Removing the catheter

If three consecutive drains remove less than 50 mL of fluid, one of the following may be the cause and catheter explantation may be a consideration:

Recovery of the patient, no more formation of ascites or pleural effusion detectable.
Pleurodesis occurred
Catheter is in a chamber without fluid.
Catheter blockage that cannot be cleared even by flushing.

Whether the catheter is being removed because of one of these reasons or a different one, the clinician should follow these instructions:

Steps to remove the catheter

Control of coagulation parameters
prepare a workplace under sterile conditions
Positioning of the patient to ensure free access to the catheter
generous skin infiltration with local anesthesia at the Kather exit site (observe exposure time)
Palpation of the polyester cuff from the outside (bulging thickening)
Incision of the skin, directly at the catheter outlet
blunt, circular dissection of the polyester cuff using a button cannula, dissecting scissors or similar (the catheter only fuses with the subcutaneous tissue at the cuff, difficult conditions can arise when removing the catheter due to the position itself or tumor walling.
one hand is carefully placed on the tunnel section as an abutment, the other hand is used to pull the catheter. If the catheter cannot be mobilized as a whole, an additional incision (corresponding to the length, at the end of the tunnel section / the incision at the puncture site serves as orientation) is necessary to separately retrieve the catheter section lying / leading there in depth.
final skin suture of the incision(s)
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