DATE OF PROCEDURE: MM/DD/YYYY
PREOPERATIVE DIAGNOSIS: Left-sided lung cancer.
POSTOPERATIVE DIAGNOSIS: Left-sided lung cancer.
PROCEDURE PERFORMED: Placement of left subclavian vein Port-A-Cath.
SURGEON: John Doe, MD
ASSISTANT: Jane Doe, MD
ANESTHESIA: Local MAC.
ESTIMATED BLOOD LOSS: Less than 5 mL.
SPECIMENS: None.
TUBES: None.
DRAINS: None.
COMPLICATIONS: None apparent.
DISPOSITION: To same day surgery in good condition.
DESCRIPTION OF PROCEDURE: The patient was taken to the operating room and 1 gram of Ancef was infused intravenously. Monitored anesthesia care was initiated. A shoulder roll was placed between the patient’s shoulder blades. Her left neck and chest were prepped and draped in the usual sterile fashion. A time-out was taken, which included the patient’s name, operative site, and proposed operation.
Using local anesthetic, the skin at the proposed skin entry site was injected. Using a hollow, thin-walled 16 gauge needle, we cannulated the subclavian vein on the first pass without difficulty. The wire was passed into the vessel, and position of the wire within the superior vena cava was confirmed.
We then created a pocket by making an incision, including the site of the wire entrance, for a length of 5 cm and using blunt dissection in the subcutaneous tissues created a pocket large enough to comfortably house the reservoir. The catheter was then measured, connected to the reservoir. The dilator was passed over a wire under direct fluoro guidance. The introducer was then removed keeping the sheath in place.
We introduced the catheter through the sheath, and the pull-apart sheaths were then separated keeping the catheter inside the vessel. The reservoir was then placed into the pocket and another fluoro was performed to confirm positioning of the catheter within the superior vena cava.
The reservoir was then secured in place with two 3-0 Prolene sutures. The subcutaneous tissues were closed with 3-0 inverted interrupted Vicryl sutures followed by Monocryl running subcuticular stitch followed by benzoin and Steri-Strips. The Port-A-Cath was then accessed with a Huber needle and good flush as well as easy aspirations were noted.
Dry sterile dressing followed by Tegaderm was applied to the patient’s skin. The patient was then awakened and taken to the same-day surgery where stat. portable chest x-ray was ordered. There were no complications.
