Irrigation; Surgical Technique - DePuy Synthes Codman Neuro CERTAS Plus Manual Del Usario

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Irrigation

It is required that the valve be irrigated before
implantation to help ensure proper performance.
1. Hold the valve vertically with the distal connector
2. Using a syringe, slowly and gently fill the entire valve
3. Once fluid flows from the distal connector barb of the

Surgical Technique

There are a variety of surgical techniques that can be
used to place the valves. The surgeon should choose
in accordance with his or her own clinical experience
and medical judgment. It is required that the valve
be irrigated as outlined in Irrigation, to help ensure
proper performance.
CAUTION: Placement of the valve can impact the
performance of the tool kit and should be taken
into account for proper patient therapy. Select a
location where the implanted valve can be positioned
horizontally for use with the tool kit (See Figure 6).
Avoid placement too close to structures, such as the
ear. It is also important to choose an implantation site
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Verify proper placement and integrity of ligatures
at all tubing junctions to prevent obstruction of
the catheter lumen and tears or abrasions of the
silicone tubing.
Exercise extreme care to prevent the silicone
components of the system from coming in contact
with towels, drapes, talc, or any linty or granular
surfaces. Silicone rubber is highly electrostatic and,
as a result, attracts airborne particles and surface
contaminants that could produce tissue reaction.
Do not immerse the BACTISEAL Catheter in
antibiotic solutions. When immersing the catheter
in sterile water or saline, keep immersion time to a
minimum. A pale orange color might be imparted to
the immersion solution. Manometer testing of the
valve with BACTISEAL Catheter is not advised.
barb pointing downward.
system with pyrogen-free, sterile saline solution or,
for catheters other than BACTISEAL Catheters, an
appropriate antibiotic solution. Once fluid begins
flowing through the valve mechanism, the distal
connector barb of the valve can be pointed upward to
assist in evacuating air from the system.
Note: A priming adapter with inlet tubing is provided
to facilitate irrigation.
CAUTION: Do not fill, flush, or pump the valve with
fluid in which cotton, gauze, or other lint-releasing
material has been soaked.
Note: More pressure might be required on the syringe
before fluid starts flowing through the valve mechanism.
This is normal and will only occur during initial irrigation
of the valve. A popping sound may occur.
Note: The SIPHONGUARD device is intended to
reduce the rapid flow of CSF. It also reduces the
ability to prime the shunt system during implantation
to a rate of approximately 0.5 mL/minute.
valve (or the distal catheter, on unitized models), and
air has been evacuated from the valve, remove the
syringe and the priming adapter (if used).
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