| The procedure is performed on a digital C-arm fluoroscopic
interventional table with tilting capability. All of these procedures have been performed
under sedation. Full resuscitation equipment including drugs and anaesthetic equipment and
suction is available in the room. Ultrasound is used to outline the bladder and define any
masses or low lying gallbladder or a large liver. We normally place a 15-cm, 8.5-F
Dawson Mueller Mac-lock catheter for primary C-tube insertion. We prepare a latex-free
tray for patients predisposed to latex allergy (e.g., spina bifida), as well as for those
with known latex sensitivity. (Moneret-Vautrin,
Beaudouin et al. 1993; Cantani 1999)
Additional materials (Figure 22) required for the procedure
include:
- NON LATEX gloves
- Sterile drapes
- Standard interventional pack
with gowns
- EMLA topical anaesthetic patch
(AstraZeneca)
- Chlorhexidine gluconate 0.5%
solution with 70% isopropyl alcohol (Soluprep [tinted], Solumed Inc.)
- Sharps container and needle
counter (Devon OR Products and Safety Solutions)
- #11 scalpel blade
(Becton-Dickenson)
- Local anaesthetic
(1% Lidocaine,
AstraZeneca, Mississauga, Canada)
- 10cc syringe for local
anaesthetic
- 18-Ga, 1.5-inch needle
to draw local anaesthetic
- 27-Ga, 1.25-inch needle
for local anaesthetic infiltration
- Glucagon (Lily,
Scarborough, Ontario, Canada)
- Low-osmolar contrast
(Omnipaque (Iohexol)
300 mg I/ml, Nycomed)
- Slip ring T-connector
extension set (Benlan), attached to a 10cc Luer-Lock syringe filled with
contrast.
- 22-F silicone (NON LATEX) Foley
catheter (Rush, Canada)
- 60-cc Luer lock syringe
for inflation of the Foley catheter
- Insufflation bulb
(EZEM Whispering, NY) for distending the colon via the Foley catheter
- Lubricating jelly
(bacteriostatic MukoŽ, Ingram and Bell, Don Mills, Ontario, Canada) for introduction of
the Foley catheter
- Paediatric Enterostomy Suture
Anchor Set (Cook Inc.)(PDF
File)
- 18-Ga, 7cm single wall
puncture needle (BSDN, Cook Inc.) loaded with two Cope pediatric gastrointestinal suture
anchors
- 125-cm Teflon coated 0.035-in
Amplatz super stiff guidewire (Cook, Inc.)
- Small mosquito clamp
- 8-F Coons dilator
(Cook Inc.)
- 15 cm, 8.5 Fr Dawson Mueller
Mac-Loc (NON LATEX) catheter including the metal stiffener (Cook, Inc.)
- Antibiotic ointment
(Polyderm (bacitracin
zinc + polymyxin B sulfate) (Taro Pharmaceuticals Inc.)
- Gauze bandage (2x2)
- Mastisol liquid adhesive
- Hypafix adhesive bandage
(Hypafix Dressing Retention Sheet, Smith and Nephew)
- U-Bag Urine Drainage bag
(Holister)
- Methylmethacrylate glue
- K-lock adhesive catheter retention
device (Zefon Medical Products)
|