Manual Part 2

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Performing the surgical procedure
Pre-operative evaluation
The Pump implant depth should not exceed 5 cm (2 inches) beneath the
surface of the skin. If the Pump is implanted too deeply in the subcutane-
ous tissue it may be difficult to access the refill port.
Formation of the pump pocket
Pump implantation can be performed either under local or general anes-
thesia. After satisfactory anesthesia, a pre-selected abdominal site is
prepped and draped in the customary surgical method.
A transverse or longitudinal incision is made and deepened through the
skin and subcutaneous tissue. Care should be taken in choosing the loca-
tion of the incision so the suture line is next to but not over the Pump inlet
fill port or the Catheter side port. A subcutaneous blunt dissection is per-
formed to create a pocket large enough to accommodate the Pump.
Meticulous hemostasis should be established with electrocautery.
Figure 11 indicates a possible Pump placement and corresponding inci-
sion sites.
The Pump is secured to the fascia of the abdominal musculature using the
three suture tabs provided. Securing the Pump with all three suture tabs is
recommended, as it will prevent migration, rotation or inversion in the
pocket and possible dislodgment of the Catheter.
Dmp9196021-011_c.book Page 93 Wednesday, April 3, 2002 5:04 PM