A.M.I. TVA TOA Sling

Customised treatment for female SUI

Adjustability – the added extra

There is a delicate balance between incontinence, continence and obstruction, and calculating the required degree of tension presents a challenge to even the most experienced surgeon. The A.M.I. TOA (Trans Obturator Adjustable) and TVA (Trans Vaginal Adjustable) Slings are equipped with two groups of integrated sutures, which are left outside the skin following surgery and enable optimal fine-tuning of tension up to five days post-operatively, with active participation from the patient. One group of sutures can be pulled down to reduce tension if there are signs of urinary retention, while the other can be pulled up to increase tension if incontinence persists. Once the appropriate adjustments have been made, the sutures are removed. The option of post-operative adjustment has been proven particularly effective for high-risk groups (e.g. combined SUI and voiding dysfunction), severe SUI or patients in whom previous suburethral sling implantation has failed.

The evidence

Results from a total of 501 patients in six different studies (see literature overview):

Adjustment was necessary in 27.3%.
90.4% of the patients were completely dry.
The erosion rate was very low at just 1.0%.

Sling features

Soft, but low-elastic monofilament polypropylene mesh which is firm enough lengthwise to provide the necessary support
Large-sized pores that allow seamless tissue integration
PE sleeve covering the mesh to facilitate less traumatic placement

Tools of the trade
A.M.I. offers tunnellers with two different diameter sizes – 4 mm and 3 mm (Slimline). The A.M.I. tunnellers are made of high-grade materials, with ergonomically-designed handles to fit comfortably in the surgeon’s hand. The flattened, spatula-shaped, rounded tip design allows smooth tissue and good instrument control during penetration. All tunnellers feature a flattened tip for slightly wider dissection to better accommodate the sling’s shape. A.M.I. reusable tunnellers are available for all commonly used tunnelling techniques.

Order Details

Order Code	Product	Technical Details
TVA5021	A.M.I. TVA Sling Sling for treatment of SUI, designed for implantation using the transvaginal retropubic approach. Equipped with sutures for post-operative tension adjustment	Polypropylene mesh sling with PE sleeve Total length of sling: 450 mm Adjustment sutures (per side): 3 upwards, 2 downwards 1 sling, delivered sterile
TOA5121	A.M.I. TOA Sling Sling for treatment of SUI, designed for implantation using the transobturator approach. Equipped with sutures for post-operative tension adjustment	Polypropylene mesh sling with PE sleeve Total length of sling: 450 mm Adjustment sutures (per side): 3 upwards, 2 downwards 1 sling, delivered sterile
TVA5030	A.M.I. TVA Tunneller Reusable instrument for transvaginal retropubic approach	Materials: Stainless steel, silicone Total length: 316 mm Length of handle: 127 mm Diameter: 4 mm 1 instrument, delivered non-sterile steam autoclavable
TOA5130	A.M.I. TOA Tunneller Reusable instruments (left and right) with a helical shape for transobturatoric approach	Materials: Stainless steel, silicone Total length: 244 mm Length of handle: 127 mm Diameter: 4 mm 2 instruments (l. & r.) delivered non-sterile steam autoclavable
TOA5140	A.M.I. TOA Tunneller Universal Reusable instruments (left and right) for inside-out transobturatoric approach	Materials: Stainless steel, silicone Total length: 225 mm Length of handle: 127 mm Diameter: 4 mm 2 instruments (l. & r.), delivered non-sterile, steam autoclavable
TVA5040	A.M.I. TVA Tunneller Slimline Reusable instrument for transvaginal retropubic approach	Materials: Stainless steel, silicone Total length: 316 mm Length of handle: 127 mm Diameter: 3 mm 1 instrument, delivered non-sterile, steam autoclavable
TOA5170	A.M.I. TOA Tunneller Slimline Reusable instruments (left and right) with a helical shape for transobturatoric approach	Materials: Stainless steel, silicone Total length: 244 mm Length of handle: 127 mm Diameter: 3 mm 2 instruments (l. & r.) delivered non-sterile steam autoclavable
TOA5180	A.M.I. TOA Tunneller Universal Slimline Reusable instruments (left and right) for inside-out transobturatoric approach	Materials: Stainless steel, silicone Total length: 225 mm Length of handle: 127 mm Diameter: 3 mm 2 instruments (l. & r.) delivered non-sterile, steam autoclavable