Laparoscopic Placement of the BardPort Intraperitoneal Catheter and Reservoir
Dr. Arlan F. Fuller, Jr.Gillette Center for Women's Oncology
Massachusetts General Hospital
Choice of Catheter and Reservoir is the IV Device
Titanium Port with 9.6F attached catheter
Pre-placement Procedure
Perform laparoscopy in the usual manner with umbilical placement of laparoscope trocar and survey of the abdominal cavity for adhesions
Place a 5 mm operative trocar in a position contralateral to the side of proposed catheter placement
Identify the prospective site in the lower quadrant for entry of the catheter into the peritoneal cavity
Mark the site for reservoir placement above the right costal
margin
Incise the skin and develop a pocket for the
reservoir
Incise the skin and develop a pocket for the
reservoir
Check that the reservoir fits snugly into the pocket
Place the tunneler on the end of the catheter and start
the passage deep to Scarpa’s fascia
Place a 5 mm transverse incision at the target site
Bluntly with a hemostat extend the incision beneath Scarpa’s fascia to contact
the tunneler
Pass the tunneler out through the target
incision
Pass the tunneler out through the target
incision
Pass the catheter through the tunnel and the target incision
and cut catheter to remove tunneler
Suture the reservoir in place to fascia and confirm catheter
function
Place introducer needle through target incision adjacent to
catheter
Visualize needle tip at the target site in the peritoneal
cavity
Pass the guidewire with “J” tip through the introducer needle
Pass the guidewire with “J” tip through the introducer needle
Visualize “J” tip of the wire at the target site in the peritoneal
cavity
Withdraw the introducer needle leaving the guidewire in place
Insert the introducer with the 10F dilator over the guidewire
into the peritoneal cavity
Visualize the dilator AND the peel-away introducer in the peritoneal
cavity
Dilator
Dilator
Introducer
Withdraw both the wire and the dilator from the
introducer
Pass the catheter through the introducer and assist
laparoscopically in advancing the catheter into the peritoneal
cavity
Peel away the introducer while holding the catheter in
the peritoneal cavity
Advance all the remaining catheter into the peritoneal
cavity
Adjust position of catheter tip and confirm function by
injection
Last, subcuticular closure of all incisions