Implantation of the AdVance™ Male Sling System is a minimally invasive surgical procedure that typically takes 20-30 minutes. Following is a brief summary of the AdVance surgical procedure.

Caution: This information is for educational purposes only. Refer to the AdVance Instructions for Use for more information, including the procedure, indications for use, adverse events, sterilization, contraindications, warnings and precautions.

Step 1

Place the patient in a dorsal lithotomy position, with legs bent at 90° and slightly spread. Insert a Foley catheter into the bladder. Make a low perineal midline incision of approximately 5-7 cm.

Step 2

Divide the BC muscle in midline, open like a book.

Step 3

Dissect up to central tendon/perineal body.

Step 4

Make small stab incisions about 1 cm below and lateral to the insertion of the adductor longus tendon at the medial border of the obturator formen. Practice rotating each needle passer above the patient to visualize the path the needle tip will take. Maintain a constant axis of rotation at about 45°. Insert needle tip into the stab wound, until two pops are felt. Maintaining a 45° angle, twist the needle handle to guide the needle tip onto the index finger, which is in the perineal incision between urethra and corpus cavernosum.

Step 5

Snap one sling end onto the needle passer tip (can't be removed). Suture knots should face away from the urethra. Be sure that the sling lies flat prior to attaching other sling end (cannot be removed once they are snapped into place) retract needle passers along same pathwarys. Before tensioning, place tack sutures into the center flaps with (recommend 3-0 Monocryl or equivalent) 3-0 Monocryl: first the proximal flap, then the distal flap. Pull sling ends with sufficient force to achieve 2-4 cm urethral bulb movement, then remove plastic sheaths and confirm proximal displacement of bulb.

For complete details, please see the following reference document:

AdVance Instructions for Use

This is a reference copy only.