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Choice of Catheter and Reservoir is the IV Device

Laparoscopic Placement of the BardPort Intraperitoneal Catheter and Reservoir Dr. Arlan F. Fuller, Jr. Gillette Center for Women's Oncology Massachusetts General Hospital. Choice of Catheter and Reservoir is the IV Device. Titanium Port with 9.6F attached catheter. Pre-placement Procedure.

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Choice of Catheter and Reservoir is the IV Device

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  1. Laparoscopic Placement of the BardPort Intraperitoneal Catheter and ReservoirDr. Arlan F. Fuller, Jr.Gillette Center for Women's OncologyMassachusetts General Hospital

  2. Choice of Catheter and Reservoir is the IV Device

  3. Titanium Port with 9.6F attached catheter

  4. Pre-placement Procedure • Perform laparoscopy in the usual manner with umbilical placement of laparoscope trocar and survey of the abdominal cavity for adhesions • Place a 5 mm operative trocar in a position contralateral to the side of proposed catheter placement • Identify the prospective site in the lower quadrant for entry of the catheter into the peritoneal cavity

  5. Mark the site for reservoir placement above the right costal margin

  6. Incise the skin and develop a pocket for the reservoir

  7. Incise the skin and develop a pocket for the reservoir

  8. Check that the reservoir fits snugly into the pocket

  9. Place the tunneler on the end of the catheter and start the passage deep to Scarpa’s fascia

  10. Place a 5 mm transverse incision at the target site

  11. Bluntly with a hemostat extend the incision beneath Scarpa’s fascia to contact the tunneler

  12. Pass the tunneler out through the target incision

  13. Pass the tunneler out through the target incision

  14. Pass the catheter through the tunnel and the target incision and cut catheter to remove tunneler

  15. Suture the reservoir in place to fascia and confirm catheter function

  16. Place introducer needle through target incision adjacent to catheter

  17. Visualize needle tip at the target site in the peritoneal cavity

  18. Pass the guidewire with “J” tip through the introducer needle

  19. Pass the guidewire with “J” tip through the introducer needle

  20. Visualize “J” tip of the wire at the target site in the peritoneal cavity

  21. Withdraw the introducer needle leaving the guidewire in place

  22. Insert the introducer with the 10F dilator over the guidewire into the peritoneal cavity

  23. Visualize the dilator AND the peel-away introducer in the peritoneal cavity Dilator Introducer Dilator

  24. Withdraw both the wire and the dilator from the introducer

  25. Pass the catheter through the introducer and assist laparoscopically in advancing the catheter into the peritoneal cavity

  26. Peel away the introducer while holding the catheter in the peritoneal cavity

  27. Advance all the remaining catheter into the peritoneal cavity

  28. Adjust position of catheter tip and confirm function by injection Last, subcuticular closure of all incisions

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