Port placement sample dictation

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Radiologists: []


History: []


Procedure: Placement of [] sided double lumen venous access port.


Technique: Informed consent was obtained. The patient was identified and placed in the supine position. The [] side of the neck and chest was prepped and draped in the usual sterile fashion. 2 % lidocaine was used for local anesthesia. In trendelenberg position, and under ultrasound guidance, the [] internal jugular vein was accessed using a micropuncture needle and a guidewire was passed.


1% lidocaine with epinephrine local anesthesia was administered to the [] chest wall. An incision was made and a subcutaneous pocket was developed as well as a subcutaneous tunnel connecting the pocket to the puncture site.


Using Seldinger technique, the catheter was passed through a peel-away sheath. The double lumen port was seated in the subcutaneous pocket and connected to the catheter through the subcutaneous tunnel. Under fluoroscopy, the catheter tip was confirmed to be at the junction of the SVC and the right atrium. The port had good forward flush and return.


Wound closure was accomplished using interrupted 4-0 Vicryl subcutaneous stitches, followed by a running 4-0 Vicryl subcuticular stitch. Steri-strips were applied. The port was instilled with heparinized saline. The wound was dressed. The patient tolerated the procedure well.


Dr. [], the attending interventional radiologist, was present for the critical portions of the procedure and reviewed all images obtained.


Medications: Fentanyl [] IV, versed [] mg IV, ancef [ ] mg IV.


Impression:


Uncomplicated placement of a [] internal jugular vein, 10 Fr. double lumen Bard MRI compatible venous access port.