Boston Scientific AMS 800 Mode D'emploi page 13

c. Hold the PRB with one hand and squeeze it until the air is removed.
d. Insert the needle into the end of the PRB tubing.
e. Fill PRB with 20 ml of solution, then aspirate the air from the PRB until air bubbles
are removed. Manipulate the PRB as needed, taking care not to stretch the PRB
(Figures 27, 28, 29).
Figure 27. Rotate the balloon
Figure 28. Collect air bubbles into one bubble
Figure 29. Aspirate air from PRB, then clamp
CAUTION: Do not over-aspirate the PRB because air can be drawn into the
system through the semi-permeable silicone membrane.
f. Inspect for bubbles, if air remains in either the PRB or tubing, repeat the
steps above.
g. Pull back on the plunger and squeeze the PRB to aspirate the fluid.
h. With the air and fluid removed from the PRB, and keeping the needle within
the tubing, clamp one shod hemostat (one notch only) 3 cm below the needle
(Figure 29). Clamp a second shod hemostat (one notch only) 3 cm below the first.
i. Remove the 15 gauge blunt tipped needle from the PRB tubing.
j. Submerge the PRB into a kidney basin of filling solution until the surgeon is ready
to implant the PRB.
CAUTION: Do not place any hemostats on top of the PRB. Any instruments on the
PRB can damage it.
3. Dissect. Then, position the PRB within the prevesical space or anterior to the
transversalis fascia on the patient's preferred pump side.
a. Make the incision and/or bluntly dissect to create a space for the PRB.
b. Prior to implanting, the PRB should be inspected for trapped air.
c. Place the PRB in the appropriate space per surgical approach.
d. Route the cuff and PRB tubing for later connections as needed (Figure 30).
Figure 30. Route the balloon KRT and the cuff KRT
4. Flush and fill the PRB.
a. Flush the PRB tubing end using a 22 gauge needle attached to a 10 ml syringe
filled with filling solution.
b. Attach a 15 gauge needle to a 30 ml syringe filled with filling solution to PRB and
unclamp the tubing.
c. Fill the PRB with approximately 22 ml of the chosen filling solution.
Note: Larger cuff sizes may require more filling solution. See Cuff
Pressurization Option.
d. Clamp (one notch only) the tubing approximately 3 cm below the needle with a
shod hemostat.
Cuff Pressurization Option:
1. Flush the PRB and the cuff tubing.
2. Make a temporary connection with a Suture-Tie Connector between the PRB and
the cuff.
3. Unclamp; wait one minute; then re-clamp.
4. Disconnect PRB and cuff.
5. Flush PRB tubing. Unclamp and aspirate filling solution.
6. Refill with 20 ml of filling solution and clamp.
7. Secure PRB within tissue by narrowing the opening with absorbable suture.
Pump Preparation and Positioning
Prepare Control Pump
1. Submerge both ends of the tubing in a kidney basin with the appropriate filling
solution.
2. Hold the pump at a 45 degree angle with the black tubing on top (Figure 31).
Figure 31. Place ends of tubing in filling solution
3. Squeeze and release pump bulb repeatedly until all air in the pump and tubing has
been displaced with fluid.
4. Inspect for bubbles, if air remains, repeat above steps.
5. While keeping tubing submerged, use shod hemostats to clamp (one notch only)
each tube 4-5 cm from the end (Figure 32).
Figure 32. Clamp tubing with ends in filling solution
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Black (K) ∆E ≤5.0