Minimally Invasive No Touch "MINT" Penile Implant Surgery with Ectopic Reservoir Hernia

VJPU 2016; 2: 078

Darren J. Katz, Christopher J. Love

Keywords: Penile prosthesis, penile implant, infrapubic incision, No touch, infection, hernia, mesh

Introduction: The authors demonstrate their updated adaptations to the MINT technique.  This technique uses the mini-invasive infrapubic technique combined with no-touch principles.  An ectopic reservoir is placed.  A prophylactic hernia mesh plug is utilized to prevent potential herniation of the reservoir. This technique has been developed by 2 high volume penile implants surgeons. 

Case presentation: Not applicable

Protocol: Each key step is demonstrated.  After a wet shave and prep, the first layer of MINT drapes is applied. A 3-4 cm infrapubic incision is made and the Alexis® retractor is placed. The neurovascular bundle is mobilised medially and the corporotomies are made. The 3 piece penile implant is be inserted utilising an ectopic reservoir placement. The video demonstrates the different approaches required for the standard patient and the obese patient. A hernia mesh plug is placed in the superficial inguinal ring to prevent herniation of the reservoir. Before the Alexis retractor is removed, the tubing concealment pocket is created using the lateral fascial bridges below the Alexis® retractor. The wound can then be closed.

Outcome (if applicable): Not applicable

Discussion: After viewing this video, the surgeon will understand each key step needed to perform the MINT technique with ectopic reservoir hernia placement and hernia mesh prophylactic insertion. The surgeon will also appreciate the technique to fashion the tubing concealment pocket, which minimises the patient’s ability to palpate the tubing.