PREOPERATIVE DIAGNOSIS: Chronic renal failure.
POSTOPERATIVE DIAGNOSIS: Chronic renal failure.
PROCEDURE PERFORMED: Insertion of right internal jugular Permacath.
SURGEON: John Doe, MD
INDICATION FOR PROCEDURE: The patient is a (XX)-year-old female with chronic renal failure who presented for insertion of a Permacath since she had pulled out the previous one.
DESCRIPTION OF PROCEDURE: The patient’s neck was accessed, looking for the vein with an ultrasound machine. The skin was infiltrated with Carbocaine 0.25%. The vein was accessed with a single percutaneous stick. A guidewire was introduced. Through the sheath, a dilator was introduced. A 23 Arrow-Cannon was placed at the superior vena cava and atrial junction. The catheter was tunneled in the anterior chest wall, and attachments were placed. The catheter was fastened to the skin with 3-0 Prolene. The working incision was closed with 4-0 Monocryl. Steri-Strips were applied. The patient left the OR in good condition.
Sample #2
PREOPERATIVE DIAGNOSES:
1. Chronic renal failure.
2. Infected Permacath.
POSTOPERATIVE DIAGNOSES:
1. Chronic renal failure.
2. Infected Permacath.
PROCEDURE PERFORMED: Removal and insertion of a right internal jugular Permacath under fluoroscopy.
SURGEON: John Doe, MD
INDICATION FOR PROCEDURE: This is a (XX)-year-old female with chronic renal failure who presented for insertion of permanent vascular access. The catheter in the right internal jugular vein was infected and thus it needs removal. A new catheter was placed in the right internal jugular vein under fluoroscopic approach.
DESCRIPTION OF PROCEDURE: The patient’s neck was prepped and draped in the usual manner. The skin was infiltrated with Carbocaine 0.25%. An incision was carried through the skin and subcutaneous tissue to the Permacath. The Permacath was removed, and a guidewire was introduced. Through this, a sheath and dilator were placed. A 23 Arrow-Cannon was placed at the superior vena cava and right atrial junction. The catheter was brought through a lateral stab wound into the chest and tunneled. Attachments were placed and inflow and outflow performed well. The catheter was fastened to the skin with 3-0 Prolene. The incision was closed with running 3-0 PDS and subcuticular 4-0 Monocryl. Steri-Strips were applied. The patient left the OR in good condition.
NOTE: Permacath may be transcribed as Perma-A-Cath, permacath, or PermCath (client preference); however, PermCath is widely considered to be the correct way to transcribe this term.
