Johnson & Johnson Codman MedStream Surgical Technique Manual Download Page 3

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PATIENT POSITIONING AND PREPARATION

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PREOPERATIVE PUMP PREPARATION

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PLACE THE INTRASPINAL CATHETER

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PREPARE THE PUMP

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PREPARE THE PUMP POCKET

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TUNNEL THE INTRASPINAL CATHETER

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TO THE PUMP POCKET

PREPARE THE CATHETER CONNECTION

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PLACE AND SECURE PUMP

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POSTOPERATIVE PROGRAMMING

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ESSENTIAL PRESCRIBING INFORMATION

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Surgical Technique

Guide

MEDSTREAM

™

PROGRAMMABLE INFUSION SYSTEM Surgical Technique Guide

492192.QX7:Layout 1 4/14/09 4:09 PM Page 1

Summary of Contents for Codman MedStream

Page 1: ...Surgical Technique Guide 492192 QX7 Layout 1 4 14 09 4 07 PM Page 2...

Page 2: ...Intraspinal Catheter please refer to its instructions for use The MEDSTREAM Control Unit is an external part of the system that is required to prepare the pump for implantation and to program the dai...

Page 3: ...UMP POCKET Page 10 TUNNEL THE INTRASPINAL CATHETER Page 11 TO THE PUMP POCKET PREPARE THE CATHETER CONNECTION Page 12 PLACE AND SECURE PUMP Page 14 POSTOPERATIVE PROGRAMMING Page 15 ESSENTIAL PRESCRIB...

Page 4: ...CODMAN Tunneler PREOPERATIVE PLANNING Identify pump location before surgery with patient The pump is usually located between costal margin and iliac crest however optimal placement is patient specific...

Page 5: ...and lower abdomen where the catheter will be tunneled to the pump Sterile drapes should be applied PREOPERATIVE PUMP PREPARATION Follow the pump preparation procedure detailed in the MEDSTREAM Pump In...

Page 6: ...approximately to 2 cm off of midline and to 1 vertebral levels below the targeted interlaminar space Note In patients with difficult spinal anatomy the needle angle may need to be adjusted ALTERNATIV...

Page 7: ...firmed by fluoroscopy remove the stylet Orient the needle bevel cephalad and thread the distal tip of catheter through the needle When the wide marker band on the catheter is at the hub of the needle...

Page 8: ...6 MAKE A SKIN INCISION Make an incision centered at the needle insertion site Expose an area of the fascia that is large enough to place the catheter anchor 492192 QX7 Layout 1 4 14 09 4 09 PM Page 6...

Page 9: ...move the guide wire and needle from the catheter simultaneously MEDSTREAM PROGRAMMABLE INFUSION SYSTEM Surgical Technique Guide PLACE PURSE STRING SUTURE Place a purse string suture through the lumbo...

Page 10: ...catheter into the SNAPLOCK Adaptor until the catheter bottoms out While maintaining the catheter position tighten the adaptor by squeezing the black collar toward the luer hub until the gap between th...

Page 11: ...cylindrical silicone anchor to the catheter where the catheter enters the lumbo dorsal fascia Fasten the anchor to the fascia using heavy non absorbable suture Create a strain relief loop in the cath...

Page 12: ...for any tears ALTERNATIVE TECHNIQUE The pump catheter may be attached to the intraspinal catheter before attaching to the pump FILL AND PRIME THE PUMP Using the OR Prep Kit follow the MEDSTREAM Pump...

Page 13: ...be accessible after implantation CREATE A SUBCUTANEOUS POCKET FOR THE PUMP When possible the incision should be along relaxed skin tension lines and not across skin creases Care should be taken to app...

Page 14: ...aspinal catheter exit wound in the back Remove the plastic insert from the tunneler tube THREAD THE CATHETER TO THE PUMP POCKET Remove the SNAPLOCK Adapter from the SURESTREAM catheter and thread the...

Page 15: ...rimmed catheters to determine the implanted catheter volume CONNECT THE SURESTREAM INTRASPINAL CATHETER TO THE SURESTREAM CONNECTOR Insert the trimmed end of the SURESTREAM Catheter into the opening i...

Page 16: ...de the strain relief sleeve over the pin connector until it contacts the stop Secure the strain relief sleeve onto the catheter and the connector by tying 2 ligatures of heavy non absorbable suture Te...

Page 17: ...Re test for catheter patency and leaks at the connection site via the bolus port and MEDSTREAM Bolus Needle CLOSE INCISIONS Irrigate the pump pocket and spinal incision site thoroughly Close the inci...

Page 18: ...fer to the MEDSTREAM Pump Instructions for Use and the MEDSTREAM Programming Guide for detailed programming instructions Step 7 Post Operative Programming 16 492192 QX7 Layout 1 4 14 09 4 10 PM Page 1...

Page 19: ...MEDSTREAM PROGRAMMABLE INFUSION SYSTEM Surgical Technique Guide Notes 17 492192 QX7 Layout 1 4 14 09 4 10 PM Page 17...

Page 20: ...18 Notes 492192 QX7 Layout 1 4 14 09 4 10 PM Page 18...

Page 21: ...19 MEDSTREAM PROGRAMMABLE INFUSION SYSTEM Surgical Technique Guide Notes 492192 QX7 Layout 1 4 14 09 4 10 PM Page 19...

Page 22: ...tient s body size is insufficient to accept the bulk and weight of the pump when conservative treatment is appropriate and in the presence of spinal anomalies that might complicate the implantation an...

Page 23: ...1016 138 Italy Johnson Johnson Medical SPA Via Del Mare 56 00040 Pratica Di Mare RM 39 06 911 94 500 fax 39 06 911 94 505 United Kingdom Johnson Johnson Medical Ltd Pinewood Campus Nine Mile Ride Woki...

Page 24: ...GUIDANCE MEDSTREAM and SURESTREAM are trademarks of Codman Shurtleff Inc CODMAN is a registered trademark of Codman Shurtleff Inc For more information contact your Codman Sales Representative 2009 Co...

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