel, a depth of insertion of the elongate barrel in the corpus cavernosum;
the penile prosthesis being selected based on the depth of insertion.
20. The method of claim 19 , wherein sliding the ring includes sliding the ring along a groove in the elongate barrel.
Priority Applications (1)
Application Number | Priority Date | Filing Date | Title |
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US17/809,163 US20220323223A1 (en) | 2018-03-23 | 2022-06-27 | Furlow insertion device |
Applications Claiming Priority (3)
Application Number | Priority Date | Filing Date | Title |
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US201862647272P | 2018-03-23 | 2018-03-23 | |
US16/357,851 US11399943B2 (en) | 2018-03-23 | 2019-03-19 | Furlow insertion device |
US17/809,163 US20220323223A1 (en) | 2018-03-23 | 2022-06-27 | Furlow insertion device |
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Application Number | Title | Priority Date | Filing Date |
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US16/357,851 Continuation US11399943B2 (en) | 2018-03-23 | 2019-03-19 | Furlow insertion device |
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US20220323223A1 true US20220323223A1 (en) | 2022-10-13 |
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Application Number | Title | Priority Date | Filing Date |
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US16/357,851 Active 2041-02-27 US11399943B2 (en) | 2018-03-23 | 2019-03-19 | Furlow insertion device |
US17/809,163 Pending US20220323223A1 (en) | 2018-03-23 | 2022-06-27 | Furlow insertion device |
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US16/357,851 Active 2041-02-27 US11399943B2 (en) | 2018-03-23 | 2019-03-19 | Furlow insertion device |
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WO (1) | WO2019183190A1 (en) |
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US11446059B2 (en) | 2018-10-15 | 2022-09-20 | Boston Scientific Scimed, Inc. | Implant insertion device |
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US5628757A (en) | 1992-02-04 | 1997-05-13 | Hasson; Harrith M. | Surgical instrument for holding a needle |
US7344554B2 (en) | 2003-02-26 | 2008-03-18 | Ams Research Corporation | Keith needle for furlow insertion tool |
US8545391B2 (en) | 2008-12-23 | 2013-10-01 | Ams Research Corporation | Penile prosthesis implantation device |
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2019
- 2019-03-19 US US16/357,851 patent/US11399943B2/en active Active
- 2019-03-20 WO PCT/US2019/023118 patent/WO2019183190A1/en active Application Filing
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US20190290435A1 (en) | 2019-09-26 |
WO2019183190A1 (en) | 2019-09-26 |
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