SJFROEMMING
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The CT head completed today was used for the Axiem navigation system and facial features registered and confirmed. Head was turned to the left and he was shaved, prepped and draped from above the right ear down to the right upper quadrant of the abdomen. Skin was infiltrated with 1% Xylocaine with epinephrine. A hockey stick incision was made above and behind the right ear and craniectomy performed with high-speed drill. Attention was then turned to the abdomen where a transverse incision was made in the right upper quadrant and carried down through layers to the peritoneum. This was incised and a 2-0 silk pursestring suture placed around the opening. A tunneling device was carried between the incisions. A Strata programmable valve had been preprogrammed at 1.5 Delta. The distal tubing was then carried between the two incisions. The dura was incised and a ventricular catheter introduced with assistance of the Axiem navigation system at appropriate trajectory and CSF was encountered. It was cut to 12 cm in length and connected to the ventricular reservoir and secured with a 2-0 silk ligature. The distal tubing slack was pulled to the abdomen and the reservoir set flush on the skull. Clear fluid flowed well through the distal catheter which was then cut to length and introduced into the peritoneal cavity. Pursestring suture was tied down without constricting the catheter. CT navigation 77011 versus Stealth guidance 61781
Please help!
Thanks, Sue F