MIETHKE proGAV 2.0 XABO Instrucciones De Manejo página 34

| INSTRUCTIONS FOR USE
Fig. 18: Patency test
Fig. 19: Avoidance of pressurisation
XABO Ventricular
Catheter
Several surgical techniques are available for the
positioning of the XABO Ventricular Catheter.
The required skin incision should be made in
form of a lobule pedicled towards the shunting
catheter or by a straight skin incision. If a Bur-
rhole Reservoir - or a SPRUNG RESERVOIR -
is used, the skin incision should not be located
right above the reservoir. To avoid CSF leakage,
care should be taken that the dura opening is
kept as small as possible after applying the burr
hole.
proGAV 2.0 XABO is available in a range of dif-
ferent configurations: If using a Burrhole Reser-
voir - or a SPRUNG RESERVOIR -, the XABO
Ventricular Catheter is implanted first. Once the
mandrin has been removed, the patency of
the XABO Ventricular Catheter can be tested
by checking if cerebrospinal fluid is dripping
out. The catheter is shortened and the Burrhole
Reservoir - or the SPRUNG RESERVOIR - con-
34
nected and the connection secured with a lig-
ature.
When using a shunt system with a CONTROL
RESERVOIR, a Burrhole Deflector is included.
The Burrhole Deflector is used to adjust the
length of the catheter to be implanted and to
position it inside the ventricle. The Ventricular
Catheter is deflected by 90° and the CONTROL
RESERVOIR put into place. The position of the
XABO Ventricular Catheter should be inspected
after the procedure by imaging (such as CT or
MRI).
A location behind the ear is suitable as an
implantation position, whereby the implantation
height has no influence on the function of the
valve system.
The adjustable valve should be touching the
bone or the periosteum since pressure must
be exerted on the valve during any later adjust-
ment.
A large arch-shaped or a small straight skin
cut with a pocket for the valve system should
be made. The catheter is pushed forward from
the burr hole to the selected valve implantation
location, shortened if necessary, and secured
to the proGAV 2.0 XABO by ligation. The valve
system should not be located directly under the
skin incision. The valve unit has an arrow in the
flow direction (arrow towards distal or down-
wards). The surface of the valve with the arrow
markings points to the outside.
XABO Peritoneal
Catheter
The access site for the XABO Peritoneal
Catheter is left to the surgeon's discretion.
For example, it can be used in a paraumbili-
cal application or applied at the level of the epi-
gastrium. Likewise, various surgical techniques
are available for placing the XABO Peritoneal
Catheter. The recommendation is to pull the
XABO Peritoneal Catheter from the valve to the
intended position using a subcutaneous Tun-
neller, if necessary with the aid of an auxiliary
proGAV ® 2.0 XABO ®
proGAV 2.0 XABO
(SA 2.0)