Integra NeuroSciences OSV II Instrucciones De Uso página 7

Note - An alternate method may be necessary when the tunneler is not long enough or when the patient's position
precludes a single pass without an interim incision.
Make the abdominal incision. Remove the handle of the tunneler. Attach the drainage catheter to the connector of the
internal tunneler wire, and pass the catheter from the head to the abdominal incisions. Remove the metal outer shaft.
Pull on the distal end of the drainage catheter. Position the valve under the skin.
Place the introducing rod into the ventricular catheter. If the Right Angle Guide (RAG) is used, introduce the
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ventricular catheter into the center of the RAG and insert the catheter into the ventricle. Holding the catheter with
covered forceps, remove the introducing rod. Verify adequate CSF flow.
For systems with burr hole cap: trim the ventricular catheter to the desired length. Insert the ventricular catheter into
the burr hole reservoir and tie with non absorbable suture. Using the introducing rod, insert the catheter into the
ventricle. Verify adequate flow.
Connect a syringe with the provided Luer connector to the ventricular catheter and aspirate 2 to 3 ml of CSF
to eliminate possible debris from the CSF.
Note - If desired, sample CSF for analysis or inject antibiotics at this time.
Place the RAG into the burr hole. The channel should point in the direction of the valve. Bend the exposed
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catheter into the channel of the RAG until the catheter snaps in place.
Note - The use of the RAG in premature infants or neonates is at the discretion of the surgeon. If the RAG is not
used, the surgeon should trim the rim of the burr hole where the catheter emerges to provide a smooth angular
transition for the catheter.
Trim the ventricular catheter to length (approximately 2 cm from the burr hole).
Carefully insert the integral inlet straight connector of the valve into the ventricular catheter. Do not dislodge
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the catheter. Tie the catheter onto the connector and to the underlying fascia, using appropriate sutures.
Note - for configurations with burr hole cap, attach the cap to the reservoir.
7. Connect a syringe with the provided Luer connector to the drainage catheter and rinse the system by
gently aspirating 2 to 3 ml of CSF to eliminate possible debris and purge air.
If desired, trim the drainage catheter.
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Introduce the drainage catheter in the peritoneal cavity using a trocar or standard laparotomy technique
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consistent with the surgeon's experience.
Caution - Prior to the introduction of the drainage catheter into the abdominal cavity, it is advisable to confirm
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the patency of the system by observing the formation of CSF droplets at the end of the drainage catheter.
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Notes:
The CSF droplets formation rate may be lower than that observed with conventional DP shunts
because of the flow restriction mode of the OSV II.
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In children, insert sufficient drainage catheter length into the abdominal cavity to allow for
growth.
Close incisions.
11.
Note - X-ray the complete system just after implantation for future reference to determine whether system
components have shifted.
Introduction of Integral Ventricular Catheter (Alternative for Steps 4-5)
If the RAG is used, slide the catheter through the center hole of the RAG. Position the RAG as far along the catheter as
possible. Lock the stylet of the ventricular catheter introducer into its cannula as shown in Figure 4. Insert the tip of the
introducer into the hole nearest the tip of the ventricular catheter. Align the catheter with the introducer cannula and snap
it into the adjustable plastic collar.
Caution - To avoid improper placement, do not overstretch the ventricular catheter when positioning it on the introducer.
Puncture the ventricle with this assembly. Carefully withdraw the stylet from the introducer cannula, causing the
ventricular catheter tip to disengage from the stylet.
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