Implantation steps

1 | Localising using ultrasound, can be marked.

2 | Disinfection.

3 | Sterile cover.

4 | Generous local anaesthesia for the puncture and tunneling area (can also be administered before applying sterile cover).

5 | Puncture under aspiration

6 | Insertion of the guiding wire through the syringe (Seldinger-technique) and removal of the syringe.

7 | First puncture incision is made around the guiding wire, about 1-2 cm wide and deep.

8 | The second puncture incision is placed about 5 cm or 8 cm away for pleural effusions and ascites, respectively. The incision itself is 1-2 cm wide and deep.

9 | Tunneling the catheter parallel to the guiding wire (from second to first puncture incision). Place the polyester cuff in the middle of the tunnel for now.

10 | Remove tunneler from catheter. Place the insertion tool (split lock) over the wire, then pull back the wire and the mandrel.

11 | Inserting the catheter through the split lock.

12 | Break open the split lock and remove it piece by piece while keeping the catheter in place.

13 | Skin suture and subcutaneous suture for fastening the catheter (Remove the skin sutures after 7-10 days and the subcutaneous sutures after 30 days)

14 | Apply the film wound dressing after the implantation and the first effusion drainage.