Percutaneous Insertion Handle for LFN and R/AFN for obese patients
Fig 1 Normal handle (left) and new handle for obese patients (right). For soft tissue clearance in very obese patients, the standard insertion instruments may be too short, as the barrel of the standard insertion handle measures only 44 mm in length. Therefore, a longer barrel for the percutaneous insertion handle was designed with an increased length of 144 mm. The added length necessitates a longer mating connecting screw and a longer 5.0 mm hexagonal screwdriver to engage the LFN/R/AFN locking mechanism.
Because of its length a more proximal skin incision than is typically used is required. By concentrating on a more proximal skin incision in this obese population one might avoid the necessity of lengthening the skin incision and deep soft tissue dissection with the existing jig.
This additional handle should not be used on a normal nonobese patient as the added length of the arm may impinge on the soft tissues making the insertion more difficult.
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