Salivary Management

Short-term stenting of the salivary ductal system

The Walvekar Salivary Duct Stent™ is designed for the short-term intubation of the salivary ductal system. Its intended function is to serve as scaffolding that will hold open salivary ductal tissue and allow the flow of fluids.
The Walvekar Salivary Duct Stent™ has two opposing suture flanges and a connecting solid rod.
The end with the flange vertical to the horizontal plane of the shaft of the stent (1) is anatomically suited for use in the parotid gland.
The flat flange that lays along the horizontal plane of the shaft of the stent (2) is anatomically suited for use in the submandibular gland.

Code No.	Outside Diameter (mm)
WSS–0.6–S–ST (STERILE)	0.6
WSS–1.0–S–ST (STERILE)	1.0

Code No.	Outside Diameter (mm)	Inside Diameter (mm)	Length (mm)
WSS–1.0–S–GW	1.0	0.5	100
WSS–1.2–S–GW	1.2	0.6	94

• Anatomically sized for easy insertion and maximum patient benefit
• Short-term stenting of the salivary duct
• Allows continued saliva flow through ducts
• Ultra-smooth Plus® treatment lessens chance of scar tissue closure
• Convenient offsetting suture flanges allow for suturing on the cheek or floor of mouth
• Offsetting suture flanges will stay flush with the cheek mucosa due to their orientation which offers an ergonomic fit
• Made of Radiopaque Pebax®

Insertion

The stent is placed at the very end of the procedure. If during salivary ductal surgery, such as salivary endoscopy, the papilla has been traumatized or violated, the stent can be slid into the duct using a non-serrated forceps for support and guidance. The stent should be held preferably by the flanges or the ends and shaft should be handled with care to avoid kinks or bends as the stent is manipulated into place. The stent can also be placed via a sialodochotomy in the floor of mouth for submandibular gland stone patients. 

The stent has two offsetting suture flanges. One end must be cut to be able to use it. The shaft of the stent is usually too long for most patients and must be trimmed. The longest length that can easily sit at the papilla is determined by inserting the stent maximally and measuring the protruding segment. Alternatively, the length of the stent required can be determined by inserting a calibrated guide wire or calibrated salivary endoscope into the relevant duct. The stent should only be grasped with appropriately sized non-serrated forceps. This length of stent is then trimmed from the distal end. The stent is reinserted and sutured in place. Additionally, the 1.0 mm and the 1.2 mm stents can be inserted over a guide wire as shown. A single loop stitch with 4-0 nylon suture is recommended as described below. Two single stitches on either side anchoring the suture hub to the mucosa can also be utilized with a 4-0 or 5-0 nylon suture if the particular anatomy or clinical situation prevents the use of the recommended stitch. The protruding tip of the stent beyond the flange can also be trimmed to prevent it from rubbing against the patient’s teeth or gums. 

The stent is removed after satisfactory healing is judged to have occurred, usually 1-2 weeks. The actual length of time that the device is left in place will depend upon the surgeon’s judgement.

Single Anchoring Loop Stitch:

The first component of the stitch is through the mucosa of the floor of the mouth or buccal mucosa. The needle is threaded inside-out through the flange on the same side. The stitch is carried across the flange and the needle inserted into the hole on the opposite side; the needle is now passing outside-in across the flange of the stent. The stitch is then passed through the mucosa of the floor of mouth or buccal mucosa of the opposite side. 

Removal

The stent slides easily from the insertion site by cutting the stay sutures and grasping it firmly. Slow steady pressure allows for its release from the duct.