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CHAPTER 91 – INSERTION OF TENCKHOFF CATHETER

Kristene K. Gugliuzza

STEP 1: SURGICAL ANATOMY

      Place the uppermost trocar or the incision in a paramedian position. This allows for burial of the cuff of the catheter under the muscle and decreases the incidence of cuff erosion through the incision. Make the optimal placement by placing the catheter on the abdomen in a position where the end of the catheter or the bottom of the cuff is situated on the symphysis pubis and the first cuff lies over the rectus muscle. Place the incision where the first cuff lays on the abdomen. The exit site is usually lateral to the first trocar. Use this site for the second trocar (Figure 91-1).
      Achieve the optimal placement of the exit site with the aid of a home dialysis nurse. This provider can meet with the patient preoperatively to design the exit site that is most functional for the patient. Functionality is predicated by the handedness of the patient (usually more comfortable when the catheter is placed on …

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