Codman MICROSENSOR Bedienungsanleitung Seite 8

6. Record the three-digit zero reference number
provided by the ICP EXPRESS Monitor. Mark the
number on the MICROSENSOR connector housing
or patient's chart for future reference.
General Surgical Procedure
The following is a general guide for informational
purposes only. The surgeon may wish to alter details
in accordance with his or her own clinical experience
and medical judgment. This device is not designed,
sold, or intended for use as a therapeutic device.
The CODMAN Cranial Hand Drill, catalog number
82-6607, is recommended for this procedure.
1. Connect and zero the ICP transducer. Refer to
the Connecting and Zeroing the Transducer section.
2. Incise the scalp to expose the skull, and make a
twist drill hole using a 5.8 mm drill bit.
3. Gently bevel the burr hole on one side to allow the
catheter to exit without a sharp angulation.
4. Puncture the dura using a needle or cautery.
5. Use the split trocar to tunnel the ventricular cathe-
ter under the scalp from the craniotomy site to any
other convenient site located at least 3 cm from the
burr hole.
6. Remove the stylet from the split trocar.
7. Insert the ventricular catheter through the split
trocar from the exit site to the burr hole wound, as
shown in Figure 2.
8. Remove the split trocar from under the scalp.
9. Verify that the transducer tip is located at the
first large hole at the distal end of the ventricular
catheter, as shown in Figure 8. If necessary, loosen
the Tuohy-Borst adapter cap (turn counterclockwise)
and adjust transducer position as required.
10. Firmly tighten the Tuohy-Borst adapter cap (turn
clockwise) and LUER-LOK connections. Verify that
the transducer tip remains in position as shown in
Figure 8. Readjust if necessary.
11. Insert the tip of the 15 cm stylet through the
middle large hole at the distal end of the ventricular
catheter (see Figure 3). CAUTION: Do not hit the
transducer tip with the stylet. Damage could result.
Accidental contact with the transducer can be
detected by a simultaneous transient waveform
response on the monitor trace and/or an increase
in the numeric display. In such case, do not
use transducer.
12. Advance the stylet and catheter at a right angle
to the skull into the lateral ventricle at a depth of
approximately 7 cm (see Figure 4). NOTE: Some
surgeons may prefer to first use the 10-gauge
ventricular needle to locate the ventricle, as shown
in Figure 5, and then pass the stylet and catheter
through the tract thus created.
13. To verify ventricular placement, remove the cap
from the side drain port of the Tuohy-Borst adapter
to allow CSF to flow through the catheter.
14. Hold the catheter in place and gently withdraw
the stylet.
15. Press down on the ventricular catheter and pull
any excess catheter away from the incision site.
16. Secure the catheter to the scalp with sutures
at the exit site. Additional sutures may be placed
through the holes in the female LUER-LOK
connector flange.
17. Close and dress the incision site.
18. If desired, attach the drainage port of the
ventricular catheter to a ventricular drainage system.
Alternate Tunneling Technique
The following is an alternate technique for tunneling
the ventricular catheter under the scalp without the
ICP transducer preloaded. The surgeon may wish
to alter details in accordance with his or her clinical
experience and medical judgment.
1. Carefully detach the ventricular catheter from the
white female LUER-LOK connector and Tuohy-Borst
adapter.
2. Gently pull the Tuohy-Borst adapter and
transducer assembly completely out of the catheter.
3. Connect and zero the transducer as described in
the Connecting and Zeroing the Transducer section.
4. Use either a split trocar (included) or a standard
tunneling trocar (not included, see Figure 6) to
tunnel the ventricular catheter under the scalp from
the craniotomy site to any other convenient site
located at least 3 cm from the burr hole.
5. At this point, the catheter can be cut to the
desired length. Leave enough excess catheter at the
incision site to permit cannulation.
6. Thread the tip of the ICP transducer back through
the proximal end of the catheter as shown in
Figure 7. Sterile saline may be used to irrigate the
inner channel of the catheter to facilitate transducer
advancement. Continue to advance the transducer
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