Section C: Post-Implantation Adjustment Procedure - DePuy Synthes Codman Neuro CERTAS Plus Manual Del Usario

where the tissue over the valve is not too thick (>10 mm)
otherwise locating, reading and adjusting with the
CODMAN CERTAS Tool Kit may not be possible.
It is recommended to record the setting of the valve
in the patient records and on the patient I.D. wallet
card. Labels are provided with each valve to record the
product lot number information in the patient records.
I.D. wallet cards are available from the local Codman
sales representative.
SECTION C: Post-implantation
Adjustment Procedure
Adjust the valve at any time after the implantation
surgery. If needed, apply a sterile drape over the incision
site. The drape will not interfere with the magnetic
coupling of the adjustment procedure.
CAUTION: Excessive swelling or thick tissue may make
it difficult to determine and/or adjust the performance
setting. See Step 4 in this section for instructions for
using the Low Profile Locator Tool in these instances.
If difficulty correctly positioning both Locator
Tools persists, wait until the swelling is reduced or
confirm the valve setting with x-ray. See SECTION D:
Troubleshooting and SECTION E: Confirming the
Current Valve Setting for more information.
1. Position the patient so that the implanted valve
2. Locate the valve by palpation. Palpate and mark the
3. Select the appropriate Locator Tool (Adjustable
4. Place the appropriate Locator Tool atop the
206521-001-G-INS.indd 14
and tools are horizontal, to optimize Indicator Tool
performance (See Figure 6).
CAUTION: If Indicator Tool is not horizontal, an
inaccurate reading might result.
center of the valve mechanism i.e., the hard portion
of the valve distal to the reservoir. Palpate and mark
the position of the inlet and outlet connector barbs/
catheters (See Figure 7).
Height Locator Tool or Low Profile Locator Tool).
If the tissue in the area of the valve is thick tissue or
if edema is present (>10 mm above the valve), use
the Low Profile Locator Tool (Figure 8). Otherwise,
use the Adjustable Height Locator Tool. Optimal
placement is achieved when the selected Locator
Tool is stable on the patient's head and the tissue that
covers the valve mechanism is just below the cut-out
in the Locator Tool (Figures 9A and 9C).
implanted valve so that the black lines are aligned
with the marked center of the hard valve mechanism
and the direction of flow arrow aligns with the
catheter barb marks (Figure 10).
Note: If using the Adjustable Height Locator Tool,
rotate the white outer ring to adjust the height until
the tissue that covers the valve mechanism is just
below the cut-out in the Locator Tool (Figure 9C) to
optimize the tool performance.
Note: If using the Low Profile Locator Tool, ensure
that the tissue that covers the valve mechanism does
not protrude through the cut-out in the Locator Tool.
If tissue is protruding through the opening, gently
hold the tool against the head to see if the tissue
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