DATE OF PROCEDURE: MM/DD/YYYY
PREOPERATIVE DIAGNOSES:
1. End-stage renal disease and need for hemodialysis.
2. Infected tunneled dialysis catheter, which was removed the day before.
POSTOPERATIVE DIAGNOSES:
1. End-stage renal disease and need for hemodialysis.
2. Infected tunneled dialysis catheter, which was removed the day before.
PROCEDURES PERFORMED:
1. Ultrasound evaluation, right common femoral vein.
2. Insertion of 24 cm long Schon temporary dialysis catheter via right common femoral vein.
3. Fluoroscopic guidance, insertion of temporary dialysis catheter.
SURGEON: John Doe, MD
ANESTHESIA: Local with sedation.
COMPLICATIONS: None.
INDICATIONS FOR PROCEDURE: The patient presented with infected tunneled dialysis catheter. He underwent removal of his left subclavian and left femoral tunneled catheter on MM/DD/YYYY. The patient has been taking IV antibiotics by the medical team. He was brought in for a temporary dialysis catheter placement to maintain his hemostasis. The idea is to allow his bacteremia to subside and subsequently place a tunneled catheter prior to his discharge. The risks and benefits of the procedure were explained to the patient. He was agreeable to proceed with it and gave his informed consent.
DESCRIPTION OF PROCEDURE: The patient was placed on the table in the supine comfortable position. The patient was given 1 mg of Versed and 50 mcg of fentanyl. Cardiopulmonary monitoring was performed. The right groin was prepped and draped. Ultrasound was used to visualize the right common femoral vein, which was patent.
The right common femoral vein was accessed percutaneously using Seldinger technique. A skin dilator was used to dilate the skin. A 24 cm Schon temporary dialysis catheter was introduced under fluoroscopic guidance all the way up to the right common iliac vein. Both stomas were aspirated. Good backflow was noted. Both stomas were flushed with saline solution. The catheter was secured in place with interrupted nylon suture.
The patient tolerated the procedure well. They should be able to use the catheter when needed for dialysis.
