Ascites - ewimed drainova Instructions

Recommended Implantation Procedure

Ascites

Determining the most suitable medical and surgical approach remains the reponsibility of the treating
physician. Which approach that will be, depends on the individual patient.
The following procedure describes the placement of the catheter in the peritoneal cavity. The follo­
wing illustrations show the placing of the catheter in the peritoneal cavity.
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1. Prepare the patient for the procedure. Locate the effusion fluid using ultrasound.
Please note: For a safer implantation with fewer complications it is advantageous to have a large
volume of effusion.
2. Mark the incision site (A) and the catheter exit site (C) and determine where the subcutaneous
tunnel (B) should run. The lateral, abdominal punture site depends on the location of the asci­
tes. The catheter exit site is typically approx. 8 c m above the puncture site and marks the end of
the approx. 5 cm long tunnel. For better access and patient comfort, the chosen exit site should
be positioned medially.
3. Position the patient for the procedure in a way that the implantation site can be easily accessed.
4. Disinfect a large area for implantation and cover with sterile material.
5. Apply a generous amount of local anesthetic to the puncture incision site (A), the catheter exit
site (C) and the tunnel (B).
Please note: The tunnel (B) should be infiltrated with 20 – 30 ml local anaesthetic, 1% fan­shaped.
This will lessen the resistance of the subcutaneous tissue and the tunneler can slide more easily
through the tissue.
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D
B
A
C
A 1. Incision:
Punction site /
catheter entrance site
Tunnel
B
2. Incision:
C
Catheter exit site
D Catheter