Rigi10™ Malleable Penile Prosthesis
Also Known As
Intrathecal pump implantation, Implantable drug delivery system implantation, Pain pump implantation, Spinal pump placement, Drug infusion pump placement, Device Implantation (specific to pump type, e.g., Baclofen pump implantation, Morphine pump implantation).
Definition
Pump placement refers to a surgical procedure involving the implantation of a medical device, typically a pump, designed to deliver medication, fluids, or create mechanical effects within the body. These systems generally consist of a pump reservoir and a catheter or other mechanism to deliver the substance or effect to a specific target site. A common application is the intrathecal drug delivery system (IDDS), where a pump is implanted, often in the abdominal wall, with a catheter tunnelled to the intrathecal space of the spinal cord to deliver analgesics (like morphine, ziconotide) or antispasmodics (like baclofen) directly into the cerebrospinal fluid (CSF).1 This method allows for targeted therapy, potentially reducing systemic side effects and requiring lower overall drug dosages compared to oral or parenteral administration.1 The purpose of such pump placements can be for chronic pain management (cancer-related or noncancer pain), spasticity reduction, or delivery of chemotherapy (e.g., Hepatic Artery Infusion pumps).1 The procedure is typically elective and requires careful patient selection and preoperative planning regarding the anatomical site for pump implantation.1
Clinical Context
Pump placement is clinically indicated for various conditions refractory to less invasive treatments. For intrathecal drug delivery systems, indications include chronic cancer-related pain, persistent noncancer pain (e.g., complex regional pain syndrome, failed back surgery syndrome), and severe spasticity (e.g., from multiple sclerosis, spinal cord injury, cerebral palsy) not adequately managed by oral medications.1 Patient selection involves a thorough assessment of the underlying condition, previous treatments, psychological evaluation, and realistic expectations. The surgical procedure for an intrathecal pump typically involves creating a subcutaneous pocket for the pump (often in the abdomen) and carefully placing a catheter into the intrathecal space, usually under fluoroscopic guidance.1 Post-operative management includes programming the pump, monitoring for efficacy and side effects (such as infection, catheter-related issues, or post-dural puncture headache3), and long-term follow-up for pump refills and adjustments. Expected outcomes include significant pain reduction, improved function, and reduced spasticity, thereby enhancing the patient’s quality of life.1 Success rates vary depending on the indication and patient population, but intrathecal drug delivery is generally considered effective for appropriately selected patients.1,2