| 摘要 |
An improved tunneler for placement of an arteriovenous graft in subcutaneous tissue of a patient, includes a shaft with opposite ends carrying a penetrating tip and a handle. The shaft is manually bendable but has sufficient rigidity for retaining a desired curvature when in use. The tip and handle are interchangeable. In implanting a graft, the shaft is passed through an incision near the distal end of a patient's limb to a proximal incision, to form a first tunnel. With the shaft in place in the tunnel, the tip and handle are interchanged, and a graft is attached to the tip and pulled toward the proximal incision until its end is exposed. A second tunnel is then formed, again by passing the instrument through the distal incision toward the proximal incision. The tip and handle are again interchanged, and, with the tip attached to the other end of the graft, the graft is pulled into place to form a loop.
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