A method and apparatus for implanting a testicular prosthetic device includes creating a passageway into the interior of an animal’s scrotum which contains a tunica vaginalis; incising the tunica vaginalis containing a testis attached to a spermatic cord; severing the spermatic cord; removing the testis through the passageway and inserting a prosthetic device through the passageway and into the lumen of the tunica and closing the tunica. The second testis is similarly removed from its tunica vaginalis through the same passageway and similar prosthetic device is placed in the cavity created. The tunica may be drawn outwardly, through the passageway, and removal of the testis by incising the tunica and severing the spermatic cord may be performed outside the animal. The tunica may also be severed and the prosthetic device placed directly within the scrotal sac.
The testicular implant is generally kidney-shaped and is sized to fit the tunica. (12) scrotum (14) septum scroti (15), and tunica vaginalis (16) containing the spermatic chords (18). It is understood that the area as shown includes fascia, ligaments, nerves, blood vessels, fat and other anatomical structures not depicted for purposes of clarity.
The prosthetic device (24) employed in accordance with the invention is generally kidney shaped, having a convex border (26), and a concave border (28), punctuated by a central cleft (30), between a pair of lobes (31). The size of the device (24) is such that it fits snugly within the tunica (16).
As best shown in Figures 2 and 4b, an incision (36) is made through the tunica large enough to permit removal of the testis (20). The testis is removed, the spermatic cord (18) is ligated, is connection to the testis (20) is severed, at ligature (38) and the prosthetic device is inserted in the tunica so that the convex surface (26) aces anterior or forward and slightly downward, and the concave surface (28) containing cleft (30) and lobes (31) faces posterior or backward and slightly upwardly. Following the placement of the prosthesis, the edges of the tunica are reapproximated and closed by a suture (40). In preferred embodiments and absorbable chromic gut ligature is employed the tunica (16) containing the prosthetic device (24) is then pushed back through passageway (22) and into the scrotum (14).
Entering through the same incision to the other side of the septum scroti (15) which divides the scrotum (14) into a pair of cavities (15a, b), one for each of the two testes, the remaining testis (20) may be removed and a second prosthetic device (24) pl aced in the same manner and then replaced on the respective side of the septum (15).
Following placement of the second prosthesis, the prescrotal incision (34) may optionally be sutured closed with a nonabsorbable skin suture (42) such as nylon. However, since the weight of the implant (24) serves to retain the implant in a pendant position within the scrotum, suturing of the incision (34) is not generally required. IN cases where the animal is likely to lick the wound so vigorously as to reopen the incision, surgical steel wire suture may be employed to suture the incision.
In other preferred embodiments, the prosthetic device (24) may be implanted direction into the scrotum (14). The procedure is similar to that previously described for tunical implantation. As best shown in Figures 3 and 4a, a prescrotal incision (34) is made and deepened to create a passageway (22) to the parietal vaginal tunic (16). The spermatic fascia and scrotal ligament are incised to free the exposed tunica (16) containing the testis (20) from its scrotal attachment. The tunica (16) containing t he testis (20) and attached spermatic cord (18) is pushed through the incision (34) to the exterior of the animal.
The exteriorized tunic (16) and underlying spermatic cord (18) are ligated and transected and the tunica, cord and all subjacent parts, including the testis are discarded, and the prosthesis (24) is placed in the scrotal sac.
In an alternate preferred method, the tunica (16) and spermatic cord (18) are separately ligated and transected. IN still another alternate preferred method, the tunica (16) incised prior to exteriorization, the tunica (16) is dissected away from the remainder of the spermatic cord (18) and the two are transected independently.
Following transection, ,the stump of the extended spermatic cord (18) is released for retraction back through the inguinal canal, well away from the now empty scrotal sac (14).
Entering through the same incision to the other side of the septum scroti (15), the remaining testis (20) may be removed and a second prosthetic device (24) is place in the same manner. In such a scrotal placement, the septum scroti (15) keeps the implants separated.