COOK Medical Kaye Bedienungsanleitung Seite 5

NEPHROSTOMY DRAINAGE
BALLOON FITTING,
STYLET REMOVED
11. If nephrostomy drainage is not clear at this stage and there are no pelvic lacerations, connect a normal
saline irrigation fluid to the ureteral catheter and irrigate the renal pelvis, as with a TUR drip.
NOTE: As an option to the above procedure, the Kaye Nephrostomy Tamponade Stent may be
placed through an existing Kaye Nephrostomy Tamponade Catheter after replacing the .038
inch diameter working wire; or the stent and catheter may be assembled prior to placement and
introduced over the .038 inch diameter safety wire following the removal of the nephroscopy
sheath.
SUGGESTED INSTRUCTIONS FOR FIRST POSTOPERATIVE DAY
1. If urine is clear or light pink on the first postoperative day, perform a nephrostogram. If good ureteral
drainage and no extravasation is evident, remove 4-5 ml of contrast medium from the balloon without
disturbing the dressing.
2. Observe for 4-6 hours.
SUGGESTED REMOVAL INSTRUCTIONS
A) 1. Completely aspirate the balloon; remove entire catheter. Observe the wound site to be sure there is
no bleeding.
2. Remove the safety wire guide and/or safety wire catheter. NOTE: Many nephrostomy catheters can
be safely removed within 36-48 hours following these suggested steps.
B) 1. Provided ureteral drainage is still desirable and tract tamponade has been effected, the Kaye catheter
may be removed (see Removal Instruction A) and the Kaye stent left to drain internally. Secure the
stent to the skin and clamp the proximal end.
2. Using a nephrostogram, check the positioning of the stent to assure that the sideports are in the
renal pelvis and the distal end of the stent is in the bladder. NOTE: The Kaye stent may also drain
externally, thereby serving as a small nephrostomy tube. Drainage can be accomplished by
reattaching the Tuohy-Borst adapter to the proximal end of the stent and connecting it to
a connecting tube. Should bleeding occur while the stent is in place, reinsert a wire guide
through the stent and reintroduce the balloon catheter over the stent.
C) 1. If the nephrostomy drainage and tract tamponade is still desirable, remove the Kaye stent and leave
the Kaye catheter in place.
5 FR. STENT
TIGHTEN TO LOCK
TWIST LOCK
ONTO BALLOON
FITTING
STENT DRAINAGE
STENT LENGTH
Figure C
5
REMOVABLE
DRAINAGE FITTING